Pilot Implementation of School-Based Behavioral Parent Training: Outcomes and Acceptability

Many children demonstrate challenging behaviors, which can pose a risk for future behavior problems and negatively impact caregivers and teachers. Behavioral parent training (BPT) is an evidence-based practice that can prevent the negative outcomes associated with early disruptive behaviors. This intervention is primarily offered in clinic settings and thus may not reach the families who need it most. Schools may be a logical point of proactive family-focused intervention, given that implementation in schools may serve to overcome barriers associated with insurance, transportation, or stigma around mental health services. Unfortunately, there are few evaluations of BPT in schools, and most school-based programs include children directly in intervention with few specifically focusing on supporting caregivers. Our study shares acceptability and outcome data from a pilot evaluation of a BPT program titled Helping Our Toddlers, Developing Our Children’s Skills (HOT DOCS) implemented in a school setting with 25 caregivers. A quasi-experimental pre-test post-test design was used to answer questions about caregiver- and child-related outcomes of the intervention and to examine acceptability and feasibility from the perspectives of caregivers and HOT DOCS co-facilitators. Results demonstrated decreased frequency and intensity of child challenging behavior, lower child-parent conflict, and reductions in parenting stress. We also had high acceptability ratings, positive qualitative feedback from caregivers and co-facilitators, and lower attrition than most clinic-based implementations of HOT DOCS. These pilot results suggest that school-based BPT is feasible and effective, and that further evaluation of the training and resources necessary for full implementation by school professionals are important.