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Intervention Summary

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Parenting Management Training - The Oregon Model (PMTO)

Parenting Management Training - The Oregon Model (PMTO) is a theory-based intervention to prevent internalizing and externalizing conduct behaviors and associated problems and promote healthy child adjustment. PMTO provides recently separated single mothers with 14 weekly group sessions to learn effective parenting practices including skill encouragement, limit-setting, problem-solving, monitoring, and positive involvement. PMTO also includes strategies to help parents decrease coercive exchanges with their children and use contingent positive reinforcements (e.g., praise, incentives) to promote prosocial behavior. Topics are presented in an integrated, step-by-step approach and are typically introduced in one or more sessions, then reviewed and revisited throughout the remainder of the program.

Descriptive Information

Areas of Interest Mental health promotion
Outcomes Review Date: October 2006
1: Internalizing behaviors
2: Externalizing behaviors
3: Delinquency
4: Academic functioning
5: Noncompliance with mother's directives
Outcome Categories Crime/delinquency
Education
Family/relationships
Mental health
Social functioning
Violence
Ages 6-12 (Childhood)
18-25 (Young adult)
26-55 (Adult)
Genders Male
Female
Races/Ethnicities American Indian or Alaska Native
Black or African American
Hispanic or Latino
White
Race/ethnicity unspecified
Settings Other community settings
Geographic Locations Urban
Suburban
Implementation History

As of October 2006, implementation of PTC was in its fourth year of a 5-year grant at Utah State University with Spanish-speaking immigrants in one- and two-parent families. The program has already been implemented in three cohorts of families. Findings for this adaptation are expected to be available in 2007. In 2006 the University of Minnesota was also in its fourth year of a 5-year grant to adapt and test the program with Spanglish- and English-speaking Latinas. The Parent Management Training--Oregon Model, the model that provides the principles and methods for PTC, has been implemented in Norway, in Iceland, in three large communities in the Netherlands, and statewide in Michigan. Competent adherence to implementation is being evaluated using the Fidelity of Implementation Rating System, based on direct observation of therapy sessions.

As of 12/1/2014 The name of this program was changed in NREPP to: Parenting Management Training - The Oregon Model (PMTO) as a reult of wanting to capture a fuller description of the program.

NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: Yes
Evaluated in comparative effectiveness research studies: No
Adaptations PMTO has been applied among Latino families with children aged 4-12, with boys and girls in Spanish-speaking one- and two-parent immigrant families, and with Spanglish- and English-speaking single Latina mothers. PMTO also has been employed in Norway, and training is underway for a large-scale dissemination in the Netherlands. An adaptation of the program for use in battered women’s shelters and in low-income housing is currently underway in Minnesota.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Indicated

Quality of Research
Review Date: October 2006

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Beldavs, Z. G., Forgatch, M. S., Patterson, G. R., & DeGarmo, D. S. (2006). Reducing the detrimental effects of divorce: Enhancing the parental competence of single mothers. In N. Heinrichs, K. Hahlweg, & M. Dopfner (Eds.), Strengthening families: Evidence-based approaches to support child mental health (pp. 143-185). Munster, Germany: Psychotherapie-Verlag.

DeGarmo, D. S., & Forgatch, M. S. (2004). Putting problem-solving to the test: Replicating experimental interventions for preventing youngsters' problem behaviors. In R. D. Conger, F. O. Lorenz, & K. A. S. Wickrama (Eds.), Continuity and change in family relations (pp. 267-290). Mahwah, NJ: Erlbaum.

DeGarmo, D. S., & Forgatch, M. S. (2005). Early development of delinquency within divorced families: Evaluating a randomized preventive intervention trial. Developmental Science, 8(3), 229-239.  Pub Med icon

DeGarmo, D. S., Patterson, G. R., & Forgatch, M. S. (2004). How do outcomes in a specified parent training intervention maintain or wane over time? Prevention Science, 5(2), 73-89.  Pub Med icon

Forgatch, M. S., & DeGarmo, D. S. (1999). Parenting through change: An effective prevention program for single mothers. Journal of Consulting and Clinical Psychology, 67, 711-724.  Pub Med icon

Forgatch, M. S., & DeGarmo, D. S. (2002). Extending and testing the social interaction learning model with divorce samples. In J. B. Reid, G. R. Patterson, & J. Snyder (Eds.), Antisocial behavior in children and adolescents: A developmental analysis and model for intervention (pp. 235-256). Washington DC: American Psychological Association.

