Sheila M. Eyberg

Evidence-Based Psychosocial Treatments for Children and Adolescents With Disruptive Behavior

This article reviews the literature from 1996 to 2007 to update the 1998 Brestan and Eyberg report on evidence-based psychosocial treatments (EBTs) for child and adolescent disruptive behavior, including oppositional defiant disorder and conduct disorder. Studies were evaluated using criteria for EBTs developed by the task force on promotion and dissemination of psychological procedures (Chambless et al., 1998; Chambless et al., 1996). Sixteen EBTs were identified in this review, up from 12 in the earlier report, and 9 “possibly efficacious” treatments (Chambless & Hollon, 1998) were identified as well. This article describes the EBTs and their evidence base and covers research on moderators and mediators of treatment outcome, as well as the clinical representativeness and generalizability of the studies. Best practice recommendations from the current evidence base also are offered, as well as calls for future research that increases understanding of the moderators and mechanisms of change for children and adolescents with disruptive behavior disorders.

Assessment of child behavior problems: The validation of a new inventory

Abstract This paper presents initial validation data for a behavioral inventory of child conduct problems. The 36‐item Eyberg Child Behavior Inventory (ECBI) was completed by mothers of two‐ to seven‐year‐old children from several samples of problem and non‐problem behavior children. Results from this study indicated the usefulness of the ECBI in discriminating between problem and non‐problem children, for purposes of evaluation; provided data on the non‐problem child as a guideline in defining reasonable therapeutic goals; and demonstrated the ability of the ECBI to reflect the change following treatment intervention.

The standardization of an inventory of child conduct problem behaviors

Abstract This study presents the standardization data for a brief behavioral inventory of child conduct problem behaviors. The 36 item Eyberg Child Behavior Inventory (ECBI) was completed by the parents of 512 children (56% boys) ages 2 to 12. The psychometric characteristics of ECBI indicated that it is a reliable (.86 to .98) and valid instrument whose normally distributed scale is sensitive to a broad range of behavioral variability on the conduct problem dimension. Boys were reported to evidence more conduct problems than girls (p < .001; and mothers consistently reported more problem behaviors than fathers (p < .001). The relative consistency of ECBI scores across ages suggested that a conduct disorder is independent of stages in the childs development. It was suggested that conduct problem behavior is a manifestation of the interaction between the parent and child. The ECBI provides a psycho‐metrically sound parent‐report instrument to be used as an adjunct to observational methods in the treatment...

Parent-Child Interaction Therapy with Behavior Problem Children: One and Two Year Maintenance of Treatment Effects in the Family

ABSTRACT Parent-Child Interaction Therapy (PCIT) is an empirically supported treatment for conduct-disordered young children in which parents learn the skills of child-directed interaction (CDI) in the first phase of treatment and parent-directed interaction (PDI) in the second. This study examined the long-term treatment outcome for 13 families who had participated in a treatment study examining the effects of treatment phase sequence one and two years earlier. Seven families were in the CDI-First treatment group and six families were in the PDI-First group. Immediately after treatment, 11 of the 13 families had achieved clinically significant changes on both observational and parent report measures, and there is no significant difference between treatment groups. Treatment effects were maintained at one-year follow-up for eight of the 13 families, and at two-year follow-up for nine families, with no long- term impact of phase sequence evident at either follow-up assessment. This study represents the first long-term follow-up of families treated with PCIT. Results suggest that this treatment may be successful in achieving long-term gains for most families of conduct-disordered preschoolers and that phase sequence has little impact on treatment outcome.

Parent and Teacher SNAP-IV Ratings of Attention Deficit Hyperactivity Disorder Symptoms: Psychometric Properties and Normative Ratings from a School District Sample.

