These therapies are getting a push because they have been shown in numerous clinical trials over the past decade to be effective on kids with severe behavioral problems, where other approaches have often failed. The techniques take a pragmatic approach, often using a set curriculum to teach new behaviors, rather than ferreting out the underlying emotional problem as with traditional psychotherapy. In another departure from traditional talk therapies, much of the counseling is often directed at parents.
Developed mostly in the past decade at academic centers, the therapies target kids with diagnoses like conduct disorder, oppositional defiant disorder or bipolar disorder, who are at risk of getting kicked out of school or breaking laws. By some
estimates, there are 1.4 million to 4.2 million children who meet the criteria for conduct disorders alone.
Review of the Incredible Years (IY) Parent, Teacher and Child Training Curricula and summarize research on the effectiveness of these three programs for reducing risk factors and strengthening protective factors associated with children?s social emotional development and school success. The chapter will include a focus on the role of home-school partnerships in preventing and treating children?s behavior problems and improving their school readiness as well as practical tips for engaging schools in the prevention and intervention process.
Over the past thirty years, hundreds of carefully controlled studies have demonstrated that there exist today a number of effective therapies and services for children and families which can reduce behaviour problems and delinquency, improve mental health, assist abusive parents to improve their child-rearing, and increase family functioning (Weisz and Weiss, 1993). Yet in spite of this evidence, few empirically supported interventions have been widely adopted in applied settings (Kazdin, Bass, Ayers, and Rodgers, 1991). In the paper, we describe an empirically supported parenting intervention developed and evaluated by the first author, including the strategies used to make it easy for clinicians in the field to implement with integrity.
While cultural adaptations have been made for specific cultural groups, the appeal of the more ?generic? but culturally sensitive EBP is that it is cost effective and allows for more flexibility in program delivery because it can be used with heterogeneous cultural groups rather than single culture groups. Multicultural groups can also foster greater understanding among parents of differing cultural backgrounds and experiences leading to more tolerant and respectful communities. The challenge of this approach is to train therapists to provide the EBPs using culturally sensitive principles that are generalizeable across cultures. The Incredible Years (IY) Parenting program has shown promising effects in many random control group studies with diverse cultures in United States as well as in numerous other countries. This paper reviews the ?principles? embedded deeply in the IY program, which are designed to provide a culturally sensitive structure to the delivery of the program.
Teachers across the nation daily face classrooms with increasing numbers of students who exhibit “conduct problems,” characterized by highrates of aggression, inattention, hyperactivity, defiance, and noncompliance.
Incredible Years Training for Parents. The Incredible Years parenting series includes three programs targeting parents of high-risk children and/or those displaying behavior problems. The BASIC program emphasizes parenting skills known to promote children’s social competence and reduce behavior problems such as: how to play with children, helping children learn, effective praise and use of incentives, effective limit-setting and strategies to handle misbehavior. The ADVANCE program emphasizes parent interpersonal skills such as: effective communication skills, anger management, problem-solving between adults, and ways to give and get support. The SUPPORTING YOUR CHILD’S EDUCATION program (known as SCHOOL) emphasizes parenting approaches designed to promote children’s academic skills such as: reading skills, parental involvement in setting up predictable homework routines, and building collaborative relationships with teachers.
Casey Family Programs conducted an evaluation that provides some preliminary evidence of effectiveness for a child welfare population of an existing evidence-based program?The Incredible Years Parent Training Program. Information on effective models for this population is lacking.
Aggressive children lacking prosocial strategies are often disliked by their peers and they tend to relate to friends in contexts, where there are high levels of aggression in the peer-group, which in turn may increase levels of child of aggression and other conduct problems (15). Interventions that lead to peer acceptance and enhanced social competence in the child with early conduct problems may disrupt the behavioural trajectories leading to lasting psychosocial problems.
One effective means of preventing early-onset conduct disorder (CD) may be to target preschool children with ADHD before more serious conduct problems have escalated. Unfortunately, one limitation of the ADHD treatment-outcome literature is that comparatively little research has been conducted with samples of children under age seven.
Clinicians working with families typically encounter children who exhibit persistent patterns of antisocial behavior-where there is significant impairment in everyday functioning. This chapter deals with features that characterize young children to whom the label of oppositional defiant disorder and/or conduct disorder is frequently applied.
Are the correlates for girls with early-onset conduct problems necessarily the same as for boys? It has been shown that externalizing symptoms such as disruptive, impulsive, hyperactive, inattentive, and overtly aggressive behaviors are important risk factors for boys’ continuing development of ODD and CD, whereas internalizing symptoms are not. In the absence of evidence, one cannot assume that this is equally true for girls.
