Hopkins nursing researcher to compare local/national parenting programs.

Do current parenting programs meet the unique needs of Baltimore families?

Through a $3.2 million grant from the National Institute of Nursing Research (NINR) Johns Hopkins nurse research Deborah Gross, DNSc, RN, FAAN, will answer that question by comparing and measuring the impact on Baltimore families of two programs: Gross' Chicago Parent Program and the Parent-Child Interaction Therapy (PCIT), the current "gold standard" in parenting interventions.

The Chicago Parent Program, developed by Gross and colleagues in 2002, focuses on a population overlooked in prior data-driven parenting programs: Latino and African American families raising children in urban neighborhoods. The program emphasizes child-centered time, the importance of family routines and traditions, the value of praise and encouragement, rewards for reducing challenging behavior, the importance of setting clear limits and following through, the need to establish consequences, stress management and problem-solving skills for parents, and the use of specific parenting strategies (e.g. ignore, distract, time out) to help parents meet their childrearing goals. The program uses group discussion and brief video vignettes of situations common to families raising young children (e.g., misbehavior in public places).

Parent-Child Interaction Therapy (PCIT) teaches similar skills to parents but uses an individual parent-child coaching model. Parents are taught specific skills to establish a nurturing and secure relationship with their child while increasing their child's prosocial behavior and decreasing negative behavior. This treatment focuses on two basic interactions: Child Directed Interaction, where parents are coached on how to engage their child in a play situation with the goal of strengthening the parent-child relationship; Parent Directed Interaction, in which parents learn to use specific behavior management techniques as they play with their child.

Gross' work is the first study showing the comparison between the Chicago Parent Program and PCIT. Designed with input from clinicians at the Family Center Outpatient Mental Health Program at the Kennedy Krieger Institute, the study targets the additional challenges that Baltimore City families face, including economic stress, violence, and sparse or nonexistent support systems. Gross is collaborating with her Co-Principal Investigator Harolyn Belcher, MD, MHS, the Family Center's Director of Research and Associate Professor in the Johns Hopkins University School of Medicine.

The five-year study, launched this past September, will run through July 2016. Gross says the goal is to provide better care, with better outcomes, and at a lower cost. "Right now, only a fraction of young children in need of mental health services are getting them. And of those who are getting services, many are not receiving the most effective treatments. This study will help us identify the most cost-effective treatments for helping young children from low-income neighborhoods with serious behavior problems," Gross explains.

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