To examine Swanson, Nolan, and Pelham—IV (SNAP-IV) psychometric properties, parent (N = 1,613) and teacher (N = 1,205) data were collected from a random elementary school student sample in a longitudinal attention deficit hyperactivity disorder (ADHD) detection study. SNAP-IV reliability was acceptable. Factor structure indicated two ADHD factors and an oppositional defiant disorder (ODD) factor. Parent and teacher scores varied by gender and poverty status (d = .49-.56) but not age; only teacher scores varied by race (d = .25-.55). Screening and diagnostic utility was evaluated with likelihood ratios (LRs) and posttest probabilities. Parent SNAP-IV scores above 1.2 increased probability of concern (LR > 10) and above 1.8, of ADHD diagnosis (LR > 3). Teacher hyperactivity/impulsivity scores above 1.2 and inattention scores above 1.8 increased probabilities of concern only (LR = 4.2 and >5, respectively). Higher teacher scores for African American children and race differences in measurement models require future study.

Parent‐child interaction training: Effects on family functioning

Parent‐child interaction training was designed for the treatment of disturbed preschool children and their families. This paper describes the treatment and its effects on seven referred children, their untreated siblings, and the psychological functioning of their parents using multiple process and outcome measures. High rates of attendance, home practice, cooperation, and satisfaction with treatment; significant pre‐ to post‐treatment changes in child and sibling behavior; and improvement in parental adjustment were found. Results suggest that one can alter parent‐child interaction patterns during a brief intervention so that family members are better able to interrelate and to deal effectively with problems.

Parent-Child Interaction Therapy for Disruptive Behavior in Children with Mental Retardation: A Randomized Controlled Trial

This article presents results of a randomized controlled trial examining the efficacy of Parent–Child Interaction Therapy (PCIT) for treating disruptive behaviors of young children (ages 3 to 6) with mental retardation (MR) and comorbid oppositional defiant disorder. Thirty families were randomly assigned to an immediate treatment (IT) or waitlist (WL) control group. Results indicated that IT mothers interacted more positively with their children after treatment than WL mothers, and their children were more compliant after treatment. On parent-report measures, IT mothers reported fewer disruptive behaviors at home and lower parenting stress related to difficult child behavior than WL mothers after treatment. Whether evidence-based treatments for disruptive behavior require modification before application to children with MR is discussed.

Father Involvement in Parent Training: When Does It Matter?

We examined the impact of father involvement on treatment. Participants were 107 families enrolled in parent-child interaction therapy (PCIT), including 56 involved-father (IF) families, 16 uninvolved-father (UF) families, and 35 absent-father (AF) families. All groups showed improvements during treatment to within the average range on the Eyberg Child Behavior Inventory (ECBI), although mothers from AF families reported better treatment outcome than mothers from IF families. Improvements occurred on the Beck Depression Inventory (BDI) and the Parenting Stress Index (PSI) as well, but there were no group differences. At a 4-month follow-up, mothers in IF families maintained treatment gains on the ECBI. In contrast, mothers in AF families reported significant decline at follow-up, although their scores remained within the normal range. Results suggest that father participation in treatment may not affect immediate treatment outcome but may help to maintain the beneficial effects of PCIT.

Parent-child interaction therapy: New directions in research

Parent-Child Interaction Therapy (PCIT) is a short-term, evidence-based parent training program for families with 2- to 6-year-old children experiencing behavioral, emotional, or family problems. Based on both attachment theory and social learning theory, PCIT research has provided evidence of efficacy, generalization, and maintenance. The new directions in PCIT research are highlighted in this article.

Outcomes of Parent-Child Interaction Therapy: A Comparison of Treatment Completers and Study Dropouts One to Three Years Later

ABSTRACT Using a quasi-experimental design, this study examined longitudinal outcomes for families previously enrolled in a study of Parent-Child Interaction Therapy (PCIT), a treatment program for young children with disruptive behavior disorders. Comparisons were made between 23 families who completed treatment and 23 families who dropped out of the study before completing treatment, using a structured diagnostic interview, and several parent-report measures. Length of follow-up for both groups ranged from 10 to 30 months after the initial assessment, with the average length of follow-up just under 20 months. Results indicated consistently better long-term outcomes for those who completed treatment than for study dropouts. These results highlight the need to identify salient predictors of treatment engagement and retention to maximize outcomes for young children.