Columbia University Mailman School of Public Health

Parenting Programs

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Introduction

Parenting programs are group format, multisession classes for parents and primary caregivers led by trained facilitators. They aim to increase parents’ knowledge and skills related to parenting behaviors and interactions with their children. Parenting programs can be provided in a number of locations, including healthcare, school, and community settings, and by facilitators with a variety of professional backgrounds, such as mental health providers, healthcare professionals, and educators. While parenting programs address a wide range of topics (such as children’s health, language and literacy, and cognitive development), this research summary focuses on those that aim to enhance social-emotional development, address problem behavior, and support the mental health of infants, toddlers and preschool-age children. Compared to more intensive interventions delivered individually to parent-child dyads (see our Research Summary on Dyadic Treatment), parenting programs, because of their group format, are typically less costly.

State Profiles that Include Parenting Programs

Research Support for Parenting Programs

The following manualized, widely-used parenting programs—which address young children’s behavior, social-emotional development, and/or mental health—have been evaluated using randomized-controlled trials conducted in the United States with parents of children from birth to five.

The Incredible Years (IY): The IY series consists of child, parent, teacher programs that aim to reduce the challenging behaviors and support the social-emotional development of children from birth to age 12. The IY BASIC parenting program involves weekly 2-3 hour sessions for groups of 10-14 parents. The number of sessions varies by curricula, which are targeted at children of different ages: Parents and Babies (8-9 sessions), Toddler Basic (12 sessions), Preschool Basic (18-20 sessions), and School Age Basic (12-16 sessions). Recorded vignettes serve as the basis of discussion during the sessions. Led by two trained group leaders, IY is delivered in a number of settings, including community agencies, healthcare settings, and schools.

A meta-analysis of IY involving 50 studies found positive effects on children’s disruptive behavior and prosocial behavior measured by parent report, teacher report, and child observations. Initial severity of child’s problem behavior was the strongest predictor of the size of the positive effects.1 Average child age in the studies ranged from 3 to 9.2 years old. For children younger than three, a randomized controlled trial of IY Toddler Basic and another of IY Parents and Babies did not find positive effects on child developmental outcomes.2 However, two randomized controlled trials were conducted with parents of children with average ages under three using IY prior to its formal separation into versions for babies and for toddlers. The first study involved parents of 2- and 3-year-old children attending child care centers serving low-income families.3 Centers were randomly assigned to receive IY parent, IY teacher, both IY parent and teacher, or to a waitlist control. There were significant positive effects on observed positive parenting for the groups that received parent training and, for all three of the experimental groups, on teacher-reported behavior problems of children initially determined to be at high risk of behavior problems. In the second study, parents of two- to four-year-old children (average age 2.8) with disruptive behaviors were randomly assigned to receive IY parenting or to a no-treatment group.4 Significant positive effects were found for the IY parents on both observed and reported parenting behaviors and child problem behaviors.

Positive Parenting Program (Triple P): Triple P teaches parents of children from birth to age 17 strategies to promote social competence and self-regulation in children. Triple P consists of five tiers, with two universal tiers designed for all parents and three tiers of targeted supports for families with greater needs. Level 1 is a community-wide media campaign. Levels 2 through 5 can be delivered in group formats, and levels 4 and 5 can be delivered individually. Triple P can be delivered in a number of settings, including the home, community agencies, healthcare settings, schools, and online. Level 2 is delivered in low-intensity seminars or one-time sessions for small to large groups of parents (10 to hundreds) who may have one or two concerns about child behavior or development but are otherwise doing well. Level 3 consists of one-to-four sessions targeting a specific behavior or issue for parents of children with mild to moderate behavior problems and is delivered in individual consultations or two-hour small group sessions. Level 4 is for parents of children with severe behavioral difficulties and can be delivered individually in 10 hour-long sessions or in groups of up to 12 parents over five in-person sessions and three individual phone consultations. Level 4 can also be delivered online or self-directed. Level 5 is for families with complex concerns such as partner conflict, mental health issues, or risk of child maltreatment, and who must also have completed level 4. It can be delivered individually or in groups. Additionally, Triple P offers variations for parents of infants (Baby Triple P) and children with disabilities (Stepping Stones Triple P). Training for Triple P providers is coordinated by Triple P International and delivered in-person to cohorts of 20, with each Triple P level and format having its own training.

