December 5, 2011

School of Nursing researcher to compare parenting programs

Do current parenting programs meet the needs of Baltimore families?

Through a $3.2 million grant from the National Institute of Nursing Research, Johns Hopkins nurse researcher Deborah Gross will answer that question by comparing and measuring the impact on Baltimore families of two programs: Gross’ Chicago Parent Program and Parent-Child Interaction Therapy, the current “gold standard” in parenting interventions.

The Chicago Parent Program, developed in 2002 by Gross and colleagues, focuses on a population overlooked in prior data-driven parenting programs: Latino and African-American families raising children in urban neighborhoods. The program emphasizes child-centered time, the importance of family routines and traditions, the value of praise and encouragement, rewards for reducing challenging behavior, the importance of setting clear limits and following through, the need to establish consequences, stress management and problem-solving skills for parents and the use of specific parenting strategies (for example, ignore, distract, time out) to help parents meet their child-rearing goals. The program uses group discussion and video vignettes of situations common to families raising young children, such as misbehavior in public places.

Parent-Child Interaction Therapy, or PCIT, teaches similar skills to parents but uses an individual parent-child coaching model. Parents are taught specific skills to establish a nurturing and secure relationship with their child while increasing the child’s pro-social behavior and decreasing negative behavior. This treatment focuses on two basic interactions: child-directed interaction, where parents are coached on how to engage their child in a play situation with the goal of strengthening the parent-child relationship, and parent-directed interaction, in which parents learn to use specific behavior-management techniques as they play with their child.

Gross’ work is the first study showing the comparison between the Chicago Parent Program and PCIT. Designed with input from clinicians at the Family Center Outpatient Mental Health Program at the Kennedy Krieger Institute in Baltimore, the study targets the additional challenges that Baltimore City families face, including economic stress, violence and sparse or nonexistent support systems.

Gross is the Leonard and Helen R. Stulman Professor in Mental Health and Psychiatric Nursing at the Johns Hopkins School of Nursing. Her co-principal investigator is Harolyn Belcher, director of research at the Family Center and an associate professor at the Johns Hopkins University School of Medicine.

The five-year study, launched in September, will run through July 2016. Gross says that the goal is to provide better
care, with better outcomes, and at a lower cost.

“Right now, only a fraction of young children in need of mental health services are getting them. And of those who are getting services, many are not receiving the most-effective treatments. This study will help us identify the most-cost-effective treatments for helping young children from low-income neighborhoods with serious behavior problems,” Gross said.