Prior to the 1970s, parent education programs consisted of:

• An “expert,” usually in the area of child development, imparting information to audiences of parents about issues such as, children’s growth in areas like walking, talking, and getting along with others.
• Suggestions for productive and healthy ways to rear and help their children. Lists of recommended readings by well-known child or parent authorities .
• “One shot”, informational presentations sponsored by schools, child guidance clinics, or parent groups

 

In the 1970′s, the focus of parent education programs changed from information dissemination to parenting skill-building. These “how to” programs provided parents with:

• A clearly enunciated parenting philosophy.
• A set of skills and strategies for dealing with a variety of normal/typical childrearing challenges and problems.
• A sequenced series of training sessions, usually 1 – 8 weeks in length.
• Guidebooks, “in-class” exercises, and application-based homework assignments.
• A facilitator “trained” to use a specific curriculum, e.g. Systematic Training for Effective Parenting STEP), Parenting Effectiveness Training PET), Confident Parenting: Survival Training Skills.
  

 

After the 1970s, most parent education and training programs combined these approaches into audience-specific curricular approaches for groups such as:

• African-American and Latino parents.
• “High Risk” parents, e.g. teen parents, divorcing parents, abusive and/or neglecting parents.
• Parents of children with exceptionalities, i.e., ADHD, mental retardation, conduct disorders.
  

Beginning in the late 1980s – early 1990s, parent educators engaged in these traditional community-based programs of parent education began to see parent participants who:

• Were “mandated” to attend classes by courts of law and/or state departments of protection.
• Were reporting atypical and pathological child behaviors.
• Were living in unstable and toxic home environments with “out of control” children.
• Were clearly not being served by any of the traditional approaches to parent education.

 

At the same time, reports by the media and numerous governmental agencies documented:

The dramatic changes in American family life — high rates of divorce and remarriage, families with both parents in the workforce, high number of teen pregnancies, increases in juvenile delinquency, crime, violence and gang-related activities.

The prevalence of chronic developmental, learning, behavioral and mental health disorders in childhood and adolescence.
The growing need of many parents for special training and support in order to survive and to stabilize their families.

These reports with their recommendations and funding for “specialized” parent training and family supports resulted in the development of a new form of parenting education where the orientation shifted from:

• Prevention to intervention.
• A ‘parent-child’ focus to a ‘family systems’ focus.
• A ‘single service/single expert’ education delivery system to a ‘multi-service/multi-disciplinary team’ therapeutic delivery system.

 

As a result, multi-systemic therapies emerged in order to address the needs of families with children at risk. These were family-centered interventions that were often focused on a home-based format. Common themes of these programs included:

 

• Program success based on prevention of placing children outside the home.
• Therapeutic services delivered to all members of the family.
• Combination of in-home services and intensive case management involving linking families to community resources.
• Philosophical roots in systems theories, ecological theories and social learning theories.

 

For many families, the therapies and interventions described above have been successful. To be sure, many parents are grateful to such programs for helping to bring their children under control and bringing health and peace to their homes.
Unfortunately, for some families, the above mentioned therapies, programs and resources are inadequate. What can be done for the parents who have “tried it all” to manage their out-of-control children but have met no success? P.A.C.T. is geared towards parents with children who bring new meaning to the term “out
of control.” These children may exhibit a wide range of destructive behaviors, psychiatric diagnoses, and have had various placement histories.

Some common characteristics include:
verbal and physical abuse towards parents and siblings	ADHD
blatant disobedience in the home delinquent behavior in school	Asperger’s autism
fire setting	previous temporary institutionalization
destroying property	previous foster care
running away	placement or other out of home care

 

 

The parents of these children feel they are in a hopeless state. One core requirement of participation and success in P.A.C.T. is that parents must feel that they have “tried everything” to save their children and their family life. Many of these families have open cases with local child protective services, either because their dangerous situation has brought them to the attention of authorities, or because they have enrolled voluntarily in order to save their families. As mentioned above, some families have even had their uncontrollable children in temporary out of home care. For the P.A.C.T. family, none of these interventions bring success. In fact, success in P.A.C.T. is contingent on parents accepting the fact that every technique they have used in the past to control their children has been wrong, evidenced by the fact that these methods have brought no success. 