Forgatch, M. S., Patterson, G. R., DeGarmo, D. S., & Beldavs, Z. G. Nine years and counting: An efficacious delinquency prevention program. Manuscript submitted for publication.

Martinez, C. R., Jr., & Forgatch, M. S. (2001). Preventing problems with boys' noncompliance: Effects of a parent training intervention for divorcing mothers. Journal of Consulting and Clinical Psychology, 69, 416-428.  Pub Med icon

Patterson, G. R., DeGarmo, D., & Forgatch, M. S. (2004). Systematic changes in families following prevention trials. Journal of Abnormal Child Psychology, 32(6), 621-633.  Pub Med icon

Supplementary Materials

Forgatch, M. S., DeGarmo, D. S., & Beldavs, Z. (2005). An efficacious theory-based intervention for stepfamilies. Behavior Therapy, 36(4), 357-365.  Pub Med icon

Forgatch, M. S., Patterson, G. R., & DeGarmo, D. S. (2005). Evaluating fidelity: Predictive validity for a measure of competent adherence to the Oregon Model of Parent Management Training. Behavior Therapy, 36, 3-13.  Pub Med icon

Knutson, N. M., Forgatch, M. S., & Raines, L. A. (2003). Fidelity of implementation rating (FIMP): The training manual for PMTO. Eugene, OR: Oregon Social Learning Center.

Outcomes

Outcome 1: Internalizing behaviors
Description of Measures Indicators of internalizing behaviors included (1) scores on the Child Depression Inventory (CDI), a 27-item symptom-oriented index (sample items include "feel sad," "feel like crying," "things bother you," "feel alone," "others love you"); (2) scores on the Loneliness in Child Scale--Child Report, a 16-item scale of loneliness and dissatisfaction with peer relations (sample items include "lonely in school" and "feel left out"); and (3) teacher reports on adaptive functioning (Teacher Report Form).
Key Findings PMTO participants showed significant decreases in internalizing behaviors at 30 months and 9 years postintervention (p < .05 and p < .10, respectively).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.6 (0.0-4.0 scale)
Outcome 2: Externalizing behaviors
Description of Measures Youth externalizing behavior was a contruct score of three main indicators: (1) teacher ratings of antisocial and delinquent behaviors (Teacher Report Form); (2) observational measures (Structured Interaction Task--SIT) obtained in the laboratory during eight structured interaction tasks, which included mother-son problem-solving discussions; and (3) observational measures of aggression using a measure of physical aversive behaviors.
Key Findings PMTO participants showed significant decreases in externalizing behaviors over time (p < .05).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.4 (0.0-4.0 scale)
Outcome 3: Delinquency
Description of Measures Youth delinquency was assessed at 9-year follow-up using (1) court records obtained by contacting applicable city and State agencies, including cumulative number of arrests at each follow-up wave; and (2) delinquent scores on the Teacher Report Form (TRF), which measures child behaviors over the previous 2 months include stealing, use of drugs or alcohol, and associating with troublemakers.
Key Findings Thirty-six months after the intervention, PMTO participants had lower rates of delinquency than other youth, as measured by teacher reports (p < .05).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.6 (0.0-4.0 scale)
Outcome 4: Academic functioning
Description of Measures Youth academic functioning was assessed using (1) the Woodcock-Johnson Psychoeducational Battery, conducted in the laboratory to measure reading achievement, and (2) the Teacher Report Form (TRF), an adaptive functioning score where teachers were asked to compare the participant to other pupils on four items (e.g., "How much is he learning?", "How hard is he working?").
Key Findings PMTO participants typically produced improved homework quality, which predicted improved adaptive functioning and reading achievement (p < .05). If participants were supported by effective parenting, they also experienced increased school adjustment.
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.8 (0.0-4.0 scale)
Outcome 5: Noncompliance with mother's directives
Description of Measures Youth noncompliance was assessed by (1) a microsocial score computed from the Interpersonal Process Code (IPC), measuring the proportion of child noncompliance following the mother's directive given the total number of directives issued by the mother during the observation period; (2) global ratings of behavior, based on overall observations made directly following scoring on the microsocial behaviors; and (3) Child Interviewer Impressions, a scaled score based on global ratings of noncompliance and consisting of three items: was cooperative during interview, was noncompliant with mother, was noncompliant with interviewer.
Key Findings PMTO participants typically scored lower than other youth in noncompliance (p < .05).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.4 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 6-12 (Childhood)
18-25 (Young adult)
26-55 (Adult)
50% Female
50% Male
86% White
9% Race/ethnicity unspecified
2% American Indian or Alaska Native
2% Hispanic or Latino
1% Black or African American

