Program Profile: The Incredible Years BASIC–Parent Training Program

This parent-training program seeks to improve parenting competencies of families with children (ages 3–8) at risk of a disruptive conduct behavior/disorder. The program is rated Promising. Treatment group parents showed a statistically significant increase in use of appropriate discipline practices and reported fewer child conduct behavior problems, compared with comparison group parents, but there was no statistically significant effect on other child outcomes, such as prosocial behavior.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

This program's rating is based on evidence that includes either 1) one study conducted in multiple sites; or 2) two or three studies, each conducted at a different site. Learn about how we make the multisite determination.

Program Goals/Target Population

The Incredible Years BASIC–Parent Training (IYPT) program is a parent-training program for families with children ages 3–8 exhibiting early symptoms of conduct problem behaviors (such as such as oppositional, aggressive, and hyperactive behaviors). The program is designed to focus on altering parenting practices and promote the use of positive parenting and behavior management strategies (including logical consequences and parental monitoring) to address issues of children’s early conduct disorder behaviors at home and with other children.

The IYPT program uses a collaborative approach, which encourages parents to think of their own solutions to problems, while integrating program techniques in a way that matches their own cultural and personal norms (Webster–Stratton 2009). Overall, the goals of the IYPT program are to promote parental competencies, strengthen family relationships, and reduce child conduct disorder.

Program Components

The IYPT program is delivered in a group format (8 to 15 parents per group), with parents grouped according to their child’s age (i.e., parents with 3- to 5-year-old children receive the preschool parent curriculum, and parents with children ages 6–12 receive the school-age curriculum). This group strategy is used to create a sense of community (or peer support), reduce parents’ isolation, and normalize parents’ experiences and situations. Both curricula consist of 12 to 18 two-hour weekly sessions. However, based on parents’ cultural background experiences, education, knowledge, and values, additional sessions can be added, if needed. For example, parent groups of extremely difficult children may need three or four additional sessions to develop incentive systems and individual behavior plans for each parent (Webster–Stratton 2004).

Group sessions are facilitated by trained group leaders, with the program incorporating three cultural sensitivity principles: 1) respecting and affirming cultural differences (i.e., parent groups determine their own rules, parents determine their own weekly goals), 2) exploring and addressing possible cultural barriers to the intervention content (e.g., discussing barriers to child-directed play or praise as part of the program), and 3) helping parents apply strategies to their goals, which are set in the first session.

During group sessions, parents are shown video vignettes (or scenes) of parents in a variety of common parenting situations and settings. As parents watch video vignettes, group leaders prompt parents to ask questions, encourage them to share ideas with each other, and have them work together to problem-solve parent scenarios. These videos are a central part of each session and are combined with group discussions to cover “core” topics and parent-initiated topics (such as how to handle fights between siblings), with parents and children in the video vignettes representing multiple cultural backgrounds. Specifically, group leaders cover “core” topics such as:

• Child-directed play
• Coaching of social, emotional, and academic skills
• Praise and rewards
• Positive parenting and relationship-building skills
• Effective limit setting
• Handling misbehavior using nonviolent discipline techniques (such as ignoring and time-out techniques, logical and natural consequences)

Additionally, the program includes brainstorming and value exercises on parenting, child development, and family issues. Parents are also guided by group leaders to set weekly goals, practice parenting strategies at home, and have a weekly telephone call with another parent from their group. These weekly telephone calls are designed to encourage interpersonal support, as parents have a friend they can speak to on a regular basis about their progress. Separately, one or two booster sessions are offered to parents to maintain learned behavior management techniques at the program.

Program Theory

The IYPT program is based on a collaborative approach and Patterson’s (1982) social learning model. Specifically, Patterson’s social learning model emphasizes the importance of the family socialization process among young children with conduct disorder problems, suggesting that negative parenting reinforcement develops and maintains children’s deviant behaviors. Thus, if parents can learn to properly address children’s misbehavior and model positive and appropriate problem-solving and discipline strategies, children can develop social competencies that lead to reduced aggressive behavior at home and at school (Webster–Stratton 2000; Webster–Stratton 2009).

Study

Seabra–Santos and colleagues (2016) conducted a randomized controlled trial to determine the effect of the IYPT preschool curriculum on the disruptive behaviors of children (ages 3–6) in Portugal. (In this study, children who are 6 years old are considered preschoolers). The SDQ screening instrument was used to identify eligible children with at-risk behavior problems. Eligibility was based on parent ratings exceeding the 80th percentile on one of the two SDQ subscales: Hyperactivity or Conduct scale. Children were excluded from the study if 1) they had a diagnosis of a neurological or developmental disorder, or severe developmental delay, or 2) they were undergoing any pharmacological or psychotherapeutic intervention. There were 124 children who met the eligibility criteria.

