What Role for Parental Attributions in Parenting Interventions for Child Conduct Problems? Advances from Research into Practice

Abstract

The role of parental attributions in parenting interventions has been the subject of intense interest from clinicians and researchers attempting to optimise outcomes in treatments for children with conduct problems. Despite research articulating the many ways parental attributions can influence behavioural parent training (BPT) outcomes, and recognition that addressing parental attributions in treatment is one of the great challenges faced by BPT practitioners, parenting interventions generally do not provide components that explicitly target or focus on changing problematic parental attributions. In this paper, we ask 'Should parental attributions be included into best practice interventions? If so, how can this be done in a way that improves outcomes without cluttering and complicating the parent training model?' We review the theoretical and empirical status of our understanding of the role of parental attributions in BPT with reference to three questions: 'do pre-treatment parental attributions uniquely predict treatment outcomes'; 'do changes in parental attributions uniquely predict treatment outcomes'; and 'does targeting parental attributions in BPT affect treatment outcomes'. Our review indicates that existing research supports the importance of focussing on parental attributions for some families in order to maximise treatment outcomes. However, clinical processes for doing this are yet to be identified and specified in a way that would allow for manualised replication and scrutiny in research designs. We finish with a discussion of how these clinical and research challenges could be approached.

Keywords: Behavioural parent training; Cognitive behaviour therapy; Conduct problems; Parental attributions; Parental cognition; Parenting; Resistance; Social cognition; Treatment implementation; Treatment outcomes.