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Internalizing behaviors 4.0 4.0 3.5 3.0 3.0 4.0 3.6
2: Externalizing behaviors 3.5 3.5 3.5 3.0 3.0 4.0 3.4
3: Delinquency 3.5 3.5 3.5 4.0 3.0 4.0 3.6
4: Academic functioning 4.0 4.0 3.5 3.0 4.0 4.0 3.8
5: Noncompliance with mother's directives 3.0 2.0 3.5 4.0 4.0 4.0 3.4

Study Strengths

The intervention was well described, and acceptable methods were used to establish intervention fidelity and study eligibility criteria. Both the intervention and controls succeeded in engaging and retaining single mothers, and were sufficiently flexible to meet individual and group needs. Secondary analyses provided evidence that the intervention was consistent with the proposed theory. Multiple methods were used to evaluate outcomes, addressing some potentially confounding variables. Most of the assessment measures had high reliability and reports of validity. Missing data were handled with sophisticated methods. Randomization methods were adequately described. The program's other strengths include the longitudinal and cross-sectional multipronged approach to assessment and the cooperation of teachers and other informants across nine measurement points.

Study Weaknesses

The lack of the examination of participation bias limits the generalizability of the study results.

Readiness for Dissemination
Review Date: October 2006

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Forgatch, M., & Rains, L. (n.d.). Marriage and parenting in stepfamilies [Handout].

Forgatch, M., Rains, L., Elgesem, E., & Knutson, N. (2006). A course in the basic PMTO model: Workshops 1, 2, & 3. Eugene, OR: Oregon Social Learning Center/Implementation Sciences International, Inc.

Knutson, N., Forgatch, M., & Rains, L. (2003). Fidelity of implementation rating system (FIMP): The manual for PMTO. Eugene, OR: Oregon Social Learning Center.

Knutson, N., Rains, L., & Forgatch, M. (2006). PMTO modules: Workshop trainer guide. Eugene, OR: Oregon Social Learning Center/Implementation Sciences International, Inc.

Oregon Social Learning Center/Implementation Sciences International, Inc. (2006). A course in the basic PMTO model: Workshops 2 & 3. Parent materials. Eugene, OR: Author.

Parenting Through Change Session Manual [English version]

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
2.8 2.5 3.0 2.8

Dissemination Strengths

Implementation materials are available in several languages, and separate materials for parents in stepfamilies are provided. This program appears to have been implemented in a variety of settings with training provided as part of a research project. A quality intervention fidelity instrument was developed specifically for PMTO.

Dissemination Weaknesses

The Spanish-language implementation and training materials do not appear to have culturally specific modifications, such as parenting information specifically adapted to Latino families. No information is provided on available training, technical assistance, or supervision. Fidelity measures for quality assurance rely on the videotaping of all client sessions, which might be difficult to implement outside a research setting. No process was provided for gathering outcome data or gaining client feedback. Implementation and training materials could benefit from some cultural modifications, such as adding culturally specific parenting information for Latino families within the Spanish materials.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Implementation materials, training, technical assistance/consultation, and quality assurance materials Contact the developer Contact the developer

Additional Information

The estimated cost of the program is $1,000 per participant, based on 10-15 participants per group, with 2 group facilitators conducting 14 sessions. This cost includes (1) recording equipment for supervision and fidelity check, training of group supervisor, and training of group facilitators; (2) user guides, program materials, and training and evaluation materials; and (3) other program expenses (personnel costs for facilitators/group supervisors, monetary incentives for participants, child care costs, meals for mothers and children, transportation cost assistance, reproduction of materials for handouts, DVDs for recording sessions, etc.).

Contact Information

To learn more about implementation or research, contact:
Marion S. Forgatch, Ph.D.
(541) 485-2711
marionf@oslc.org

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.