After the baseline assessment, children (and their caregivers) were randomly assigned to the treatment group (n = 68) or the control group (n = 56) (first using a 2:1 ratio, then switching to a 1:1 ratio to ensure there were enough participants in the control group). Of the total sample, 73 percent of children were male, with an average age of 4.6 years. Almost all (98 percent) of the caregivers were mothers; thus, caregivers are referred to as mothers in the overall study analysis. On average, mothers were 35.3 years old, with 80 percent married or living as married. There were no statistically significant differences in baseline characteristics between the treatment and control groups.

Data were collected at four time points: baseline (pre-intervention), immediately following the intervention (postintervention), at a 12-month follow up (follow-up 1), and at 18-month follow-up assessment (follow-up 2). The CrimeSolutions review of the study focused on the outcomes at postintervention, as control group children were offered the IYPT program prior to the 12-month follow-up. Outcomes of interest included child hyperactivity behavior, child conduct problems, child social skills, child prosocial behavior, child deviant behavior, dysfunctional discipline practices, satisfaction with parenting, efficacy of parenting, positive parenting practices, and critical parenting practices. Child hyperactivity and conduct disorder behavior were measured through mother-reported scores on the SDQ assessment. The Preschool and Kindergarten Behavior scale (PKBS) was used to measure child social skills (36 items) and problem behaviors (46 items) through mother-reported responses (during the last 3-months). The Dyadic Parent–Child Interaction Coding System (DPICS) was used to observe child prosocial behavior (defined as verbal and nonverbal positive effects and physical warmth); child deviant behavior (defined as crying–whining–yelling, physical negativity, smart talk, destructiveness, and noncompliance); positive parenting behaviors (defined as labeled and unlabeled praise, physically positive behavior); and critical parenting behaviors (defined as critical statements and negative commands) for 25 minutes, coding the presence and absence of behaviors within 5-minute segments. The APS (30 items) self-report assessment was used to measure maternal dysfunctional discipline practices. The Parenting Sense of Competence scale (PSOC) was used to measure perceived parenting satisfaction (how confident mothers felt about their parenting competencies) and efficacy (how confident mothers performed their parenting capacities). A general linear model (GLM) for repeated measures of analysis of variance (ANOVAs) was used to determine differences between the treatment and control groups at posttreatment. The study authors did not conduct subgroup analyses.

Study

Leijten and colleagues (2015) conducted a randomized controlled trial to determine the effect of the IYPT preschool and school-age curriculum on disruptive behavior problems of children (ages 3–8) in the Netherlands. Families were randomly assigned (using a 2:1 ratio) to the treatment group (that immediately received IYPT) or the waitlist control group (that received IYPT after 3 months). Study participants were 154 mothers/families who experienced parenting difficulties attributable to their children’s disruptive behavior. Children were 3 to 8 years old (the average age was 5.6 years). About one third of the families (n = 45) were referred for disruptive child behavior to an outpatient clinic for child and adolescent psychiatry. To ensure variation in socioeconomic and ethnic background of the study sample, the remaining two thirds of families (n = 109) were recruited from the most deprived neighborhoods of Utrecht (one of Netherlands’ four largest cities).

Of the 45 families who were involved in the study and referred to the outpatient clinic, 71 percent had children who were boys, the average age of mothers was 35.6 years, and the ethnic background of the families was Caucasian (84.4 percent), Moroccan (11.1 percent), and other (4.5 percent). Of the 109 families who had been recruited from Utrecht, 58 percent had children who were boys, the average age of mothers was 33.1 years, and the ethnic background of the families was Moroccan (38.6 percent), Caucasian (25.7 percent), Turkish (18.3 percent), and other (17.4 percent).

Of the total study sample, 107 mothers were assigned to the IYPT treatment group and 47 mothers to the waitlist control group. There were no statistically significant differences between the treatment and control groups at baseline in demographic characteristics (such as ethnicity), levels of parenting or child behavior, or percentage of referred or recruited families at baseline.

Data were collected at baseline (T1), posttest (T2), and the 3-month follow-up (T3). However, at T3 all children had received the IYPT program, thus the CrimeSolutions review of this study concentrated on the outcome data collected at the posttest (T2). Outcomes of interest included disruptive behavior intensity, disruptive problem behavior, child conduct problems, child hyperactivity and inattention behavior, child aggressive behavior, use of appropriate parent discipline practices, use of harsh and inconsistent discipline practices, use of praise and incentive parenting practices, use of clear expectations, and maternal parenting stress. The 36-item Eyberg Child Behavior Inventory (ECBI) was used to measure mother-reported intensity behavior (how often problem behavior occurs, using a 7-point scale) and problem behavior (how often disruptive behavior is perceived as a problem, with yes/no responses). The 25-item SDQ assessment was used to measure child conduct problems and hyperactivity and inattention. The parent version of the 6-item Teacher Rating of Aggression scale was used to measure child aggressive behavior, including reactive aggression questions (e.g., ‘‘when she/he is teased or threatened, she/he reacts angry and strikes back’’) and proactive aggression questions (e.g., she or he “uses physical force to dominate other children’’), on a five-point scale ranging from 1 (never) to 5 (always). The 80-item Parent Practices Interview (PPI) was used to measure parenting practices (i.e., the use of appropriate discipline, harsh and inconsistent discipline, praise and incentives, and clear expectations), using a 7-point scale ranging from 1 (completely disagree or most unlikely) to 7 (completely agree or most likely). Researchers also employed subscales of the Parenting Stress Index (PSI), which included 33 items: two key subscales from the parent domain (restricted role and isolation) and two key subscales from the child domain (acceptability and reinforces parent), to measure maternal stress. Mothers responded to each of the items (such as ‘‘I’m less interested in people than I used to be’’ and ‘‘sometimes it feels as if my child does not like me”), using a 6-point scale ranging from 1 (completely disagree) to 6 (completely agree). ANCOVAs were used to determine differences between mother–child dyads in the IYPT treatment group and the control group, at posttest. The study authors did not conduct subgroup analyses.