Management of behavior problems in an inpatient child and adolescent psychiatric unit is largely the responsibility of nurses, yet few evidence-based programs exist that prepare nurses for this role. A pilot study examined the effects of a 3-day standardized parent/teacher training program adapted for inpatient child and adolescent psychiatric unit nurses. Findings indicated that the standardized parent/teacher training program resulted in significant increases in self-reported use of child praise/incentives and working with parents, with accompanying desired changes in observed nurse behaviors during nurse?child play sessions. Participants rated the program positively and highlighted gains of greater empathy and fewer judgments of parents. Findings support evidence-based training programs for nursing staff and suggest further research.
Few direct studies have looked at the economic costs of conduct disorder or its consequences. Related studies suggest that costs are high. In the United States the cost for crimes committed by a typical juvenile delinquent (under 18) was estimated at $80,000? $325,000 (?56,000??232,000). Between ages 19 and 24 a typical adult criminal costs a further $1.2m. Victim costs were by the far the greatest part of this total. Dropping out early from school added $243,000?$388,000 to age 24, heavy drug use a further $150,000?$360,000. Rescuing a high risk youth from this typical life path was estimated to save $1.7m?$2.3m.
This interdisciplinary training program prepares 9 Michigan State University doctoral students from school psychology and special education-emotional impairment for leadership roles in the development, implementation, and evaluation of interventions and prevention programs for youth exhibiting disruptive behaviors within the school setting. The objectives of this project include: (a) recruit and admit qualified candidates using effective strategies to recruit students from underrepresented populations including individuals with disabilities, (b) advise, provide financial assistance, and provide graduated and sustained training in areas and contexts that match doctoral leadership training goals, (c) plan, manage, and evaluate the project via involvement of parents of children with disruptive behaviors, interdisciplinary faculty who specialize in this population, and through the involvement of school, community, and administrative personnel (d) evaluate the program repeatedly across time to assure successful student completion and validation of the training methods and procedures, (e) help students assume leadership roles at local, state, or national levels, (f) institutionalize and disseminate our training model to other institutions and constituents across the country. 
A decade ago parenting programs were not in fashion. It was commonplace to talk about the effects of family breakdown or the problems of single mothers, but relatively few people were paying much serious attention to what parents did or to how parenting behaviors could be changed with children’s health and development in mind. Not so today: many jurisdictions are awash with programs, most of them of doubtful value.
Conduct disorder (CD) is estimated to affect 5-10% of children aged 5-15 years in the United Kingdom and the United States. For those children with early onset in pre-school years, CD frequently persists into adulthood, and predicts poor employment prospects, marriage breakdown and self-harming and/or anti-social criminal behaviour. The economic implications of severe behavioural problems in childhood are serious. It has been estimated that by age 28 the costs of publicly resourced services for those with conduct disorder in childhood were 10 times higher (?70,019) than for those with no behavioural problems (?7,423). Parenting is a key determinant in child behaviour. Parents who encourage pro-social behaviour have children with fewer behaviour problems. Parenting-training programmes are effective in helping families with children at risk of developing conduct disorders.
With the occurrence of multiple homicides on school campuses during the 1997-1998 and 1998-1999 academic years-such as in Springfield, Oregon and Littleton, Colorado-there has been a growing public perception that an increasing number of students may “go Off” at any time and cause serious harm to themselves and/or others. In response to this perception, school administrators, lawmakers, and prosecutors have recently “cracked-down” on juvenile violence. Metal detectors, security guards and police, crisis drills, “zero tolerance” discipline policies, and alternative programs for aggressive children are now found in many schools that previously saw little need for such measures. Several stats now require that children who commit violent crimes be tried as adults. Lawmakers have also proposed school prayer, mandatory student uniforms, mandatory use of “ma’am” or “sir” when responding t teachers, and the school-wide posting of the Ten Commandments as partial solutions to the widely perceived rising tide of school violence. Although well intended, too often such “solutions” have been misguided, based on little, if any, empirical research supporting their effectiveness in preventing school violence and promoting children’s mental health.
Carolyn Webster-Stratton adores and understands kids who throw things, bite, kick, refuse to obey every request or command and who rarely get invited to birthday parties. Kids who are asked to leave preschools and, if they are invited to a play date, are never asked again.
A decade ago parenting programs were not in fashion. It was commonplace to talk about the effects of family breakdown or the problems of single mothers, but relatively few people were paying much serious attention to what parents did or to how parenting behaviors could be changed with children’s health and development in mind. Not so today: many jurisdictions are awash with programs, most of them of doubtful value.
In the present study, generalisation effects from home to day-care/school settings were examined in a clinic sample of children aged 4-8 years treated because of Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) with The Incredible Years Parent Training programme or Parent Training combined with Classroom Training. 