A meta-analysis of Triple P involving 101 studies found significant short- and long-term effects for Triple P on reported child social, emotional, and behavior outcomes, parenting practices, parenting satisfaction and efficacy, parental adjustment, and on child observational outcomes.5 Each level of Triple P had significant positive effects on reported child social, emotional, and behavior outcomes, and larger effect sizes were associated with younger child age and higher severity of initial child problem behaviors. While only one of the studies in the meta-analysis was conducted in the United States, a separate study examined the effects of Triple P on population-level child maltreatment outcomes by randomly assigning 18 counties in South Carolina to implement the full five-level Triple P system targeting families with children birth to eight.6 At two years post-implementation, the Triple P counties had significantly lower rates of substantiated child maltreatment, hospitalizations and injuries due to child maltreatment, and lower rates of out-of-home placements for child maltreatment among children birth to eight. Studies of Baby Triple P have not found significant positive effects on child or parent outcomes; however a randomized control study of Stepping Stones Triple P (SSTP) with families enrolled in Part C Early Intervention (average child age was 20 months) found a significant impact on the observed quality of the parent-child relationship at 12 months post-intervention.7 The SSTP version of Triple P is designed for families with children who have a disability.

Circle of Security-Parenting (COS-P): COS-P is an eight-session group, video-based parenting program for families with children under six years old. Delivered by a trained facilitator through weekly 90-minutes sessions that include a video component, COS-P aims to strengthen the parent-child relationship by helping parents serve as a source of security for their children. A randomized controlled trial of COS-P in Head Start found positive effects on children’s observed behavior related to inhibitory control (the ability to control attention and behavior) and mothers’ reports of their response to child’s distress.8

Chicago Parent Program (CPP): CPP is a 12-session program for parents of children 2-5 years old that aims to promote positive parenting and reduce problem behaviors. It was developed in collaboration with African American and Latino parents from a range of economic backgrounds so that its materials are relevant across ethnic, racial, and socioeconomic groups. The program is implemented with groups of 10-15 parents who meet for 11 two-hour weekly sessions led by two group leaders. Using video vignettes to stimulate discussion, the sessions’ topics include: “the concept of child-centered time; the importance of family routines and traditions; the value of praise and encouragement; the role of rewards for reducing challenging behavior; the importance of setting clear limits and of following through on limit-setting …and stress management; and problem-solving skills.”9

Two randomized controlled trials of CPP among African-American and Latino parents found that at one-year follow-up CPP reduced corporal punishment and child behavior problems.10 In one of the studies, parents also gave fewer commands to children, and in the other, parents reported greater self-efficacy.

Child Parent Relationship Therapy (CPRT): CPRT is a 10-session play-based program that aims to strengthen parent-child attachment for parents with children 3-8 years old who have behavior or social-emotional problems, or attachment disorders. A licensed mental health provider with training and supervision in CPRT leads weekly two-hour sessions for 5-8 parents. After three sessions learning CPRT principles and skills, parents bring 30-minute video recordings of at-home play sessions for discussion and feedback for the next seven sessions to build and refine their skills. The focus of the final two sessions is incorporating CPRT skills into daily interactions with their children.

A literature review of 32 control group design studies (13 randomized control trials, 19 quasi-experimental) published between 1995 and 2010 found that CPRT parents reported fewer child behavior problems and lower levels of parent-child relationship stress and were observed to engage in more empathic interactions with their children.11 Relevant studies in the literature review were conducted with parents of children from 2 to 10 years old across a wide range of demographic groups (Hispanic, African-American, Native American, Chinese immigrant, and Korean immigrant parents, as well as single parents). One experimental design study in the review, conducted with low-income African-American parents of children in Head Start with behavior problems, found significant improvements in reports of child behavior problems and parent-child relationship stress.12

