Vol.:(0123456789) 1 3
Child Psychiatry & Human Development
https://doi.org/10.1007/s10578-020-01028-y
ORIGINAL ARTICLE
Parent Management Training Oregon Model and Family‑Based
Services as Usual for Behavioral Problems in Youth: A National
Randomized Controlled Trial in Denmark
Christofer Scavenius
1
· Anil Chacko
2
· M. R. Lindberg
3
· Megan Granski
2
· M. M. Vardanian
2
·
Maiken Pontoppidan
1
· Helle Hansen
1
· Misja Eiberg
1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
This randomized control trial used intent-to-treat analyses to compare parent management training—Oregon model (PMTO)
(N = 64) to family-based services as usual (SAU) (N = 62) in 3.5–13-year-old children and their families in Denmark. Out-
comes were parent report of child internalizing and externalizing problems, parenting efcacy, parenting stress, parent sense
of coherence, parent-report of life satisfaction, and parental depressive symptoms. Outcomes were measured at pretreatment,
post-treatment, and 18–20 months post-treatment. Results demonstrated that both PMTO and family-based SAU resulted
in signifcant improvements in child externalizing and internalizing problems, parenting efcacy, as well as parent-reported
stress and depressive symptoms, life satisfaction, and aspects of sense of cohesion. Efect sizes at post-treatment and follow-
up were in the small to moderate range, consistent with prior PMTO evaluations. However, there were no signifcant difer-
ences between PMTO and family-based SAU. Further research on the process and content of family-based SAU is needed
to determine how this approach overlaps with and is distinct from PMTO.
Keywords Parent management training—Oregon model (PMTO) · Behavioral parent training · Children · Behavior
problems · Efectiveness
Introduction
Parent management training—Oregon model (PMTO) [1] is
a specifc brand of what are generally referred to as behavio-
ral parent training (BPT) interventions [2]. BPT approaches
integrate theory, research and practice on family interaction
and child behavior [1, 2]. BPT is based on operant condi-
tioning and social learning theory [3], which emphasizes the
child’s social environment and reinforcement contingencies
that shape both challenging and prosocial behaviors [1, 4].
Challenging parent–child interactions occur in all families;
however, in well-functioning families, parents teach children
to resolve conficts using positive means such as humor and
negotiation [5, 6]. In less well-functioning families, however,
children’s problematic behavior is learned through modeling
of parent’s aversive behaviors (e.g., arguing, aggression) as
well as negative reinforcement (removal of parental requests
to perform undesired behavior) during compliance interac-
tions. Through social learning, operant conditioning and
repeated coercive cycles [1, 4], harsh, punitive and aggres-
sive behavior patterns are formed in children, maintained,
and over time these behaviors tend to generalize from the
family setting to other social settings (e.g., school and peer
contexts) [3, 7].
PMTO is an evidence-based psychosocial intervention for
the treatment of child behavioral challenges, targeting spe-
cifc parenting practices to reduce negative coercive cycles
between parents and their child. PMTO focuses on teaching
parents proactive, non-punitive methods to address, pre-
vent, and reduce challenging behavior in their child. PMTO
has a long-standing and robust history as an intervention
Electronic supplementary material The online version of this
article (https://doi.org/10.1007/s10578-020-01028-y) contains
supplementary material, which is available to authorized users.
* Anil Chacko
anil.chacko@nyu.edu
1
VIVE – The Danish Center for Social Science Research,
Copenhagen, Denmark
2
New York University, New York, NY, USA
3
Aalborg University, Aalborg, Denmark