GenerationPMTO

A family training program that aims to teach effective family management skills in order to reduce antisocial and problematic behavior in children through trainings implemented in a variety of formats and settings.

GenerationPMTO is a group of theory-based parent training interventions that can be implemented in a variety of family contexts. The program aims to teach effective family management skills in order to reduce antisocial and problematic behavior in children ranging in age from 3-16 years. GenerationPMTO is delivered in group- and individual-family formats, in diverse settings (e.g., clinics, homes, schools, community centers, homeless shelters), and over varied lengths of time depending on families’ needs. Typically, sessions are one week apart to optimize the opportunity for learning and rehearsing new practices. The number of sessions provided in parent groups ranges from 6 to 14; in clinical samples the mean number of individual treatment sessions is 25.

The central role of the GenerationPMTO therapist is to teach and coach parents in the use of effective parenting strategies, namely skill encouragement, setting limits or effective discipline, monitoring, problem solving, and positive involvement. In addition to these core parenting practices, parents are taught to identify and regulate emotions, enhance communication, give clear directions, and track behavior. Finally, the program weaves the promotion of school success throughout relevant components.

GenerationPTMO has experienced widespread implementation across several states and international locations. The Blueprints certification of GenerationPMTO is based on four studies – two conducted in the United States, one in Norway, and one in Iceland. An independent research team (not associated with the program developers) conducted the most recently certified study; with this last evaluation, the program meets the requirements for “Model Plus” status on the Blueprints registry.

Forgatch & DeGarmo (1999) randomized 238 recently separated mothers and their sons in grades 1-3 to the intervention (n=153) or to a non-intervention control group (n=85). The participants lived in a moderate-sized city in the Northwest. Results show that compared to the control group at posttest, intervention boys experienced a significant decrease in noncompliance; their mothers experienced reductions in coercive parenting and negative reinforcement and increases in positive parenting, effective parenting practices and adaptive functioning. At 30 months, child internalizing and externalizing behaviors decreased as did maternal depression. At the last follow-up, the intervention significantly reduced the 9-year average and rate of growth in teacher-reported delinquency. Additionally, assignment to the intervention was associated with reduction in average levels of deviant peer associations from baseline to 8 years. Intervention boys and their mothers experienced lower arrest rates and boys experienced delayed age at first arrest compared to the control group.

Bjørknes & Manger (2012) and Bjørknes et al. (2012) conducted a randomized control trial among 96 immigrant families in Norway. Eligible families had a child with or at risk of developing conduct problems. Mothers were randomly assigned to either the intervention (n=50) or to a waitlist control group (n=46) with assessments occurring at baseline and post-intervention. The program improved positive parenting practices and child conduct problems for intervention families as compared to control families.

Sigmarsdóttir et al. (2014) recruited participants from five municipalities in Iceland. Eligible families were referred by schools, educational services or social services and had a child displaying behavioral problems at home and/or in school. Families were randomly assigned to the intervention (n=51) or to a services-as-usual control condition (n=51) in which subjects received a variety of community services normally provided for children with behavioral problems. Parents, teachers, and children completed assessments at baseline and end of treatment (approximately one year after baseline). A significant reduction was found for child adjustment problems (construct comprised of behavior problems, social skills, and depressive symptoms) among children whose parents received the treatment, compared to children in the control condition.

A team of independent evaluators, Akin et al. (2016, 2018), conducted a randomized controlled trial in a Midwestern state with families of children who were in foster care and had a serious emotional disturbance. In this study, 918 families were randomized into intervention (n=461) and control (n=457) groups. Assessments occurred at baseline, posttest, and 6-month follow-up (12 months after baseline). Compared to control group participants at posttest and follow-up, children in the intervention group significantly improved on social emotional functioning, problem behaviors and social skills.

In terms of cost-benefit analysis, Washington State Institute for Public Policy (December 2019) reports $1.87 in measured benefits per $1 spent in implementing GenerationPMTO.

References:

Akin, B. A., Lang, K., McDonald, T. P., Yan, Y., & Little, T. (2016). Randomized trial of PMTO in foster care: Six-month child well-being outcomes. Research on Social Work Practices, 29(2), 206-222.

Akin, B. A., Lang, K., Yan, Y., & McDonald, T. P. (2018). Randomized trial of PMTO in foster care: 12-month child well-being, parenting, and caregiver functioning outcomes. Children and Youth Services Review, 95, 49-63.

Bjørknes, R., & Manger, T. (2012). Can parent training alter parent practices and reduce conduct problems in ethnic minority children? A randomized controlled trial. Prevention Science, 14(1), 52-63.

Bjørknes, R., Kjøbli, J., Manger, T., & Jakobsen, R. (2012). Parent training among ethnic minorities: Parenting practices as mediators of change in child conduct problems. Family Relations, 61, 101-114.

DeGarmo, D. S., Patterson, G. R., & Forgatch, M. S. (2004). How do outcomes in a specified parent training intervention maintain or wane over time? Prevention Science, 5, 73-89.

Forgatch, M., & DeGarmo, D. (1999). Parenting Through Change: An effective prevention program for single mothers. Journal of Consulting and Clinical Psychology, 67(5), 711-724.

Forgatch, M. S., Patterson, G. R., DeGarmo, D. S., & Beldavs, Z. (2009). Testing the Oregon delinquency model with 9-year follow-up of the Oregon Divorce Study. Development and Psychopathology, 21(5), 637-660.

Martinez, C., & Forgatch, M. (2001). Preventing problems with boys’ noncompliance: Effects of a parent training intervention for divorcing mothers. Journal of Consulting and Clinical Psychology, 69(3), 416-428.

Sigmarsdóttir, M., Thorlacius, O., Guõmundsdóttir, E. V., & DeGarmo, D. S. (2014). Treatment effectiveness of PMTO for children’s behavior problems in Iceland: Child outcome in a nationwide randomized controlled trial. Family Process, 54, 498-517.

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