References

  1. Menting, A. T. A., Orobio de Castro, B., & Matthys, W., (2013). Effectiveness of the Incredible Years parent training to modify disruptive and prosocial child behavior: A meta-analytic review. Clinical Psychology Review, 33(8), 901-913.
  2. Hutchings, J., Griffith, N., Bywater, T., & Williams, M. E. (2017). Evaluating the Incredible Years Toddler Parenting Programme with parents of toddlers in disadvantaged (Flying Start) areas of Wales. Child: Care, Health and Development, 43(1), 104-113. Pontoppidan, M., Klest, S. K., & Sandoy, T. M. (2016). The Incredible Years Parents and Babies Program: A pilot randomized controlled trial. PLoS ONE, 11(12).
  3. Gross, D., Fogg, L., Webster-Stratton, C., Garvey, C., Julion, W., & Grady, J. (2003). Parent training of toddlers in day care in low-income urban communities. Journal of Consulting and Clinical Psychology, 71(2), 261-278.
  4. Perrin, E. C., Sheldrick, C., McMenamy, J. M., Henson, B. S., & Carter, A. S. (2014). Improving parenting skills for families of young children in pediatric settings: A randomized clinical trial. JAMA Pediatrics, 168(1), 16-24.
  5. Sanders, M. R., Kirby, J. N., Tellegen, C. L., & Day, J. J. (2014). The Triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support. Clinical Psychology Review 34(4), 337-357
  6. Prinz, R. J., Sanders, M. R., Shapiro, C. J., Whitaker, D. J., & Lutzker, J. R. (2009). Population-based prevention of child maltreatment: The U.S. Triple P System Population Trial. Prevention Science, 10(1), 1-12.
  7. Popp, L., Fuths, S., & Schneider, S. (2019). The relevance of infant outcomes measures: A pilot-RCT comparing Baby Triple P Positive Parenting Program with care as usual. Frontiers in Psychology, 10, 2425.
    Tsivos, Z.-L., Calam, R., Sanders, M. R., & Wittkowski, A. (2015). A pilot randomised controlled trial to evaluate the feasibility and acceptability of the Baby Triple P Positive Parenting Programme in mothers with postnatal depression. Clinical Child Psychology and Psychiatry, 20(4), 532-554.
    Shapiro, C. J., Kilburn, J., & Hardin, J. W. (2014). Prevention of behavior problems in a selected population: Stepping Stones Triple P for parents of young children with disabilities. Research in Developmental Disabilities, 35(11), 2958-2975.
  8. Cassidy, J., Brett, B. E., Gross, J. T., Stern, J. A., Martin, D. R., Mohr, J. J., & Woodhouse, S. S. (2017). Circle of Security-Parenting: A randomized controlled trial in Head Start. Development and Psychopathology, 29(2), 651-673.
  9. Gross, D., Garvey, C., Julion, W., Fogg, L., Tucker, S., & Mokros, H. (2009). Efficacy of the Chicago Parent Program with low-income African American and Latino parents of young children. Prevention Science, 10(1), 54-65.
  10. Gross, D., Garvey, C., Julion, W., Fogg, L., Tucker, S., & Mokros, H. (2009). Efficacy of the Chicago Parent Program with low-income African American and Latino parents of young children. Prevention Science, 10(1), 54-65.
    Breitenstein, S. M., Gross, D., Fogg, L., Ridge, A., Garvey, C., Julion, W., & Tucker, S. (2012). The Chicago Parent Program: Comparing 1-year outcomes for African American and Latino parents of young children. Research in Nursing & Health, 35(5), 475-489.
  11. Bratton, S. C., Landreth, G. L., & Lin, Y.-W. D. (2010). Child-Parent Relationship Therapy: A review of controlled-outcome research. In J. N. Baggerly, D. C. Ray, & S. C. Bratton (Eds.), Child-Center Play Therapy research: The evidence base for effective practice (pp. 267-293). Hoboken, NJ: John Wiley & Sons.
  12. Sheely-Moore, A. I., & Bratton, S. C. (2010). A strengths-based parenting intervention with low-income African American families. Professional School Counseling 13(3), 175-183.