Contains Video1Delivering Parent Management Training in an Integrated Primary Care Setting: Description and Preliminary Outcome Data☆,☆☆,
Section snippets
Externalizing Behavioral Problems in Primary Care
Children and their caregivers present to their primary care providers for a variety of problems, mostly medical in nature; however, research indicates that 12% to 16% of children present to their pediatrician with unaddressed emotional or externalizing behavioral concerns (Briggs-Gowan et al., 2003, Costello et al., 1988, Polaha et al., 2011). One study, conducted in pediatric primary care, surveyed families using the Pediatric Symptom Checklist and found that 16.2% of children met clinical
Participants
Participants were from an open trial evaluating the efficacy of integrated behavioral health care services at two primary care clinics. The study period (November 2010 to September 2012) included 56 caregiver/child dyads seen for at least two behavioral health visits. Analyses were based on 21 caregivers and their children who presented with a primary complaint of externalizing child behavior (Mage = 7.76 years, SDage = 4.31, range 1–17 years; 38.1% female; 66.7% Hispanic; 95.2% insured).
Results and Discussion
A paired-samples t-test showed significant improvement in child global distress following IBHC treatment (Mpre = 1.72, SDpre = 0.81; Mpost = 1.21, SDpost = 0.89), t(20) = 3.70, p < .001, within subjects Cohen’s d = .81 (rpre-post = .73). When using a difference score of .50, as recommended by the ACORN developers (Brown, 2011), 38.1% of patients experienced reliable change despite the brevity of the intervention. Similar reductions in global distress scores were obtained for both child (as reported by
Conclusion
Relatively little is known about the efficacy of delivering brief parenting interventions to children with disruptive behavior problems in integrated primary care settings. A variety of PMT protocols have been shown to produce significant reductions in problematic child behavior (Barkley and Benton, 1998, Eyberg, 1988, Kazdin, 2003, McMahon and Forehand, 2003, Webster-Stratton, 1984), but the formats used (10 to 12, hour-long sessions) are impractical for behavioral health consultants to
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Cited by (25)
Expanding Access to Cognitive Behavioral Therapy: A Purposeful and Effective Model for Integration
2024, Cognitive and Behavioral PracticeIntegrated Behavioral Health Role in Helping Pediatricians Find Long Term Mental Health Interventions with the Use of Assessments
2021, Pediatric Clinics of North AmericaCitation Excerpt :Another concern often seen in IBH settings are childhood externalizing concerns such as ADHD, oppositional defiant disorder, and conduct disorder.34,35 For such concerns, an intervention may include PMT, which is a broad term to describe interventions in which parents are taught skills that they can use to manage their child’s behaviors.34,35 As with other mental health treatment interventions, PMT is often administered over a period of time that is longer than the typical length or number of IBH sessions.34
Reviewing the need for technological and other expansions of evidence-based parent training for young children
2015, Children and Youth Services ReviewCitation Excerpt :Also, physicians can help initialize report by introducing parents to mental health professional (Gomez et al., 2014). Gomez et al., (2014) integrated parent training into the structure of regular pediatric visits (i.e., 20–30 minute sessions) and demonstrated initial positive results in a small evaluation (n = 21). Unlike traditional parent training programs, which often focus on completing a thorough assessment during the first visit, the professionals provided information to parents on the very first visit in order to maximize time with families.
Integrating cognitive behavioral therapy into primary care settings
2014, Cognitive and Behavioral PracticeStudy What You Do: Developing a Psychotherapy Tracking Database in a Large-Scale Integrated Behavioral Health Service
2023, Annals of Family Medicine
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The authors wish to thank Kathy Grisham and Kim Shuler of Community Clinic at St. Francis House for partnering with us in the provision and evaluation of integrated care services. We also thank Pat Walker Health Center at the University of Arkansas for permission to film at their primary care site. We are grateful to Bianca Villalobos, Juventino Hernandez Rodriguez, and Elizabeth Anastasia for assistance with data collection, Blake Erickson for his narration, and the actors (both young and old) who assisted with the videos.
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This project was supported by grant D40HP19640 (PI: Ana J. Bridges) from the U.S. Department of Health and Human Services/Health Resources and Services Administration (USDHHS/HRSA).
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Video patients/clients are portrayed by actors.