Study

Little and colleagues (2012) conducted a randomized controlled trial to determine the effect of the Incredible Years BASIC–Parent Training (IYPT) preschool curriculum on the conduct disorder behaviors (such as often having temper tantrums, often fighting with other children) of 3- to 4-year-old children in Birmingham, England. Parents and children were identified as potential study participants through 1) referrals from a local children’s services department agency, 2) self-referrals, and 3) screening children who are served by a Birmingham children’s center.

There were 161 children (and their parents) who met the eligibility criteria for the study, which was based solely on whether the child was at risk of a social–emotional or behavioral disorder that was determined through parent-reported “total difficulties” scores that exceeded the “high need” threshold (17 or above out of 40) measured by the Strengths and Difficulties Questionnaire (SDQ). The children (and their parents) were randomized (using a 2:1 ratio) to the intent-to-treat (ITT) IYPT treatment group (n = 110) or the “waitlist” control group (n = 51), which received services as usual.

Of the total study sample, there were 101 boys and 60 girls, with an average age 3.6 years. Half of the families reported that they relied on benefits (from the government) as their main source of income. At baseline, children and parents in the control group had several differences in child behavior outcomes compared with children and parents in the treatment group (such as conduct disorder, total difficulties, peer problem scores) and parent behavior outcomes (such as overreacting and verbosity scores). These group differences were statistically significant, thus ANCOVA analyses controlled for these group differences, using covariates (such as children’s baseline scores on behavior outcome measures, child age, and child sex).

Data were collected at baseline (before randomization; wave 1) and follow-up (6 months after baseline; wave 2). Outcomes of interest included child emotional problems; child peer problems; child prosocial behavior; child total difficulties scores; child impact (i.e., distress and impairment); and dysfunctional parenting discipline practices (defined as negative parenting practices). Child behavior outcomes were measured using the 25-item SDQ screening assessment, with parent responses ranging from 0 (not true) to 2 (certainly true). The 30-item Arnold and O’Leary Parenting inventory scale (APS) was used to measure total dysfunctional discipline practices, with parents self-reporting parenting behaviors. An estimated mean difference analysis was used to determine differences between parent–child dyads in the IYPT treatment group and the control group, at posttreatment. The study authors did not conduct subgroup analyses.

The Incredible Years BASIC–Parent Training (IYPT) curriculum is implemented by trained program staff (referred to as group leaders or practical practitioners/clinicians) by an accredited Incredible Years trainer (Leijten et al. 2015; Little et al. 2012; Seabra–Santos et al. 2016). All of the group leaders are bachelor’s-, master’s-, or Ph.D.–level clinicians.

Training consists of a 3- to 4-day workshop with group leaders understanding the core therapeutic processes and principles, which are defined as foundational elements to the successful implementation of the program (i.e., using the collaboration model and culture sensitivity principles). A group leader’s manual is also provided and includes questions that can be asked following each videotaped vignette, what the developer’s interpretation was of each vignette, and points for consideration. In addition, practical information (such how to arrange the room for the first group session, or suggestions for engaging low-income families) is contained within the manual.

During the program, group leaders are video-monitored and participate in half-day (weekly or every other week) supervision trainings (Little et al. 2012; Seabra–Santos et al. 2016). These supervision trainings are with an accredited Incredible Years trainer, who provides feedback and consultation based on the reviewed videotape.

For additional information, visit the Incredible Years BASIC–Parent Training (IYPT) program website.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Following are CrimeSolutions-rated programs that are related to this practice:

Early Family/Parent Training Programs

This practice includes programs that seek to provide families and parents with training and skills to help promote their children’s physical, mental, and social skills. The practice is rated Effective for reducing child problem behaviors for children whose families participated in early family/parent training programs, compared with control group children whose families did not participate in programming.

Evidence Ratings for Outcomes

Juvenile Problem & At-Risk Behaviors - Multiple juvenile problem/at-risk behaviors

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?