Theoretical and empirical evidence suggests that two of the most common childhood syndromes, disruptive behaviors and depression, have similar developmental antecedents and may respond to similar interventions. Recent evidence suggests that parenting interventions that target more nurturing and less harsh parenting risk factors lead to reduced internalizing symptoms in children (Webster-Stratton & Herman, 2008) in addition to the well-established effects on child conduct problems. For instance, Webster-Stratton and Herman (2008) found that children whose parents participated in the IY Parent Training (PT) program had reduced depressive symptoms at post-treatment compared to children in a wait-list control condition. Effects were mediated by changes in parenting effectiveness.
This report has been prepared to provide an account of the Norwegian The Incredible Years programme, in accessible form. Beside a description of the programme, it concentrates on the results of clinical trials carried out in Trondheim and Troms? in 2001-2003, and presents material from a user evaluation carried out in 2003-2004. A brief examination of implementation issues is also included. Important project components in the programme seen as a whole have had to be omitted here, either because they are not yet complete or because space did not allow their inclusion. The treatment trial material presented here is based on work carried out by Bo Larsson, Willy-Tore M?rch, May Britt Drugli and Sturla Fossum. The user evaluation material is based on work carried out by Jim Lurie and the undersigned. Charlotte Reedtz, Jim Lurie and the undersigned have worked on collection of material to standardise instruments used in the research.
The incidence of Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) in children is alarmingly high, with reported cases of early-onset conduct problems in young preschool children 4-6% (Egger & Angold, 2006) and as high as 35% for low-income families (Webster-Stratton & Hammond, 1998). Developmental theorists have suggested that, compared to typical children, ‘early starter’ delinquents, that is, those who first exhibit ODD symptoms in the preschool years, have a two- to threefold risk of becoming tomorrow’s serious violent and chronic juvenile offenders (Loeber et al., 1993; Patterson, Capaldi, & Bank, 1991; Snyder, 2001; Tremblay et al., 2000). These children with early-onset CD also account for a disproportionate share of delinquent acts in adulthood, including interpersonal violence, substance abuse, and property crimes. Indeed, the primary developmental pathway for serious conduct disorders in adolescence and adulthood appears to be established during the preschool period.
Effective interventions for children with conduct problems ideally target multiple risk factors and are best offered as early as possible. Conduct disorder becomes increasingly resistant to change over time, so early intervention is a crucial strategy for the prevention or reduction of conduct problems, violence, substance abuse, and delinquency. Children with ODD and CD are clearly identifiable as early as 3-4 years of age, and there is evidence that the younger the child is at the time of intervention, the more positive the behavioral adjustment at home and at school following treatment. Intervention that is delivered prior to school entry and during the early school years can strategically target risk factors across multiple domains; home and school, and through multiple change agents; parent, teacher, and child. Unfortunately, less than 20% of young children meeting DSM-IV criteria for ODD are referred for mental health services (Horwitz, Leaf, Jeventhal, Forsyth, & Speechley, 1992). Even fewer of those referred obtain evidence-based interventions.
The Hospital Education Service provides education for children and young people attending or admitted to hospital. One of the main roles of this service is to ensure minimal disruption to children’s education during these difficult times.
Incredible Years has been used in hundreds of sites in at least 15 States (Arkansas, California, Colorado, Delaware, Florida, Kansas, Ohio, Oregon, Maine, Massachusetts, Minnesota, New York, North Carolina, Pennsylvania, and Washington). The program has also been implemented in Australia, Canada, Denmark, England, Germany, Ireland, the Netherlands, New Zealand, Norway, Portugal, Russia, Scotland, Sweden, and Wales. Incredible Years research staff have trained more than 10,000 professionals worldwide. Research articles for both U.S. and non-U.S. evaluation studies are available.
Families of 97 children with early-onset conduct problems, 4 to 8 years old, were randomly assigned to 1 of 4 conditions: a parent training treatment group (PT), a child training group (CT), a combined child and parent training group (CT + PT), or a waiting-list control group (CON). Post treatment assessments indicated that all 3 treatment conditions had resulted in significant improvements in comparison with controls. Comparisons of the 3 treatment conditions indicated that CT and CT + PT children showed significant improvements in problem solving as well as conflict management skills, as measured by observations of their interactions with a best friend; differences among treatment conditions on these measures consistently favored the CT condition over the PT condition. As for parent and child behavior at home, PT and CT + PT parents and children had significantly more positive interactions, compared with CT parents and children. One-year follow-up assessments indicated that all the significant changes noted immediately post treatment had been maintained over time. Moreover, child conduct problems at home had significantly lessened over time. Analyses of the clinical significance of the results suggested that the combined CT + PT conditions produced the most significant improvements in child behavior at 1-year follow-up.