 

Theoretical foundations

P.A.C.T. takes a unique approach, incorporating tenets of behaviorism and parent education. P.A.C.T. is based on a behaviorist approach to development centered on two main learning concepts:

(1) Parents can become more effective parents by incorporating a set of learned techniques; and

(2) Children’s behavior is influenced by the types of responses they elicit from their parents. The program is explicitly not therapy. It is purely a training program for parents. P.A.C.T.
holds that by changing the ways in which parents react to their children’s violent behavior, parents will be able to shape their children’s disruptive actions.

The P.A.C.T. program


Parents arrange weekly 15-minute meetings with the P.A.C.T. trainer during which they learn the 27 core principles of the program (See Figure 1). Meetings are arranged at a location of the parents’ choosing; if a parent does not feel comfortable meeting in the home, a local restaurant or parked car will do. At no point does the P.A.C.T. facilitator meet the troubled child or children.

The weekly sessions are conducted as follows:

• Parent is introduced to one of the 27 P.A.C.T. techniques. Techniques describe the
  cessation of parent behaviors that enable children’s destructive behavior and are phrased as simple directives such as “Stop yelling.”
  
• Once lesson is clarified, parent goes home to implement the new technique. Parent charts
  how many times he or she uses the enabler (e.g. yelling) while also charting the frequency of child’s destructive behavior.
  
• At the next meeting, if parent has mastered the previous lesson, the next lesson is introduced. If not mastered, parent must continue working on the technique before moving to the next.

P.A.C.T. also includes a manual which parents read and refer to throughout their training. This manual provides background information on the program, goes into depth about each of the 27 enablers, and provides areas for charting the family’s progress. 

The state of Connecticut is currently supporting P.A.C.T. for these needy families. The State is subsidizing the program for its DCF families based on informal reports of its tremendous success. The purpose of this study was to obtain preliminary program evaluation data using more standardized measures. 
 

Methods


Thirty-five parents who completed P.A.C.T. were randomly selected and mailed an invitation to be interviewed. A pre-paid response card was included on which parents noted their phone number and convenient times to be contacted. Unfortunately, because of many families moving over the years, several invitations were undeliverable. Of the letters that reached parents, only 4 sent back cards agreeing to be interviewed. 

 

	Round 1	Round 2	Round 3	Total
Sent	29	9	3	35
Undeliverable	9	3	0	12
Interviewed	3	1	0	4
Declined	2	0	0	2
Total Returned	14	4	0	18
No Response	9	5	3	17

 

 

Parents participated in a phone interview which took about a half-hour to conduct. The pre-formulated interview protocol covered three main types of questions:

 

• Parent’s general sense of the effects of P.A.C.T.
• Changes in child’s behavior after P.A.C.T.
• Changes in parent’s behavior after P.A.C.T.

 

To access changes in the child’s behavior, parents were asked to reflect on their child’s behavior beforeP.A.C.T. and during the past week. Parents were read a list of behaviors and asked how many times per week, before P.A.C.T. and currently, the child exhibited the behaviors. Possible answers ranged from zero
times per week to 11+ times per week. To access parent’s behavior change, parents were asked to report how many times per week they used each of the 27 enablers before P.A.C.T. and in the past week. 

 

Results

The results described here are based on the 4 interviews conducted. Therefore, any trends should be interpreted with caution and used as a springboard for further investigation.

Table 1: Correlation Table

SUMCHBEF = Sum child behaviors before P.A.C.T.
SUMCHAFT = Sum child behaviors in the past week
SUMPARBEF = Sum parent behaviors before P.A.C.T.
SUMPARAFT = Sum parent behaviors in the past week

	SUMCHBEF	SUMCHAFT	SUMPARBEF	SUMPARAFT
SUMCHBEF Pearson Cor. Sig, (2-tailed)	1 . 4	.985(*) .015 4	.958(*) .042 4	.644 .356 4
SUMCHAFT Pearson Cor. Sig, (2-tailed)	.985(*) .015 4	1 . 4	.964(*) .036 4	.749 .251 4
SUMPARBEF Pearson Cor. Sig, (2-tailed)	.958(*) .042 4	.964(*) .036 4	1 . 4	.601 .399 4
SUMPARAFT Pearson Cor. Sig, (2-tailed)	.644 .356 4	.749 .251 4	.601 .399 4	1 . 4