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The Application of Behavior Change Theory to Family-Based Services: Improving Parent Empowerment in Children’s Mental Health

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Abstract

We describe the development of a parent empowerment program (PEP) using a community-based participatory research approach. In collaboration with a group of dedicated family advocates working with the Mental Health Association of New York City and state policy makers, academic researchers took an iterative approach to crafting and refining PEP to better prepare family advocates to help bridge the gaps in service access among children with emotional and behavioral problems. Despite the growth of family-led, family support programs nationally, research that demonstrates the positive benefits of such programs is scarce in the children’s mental health literature. The PEP model is based on research data about barriers families face in mental health service utilization (e.g., stigma, perceptions of providers, attitudes towards mental illness, service availability, etc.). PEP is premised on (a) the concept of empowerment as a process, (b) the need to engage parents in becoming active agents of change, and (c) the application of an integrated framework to empower parents, called the Parents as Agents of Change model. Our paper focuses on describing the application of a Unified Theory of Behavior Change as a theoretical framework to help activate parents as change agents in meeting their children’s mental health needs. Based on an integrated model of grassroots driven Principles of Parent Support and research-based Unified Theory of Behavior Change, PEP’s Parents as Agents of Change model provides a conceptual framework for testing the effectiveness of family support services in children’s mental health, a much-needed area for future research.

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References

  • Bickman, L., Heflinger, C. A., Northrup, D., Sonnichsen, S., & Schilling, S. (1998). Long term outcomes to family caregiver empowerment. Journal of Child and Family Studies, 7, 269–282.

    Article  Google Scholar 

  • Bruns, E. J., & Hoagwood, K. E. (2008). State implementation of evidence-based practice for youths, part I: Responses to the state of the evidence. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 369–373.

    Article  Google Scholar 

  • Chacko, A., Wymbs, B. T., Wymbs, F. A., Pelham, W. E., Swanger-Gagne, M. S., Girio, E., et al. (2009). Enhancing traditional behavioral parent training for single mothers of children with ADHD. Journal of Clinical Child and Adolescent Psychology, 38, 206–218.

    Article  PubMed  Google Scholar 

  • Dadds, M. R., & McHugh, T. A. (1992). Social support and treatment outcome in behavioral family therapy for child conduct problems. Journal of Consulting and Clinical Psychology, 60, 252–259.

    Article  PubMed  Google Scholar 

  • Farmer, E. M. Z., Dorsey, S., & Mustillo, S. A. (2004). Intensive home and community interventions. Child and Adolescent Psychiatric Clinics of North America, 13, 857–884.

    Article  PubMed  Google Scholar 

  • Fishbein, M. (1980). A theory of reasoned action: Some applications and implications. In H. Howe & M. Page (Eds.), Nebraska symposium on motivation, 1979 (pp. 65–116). Lincoln, NE: University of Nebraska Press.

    Google Scholar 

  • Fishbein, M., Triandis, H., Kanfer, F., Becker, M., Middlestadt, S., & Eichler, A. (2001). Factors influencing behavior and behavior change. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 3–17). Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Fristad, M. A., Goldberg-Arnold, J. S., & Gavazzi, S. M. (2002). Multifamily psychoeducation groups (MFPG) for families of children with bipolar disorder. Bipolar Disorders, 4, 254–262.

    Article  PubMed  Google Scholar 

  • Gibson, C. H. (1995). The process of empowerment in mothers of chronically ill children. Journal of Advanced Nursing, 21, 1201–1210.

    Article  PubMed  Google Scholar 

  • Griffin, J. A., Cicchetti, D., & Leaf, P. J. (1993). Characteristics of youth identified from a psychiatric case register as first-time users of services. Hospital & Community Psychiatry, 44, 62–65.

    Google Scholar 

  • Hoagwood, K. E. (2005). Family-based services in children’s mental health: A research review and synthesis. Journal of Child Psychology and Psychiatry, 46, 690–713.

    Article  PubMed  Google Scholar 

  • Hoagwood, K. E., Green, E., Kelleher, K., Schoenwald, S., Rolls-Reutz, J., Landsverk, J., et al. (2008). Family advocacy, support and education in children’s mental health: Results of a national survey. Administration and Policy in Mental Health and Mental Health Services Research, 35, 73–83.

    Article  PubMed  Google Scholar 

  • Ireys, H., DeVet, K., & Sakwa, D. (2002). Family support and education. In B. Burns & K. Hoagwood (Eds.), Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders (pp. 154–176). New York: Oxford University Press.

    Google Scholar 

  • Jaccard, J., Dodge, T., & Dittus, P. (2002). Parent-adolescent communication about sex and birth control: A conceptual framework. New Directions for Child & Adolescent Development, 97, 9–41.

