Effectiveness of community implementation of attachment and biobehavioral catch-up and preliminary evidence for in vivo feedback as a predictor of parent behavior change
Date
2016
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Publisher
University of Delaware
Abstract
Bringing evidence-based treatments to community practice is a critical challenge for the field. However, in the community, evidence-based treatments can fail to benefit patients, and variables that predicted outcome in the lab can fail to perform as expected. Therefore, when evidence-based treatments are implemented in the community, it is essential to investigate treatment effectiveness, as well as predictors of treatment success. The present study assessed whether Attachment and Biobehavioral Catch-up (ABC), an intervention for high-risk parents that has been shown to be efficacious in randomized clinical trials, was effective in a community based setting. The study also examined whether in the moment feedback, considered a critical component of the intervention, was a predictor of parent behavior change. This study examined data collected from 56 cases by 8 clinicians in a community setting in Hawaii. Caregivers were primarily birth parents, and most were referred through Child Protective Services involvement or for reasons of harsh parenting or neglect. Parental behavior was assessed before and after intervention using a semi-structured play task. In the moment feedback was assessed from session videos. Increases in parental sensitivity and positive regard, and decreases in parental intrusiveness, were observed. Clinicians’ frequency and quality of in the moment feedback predicted change in intrusiveness and sensitivity at post-treatment. These results support the effectiveness of ABC in enhancing parent behavior among parents at high risk for maltreatment, and demonstrate that ABC can be successfully implemented by community clinicians. The results further show that a hypothesized active ingredient of treatment, in the moment feedback, predicts community-based ABC outcomes.
Description
Keywords
Active ingredients, Evaluation, Fidelity, Parent training