Practitioner review

When parent training doesn't work: Theory-driven clinical strategies

Stephen Scott*, Mark R. Dadds

*Corresponding author for this work

Research output: Contribution to journalReview article

88 Citations (Scopus)

Abstract

Improving the parent-child relationship by using strategies based on social learning theory has become the cornerstone for the treatment of conduct problems in children. Over the past 40 years, interventions have expanded greatly from small, experimental procedures to substantial, systematic programmes that provide clear guidelines in detailed manuals on how practitioners should implement the standardised treatments. They are now widely disseminated and there is a great deal of empirical support that they are very effective for the majority of cases. However, evaluations of even the best of these evidence-based programmes show that a quarter to a third of families and their children do not benefit. What does the practitioner then do, when a standard social learning approach, diligently applied, doesn't work? We argue that under these circumstances, some of the major theories of child development, family functioning and individual psychology can help the skilled practitioner think his or her way through complex clinical situations. This paper describes a set of practical strategies that can then be flexibly applied, based on a systematic theoretical analysis. We hold that social learning theory remains the core of effective parent training interventions, but that ideas from attachment theory, structural family systems theory, cognitive-attribution theory, and shared empowerment/motivational interviewing can each, according to the nature of the difficulty, greatly enrich the practitioner's ability to help bring about change in families who are stuck. We summarise each of these models and present practical examples of when and how they may help the clinician plan treatment.

Original languageEnglish
Pages (from-to)1441-1450
Number of pages10
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
Volume50
Issue number12
DOIs
Publication statusPublished - Dec 2009
Externally publishedYes

Keywords

  • Antisocial behaviour
  • Conduct disorder
  • Parent training
  • Parent-child relationship
  • Treatment

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