    Article  Google Scholar 

  • Jaccard, J., Litardo, H. A., & Wan, C. K. (1999). Subjective culture and social behavior. In J. Adamopoulos & Y. Kashima (Eds.), Social psychology and cultural context (pp. 95–106). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among U.S. children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159, 1548–1555.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., Holland, L., & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65, 453–463.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., & Wassell, G. (2000). Predictors of barriers to treatment and therapeutic change in outpatient therapy for antisocial children and their families. Mental Health Services Research, 2, 27–40.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., & Whitley, M. K. (2003). Treatment of parental stress to enhance therapeutic change among children referred for aggressive and antisocial behavior. Journal of Consulting and Clinical Psychology, 71, 504–515.

    Article  PubMed  Google Scholar 

  • Koroloff, N. M., & Elliott, D. J. (1996). Linking low-income families to children’s mental health services: An outcome study. Journal of Emotional and Behavioral Disorders, 4, 2–11.

    Article  Google Scholar 

  • Koroloff, N. M., & Friesen, B. J. (1997). Challenges in conducting family-centered mental health services research. Journal of Emotional and Behavioral Disorders, 5, 130–137.

    Article  Google Scholar 

  • Kutash, K., English, L., Duchnowski, A. J., Lynn, N. B., Romney, S., & Greeson, M. T. (2006). The “Parent Connectors” program: An empirical investigation of a parent support program. Tampa, FL: Louis de la Parte Florida Mental Health Institute, University of South Florida.

    Google Scholar 

  • McKay, M., DeLyser, G., Haynes, L., Prazak, P., Tokarz, A., Gonzales, J., Kim, L., & Quintana, E. (2009). Multiple family groups: An opportunity to involve urban children with conduct difficulties and their families in mental health services. Psychiatric Services (in press).

  • McKay, M., Pennington, J., Lynn, C. J., & McCadam, K. (2001). Understanding urban child mental health l service use: Two studies of child, family, and environmental correlates. Journal of Behavioral Health Services Research, 28, 475–483.

    Article  PubMed  Google Scholar 

  • McKay, M., Stoewe, J., McCadam, K., & Gonzales, J. (1998). Increasing access to child mental health services for urban children and their caregivers. Health and Social Work, 23, 9–15.

    PubMed  Google Scholar 

  • New York State Office of Mental Health (NYSOMH). (2008). Children’s plan: Improving the social and emotional well being of New York’s children and their families. Albany, NY: Division of Children and Families, New York State Office of Mental Health.

    Google Scholar 

  • NIMH Workshop Report. (1991). Factors influencing behavior and behavior change—Final report on theorist’s workshop. Washington, DC: National Institute of Mental Health.

    Google Scholar 

  • Owens, P. L., Hoagwood, K., Horwitz, S. M., Leaf, P. J., Poduska, J. M., Kellam, S. G., et al. (2002). Barriers to children’s mental health services. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 731–738.

    Article  PubMed  Google Scholar 

  • Pescosolido, B. A., Jensen, P. S., Martin, J. K., Perry, B. L., Olasfsdottir, S., & Fettes, D. (2008). Public knowledge and assessment of child mental health problems: Findings from the National Stigma Study-Children. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 339–349.

    Article  PubMed  Google Scholar 

  • Ruffolo, M., Kuhn, M., & Evans, M. (2006). Developing a parent-professional team leadership model in group work: Work with families with children experience behavioral and emotional problems. Social Work, 51, 39–47.

    PubMed  Google Scholar 

  • Schoenwald, S. K., Chapman, J. E., Kelleher, K., Hoagwood, K. E., Landsverk, J., Stevens, J., et al. (2008). A survey of the infrastructure for children’s mental health services: Implications for the implementation of empirically supported treatments (ESTs). Administration and Policy in Mental Health and Mental Health Services Research, 35, 84–97.

    Article  PubMed  Google Scholar 

  • Stiffman, A. R., Pescosolido, B., & Cabassa, L. J. (2004). Building a model to understand youth service access: The gateway provider model. Mental Health Services Research, 6, 189–198.

    Article  PubMed  Google Scholar 

  • U. S. Department of Health and Human Services. (2001). Mental health: Culture, race, ethnicity. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.

    Google Scholar 

Download references

Acknowledgments

Preparation of this manuscript was supported by grants funded by the National Institute of Mental Health (R34MH071745, P20MH078178, and R34MH074774).

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Correspondence to S. Serene Olin.

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Olin, S.S., Hoagwood, K.E., Rodriguez, J. et al. The Application of Behavior Change Theory to Family-Based Services: Improving Parent Empowerment in Children’s Mental Health. J Child Fam Stud 19, 462–470 (2010). https://doi.org/10.1007/s10826-009-9317-3

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