The Oregon Model of Behavior Family Therapy: From Intervention Design to Promoting Large-Scale System Change

Abstract

This paper reviews the evolution of the Oregon model of family behavior therapy over the past four decades. Inspired by basic research on family interaction and innovation in behavior change theory, a set of intervention strategies were developed that were effective for reducing multiple forms of problem behavior in children (e.g., Patterson, Chamberlain, & Reid, 1982). Over the ensuing decades, the behavior family therapy principles were applied and adapted to promote children's adjustment to address family formation and adaptation (Family Check-Up model), family disruption and maladaptation (Parent Management Training-Oregon model), and family attenuation and dissolution (Treatment Foster Care-Oregon model). We provide a brief overview of each intervention model and summarize randomized trials of intervention effectiveness. We review evidence on the viability of effective implementation, as well as barriers and solutions to adopting these evidence-based practices. We conclude by proposing an integrated family support system for the three models applied to the goal of reducing the prevalence of severe problem behavior, addiction, and mental problems for children and families, as well as reducing the need for costly and largely ineffective residential placements.

Keywords: developmental models; parent training; peers; prevention; treatment foster care.

FIGURE 1

The Cascade Model. Developmental outcomes of early problem behavior and family management as a countervailing force.

FIGURE 2

Innovations of behavioral parenting interventions addressing family disruption and reformation.

FIGURE 3

Towards a cost-effective, coordinated, comprehensive community support system for children and families.