Concurrent Parent and Child Group Outcomes for Child Externalizing Disorders: Generalizability to Typical Clinical Settings.

Parent behavior management and child social skills training programs have demonstrated efficacy in clinical research settings and are highly efficient treatment modalities. Few studies have examined their effectiveness and efficiency within the typical clinical setting. The current paper examines the use of a concurrent parent behavior management and child social skills training program, evaluating the current sample, which consists of 22 children (ages 5-10) and their guardians, as well as two previous typical clinical samples. The Eyberg Checklist was utilized to assess pre and post treatment intensity scores for childhood externalizing symptoms, with an average treatment effectiveness of 0.89 standard deviations. This is consistent with previous findings (Tynan, et al., 1999; Tynan, et al., 2004) and further demonstrates the effectiveness of the concurrent parent and child training approach as utilized within the typical clinical setting. Keywords: Parent Management Training, Child Social Skills Training, Outcome Study Introduction Among child and adolescent populations, the most frequent referrals for mental health services consist of children and adolescents with externalizing disorders, including: oppositional-defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), intermittent explosive disorder, and adjustment disorder with disturbance of conduct (Kazdin, 1996). Hence, it is essential that a mental health system aimed at providing services to children needs to provide effective and efficient services for children with externalizing disorders. This is particularly important given the growing need for services among this population (Achenbach, ., 1993), coupled with the current environment of managed care, which demands increased accountability among mental health providers (Hoagwood, Jensen, Petti, & Burns, 1996). For this population, parent training programs and child social skills training programs have demonstrated efficacy in research settings (Brestan & Eyberg, 1998; Webster-Stratton & Hammond, 1997); yet there continues to be a paucity of information on their implementation and effectiveness within typical clinical settings (Weisz & Weiss, 1993). Based on their proven efficacy within clinical research settings, as well as their well-defined, short-term, and goal-oriented nature, parent training programs and child social skills training programs appear ideal to meet the need for efficient and effective services within the typical clinical setting; however, further examination within typical clinical settings is needed. An example of the application of these group training programs provided within a community setting was discussed by Tynan, Schuman & Lampert (1999). Tynan, et al., (1999) utilized a community sample of children with externalizing disorders and their parents from an affluent suburban community and later replicated that study among a lower-income rural population (Tynan, Chew, & Algermissen, 2004). Both of these studies examined the effectiveness of concurrent parent behavior management training and child social skills training. In both studies, the 8-week treatment program yielded similar results to those of research-based programs. Yet, further examination of this training program is needed, particularly in regard to its ability to generalize to more diverse clinic or community samples. The purpose of the current paper is to further assess the generalizability of this training program, by examining data from a more geographically and socieoeconomically diverse client population. In addition, the data from the current sample, as well as the two previous clinic samples will be combined for examination. Method Referrals The Behavioral Health division at A.I. duPont Hospital for Children in Wilmington, Delaware, has been offering concurrent parent behavioral management training and child social skills groups for children ages 5-10 years of age with externalizing disorders for the past two years. …