The process in-between: Parents' perceptions about how practitioners promote the outcomes of the Incredible Years Basic program.

Practitioners are recognized as one of the key components that make parenting interventions meaningful and helpful to families, and the impact of practitioners' skills on the outcomes of parenting interventions has been consistently recognized in research. However, the mechanisms and ongoing processes through which the practitioners' actions and skills may impact parental engagement and other outcomes remain unknown. This qualitative study explored parents' perceptions about the processes through which specific practitioners' skills contribute to the outcomes of the Incredible Years Basic Parent Program (IYPP). Twenty-four Portuguese parents who had completed the IYPP were interviewed in four focus groups, and the data were analyzed through thematic analysis. Practitioners' skills were perceived by parents as having an impact on their engagement in the program, their process of change, and their interpersonal relationships. Practitioners were perceived to demonstrate their influence in the intervention process through six different roles: the roles of a confidant, a positive coach, a partner, a maestro, a tailor, and a congruent person. This study reinforces the prominent role of practitioners in enabling parental outcomes of an evidence-based parenting program and suggests that more attention should be paid to continuing supervision and other professional development processes.

Therapist Factors Matter: A Systematic Review of Parent Interventions Directed at Children's Behavior Problems.

The present review systematically explored research examining the relationship between therapist-related factors and the outcomes of parent interventions directed at children's behavior problems. A systematic search of the literature was conducted with online scientific databases, parenting programs, web sites, and bibliographic references of the selected articles, according to PRISMA guidelines. A total of 24 quantitative studies met the inclusion criteria. Although some methodological limitations were identified with respect to the measurement of therapist factors, the reviewed research strongly suggests that the therapist plays a critical role in parent interventions directed at behavior problems. In particular, many parent outcomes are found to be related to the parent-therapist alliance, the therapist's fidelity to the intervention, specific therapist's in-session actions, and the therapist's personal variables. The parent-therapist alliance and therapist fidelity to the intervention consistently relate to changes in parenting practices, and alliance additionally relates to fewer perceived barriers to participation in treatment, more treatment acceptability, and greater parenting satisfaction and self-efficacy. In addition, specific in-session therapist interpersonal actions relate to parents' engagement and satisfaction, while both the therapist's interpersonal actions and more active skills relate to parent change. Therapist's personal variables have been scarcely or poorly studied to date, but the results found justify the need to develop further research in this area. In conclusion, more attention should be given to the role of the therapist when implementing parenting programs directed at behavior problems, and more and better research is needed that can overcome the methodological limitations identified.

La presente revisión exploró de forma sistemática las investigaciones que examinam la relación entre los factores relacionados con el terapeuta y los resultados de intervenciones para padres de niños con problemas de conducta. Se realizó una búsqueda sistemática de la bibliografía con bases de datos científicas en línea, sitios web de programas de entrenamiento para padres y referencias bibliográficas de los artículos seleccionados, de acuerdo con las pautas de PRISMA. Un total de 24 estudios cuantitativos reunieron los criterios de inclusión. Aunque se identificaron algunas limitaciones metodológicas con respecto a la medición de los factores del terapeuta, la investigación analizada sugiere marcadamente que el terapeuta desempeña un papel crítico en las intervenciones dirigidas a padres de niños con problemas de conducta. En particular, muchos resultados de los padres se encuentran relacionados con la alianza entre los padres y el terapeuta, la fidelidad del terapeuta a la intervención, las acciones específicas del terapeuta dentro de la sesión y las variables personales del terapeuta. La alianza entre los padres y el terapeuta y la fidelidad del terapeuta a la intervención se relacionan constantemente con los cambios en las prácticas parentales, y la alianza además se relaciona con menos obstáculos percibidos para la participación en el tratamiento, una mayor aceptabilidad de lo mismo y una mayor satisfacción y autoeficacia de los padres. Además, las acciones interpersonales específicas del terapeuta dentro de la sesión se relacionan con la participación y la satisfacción de los padres, mientras que tanto las acciones interpersonales del terapeuta como las habilidades más activas se relacionan con el cambio de las praticas parentales. Hasta la fecha, las variables personales del terapeuta se han estudiado poco o deficientemente, pero los resultados encontrados justifican la necesidad de desarrollar la investigación en esta área. Para concluir, se debe prestar más atención al papel del terapeuta a la hora de implementar programas de entrenamiento para padres de niños con problemas de conducta, y se necesitan más y mejores investigaciones que puedan superar las limitaciones metodológicas identificadas.

Do Parents Perceive Practitioners to Have a Specific Role in Change? A Longitudinal Study Following Participation in an Evidence-Based Program.

Little attention has been given to the role of practitioners in evidence-based parenting programs and to the evaluation that parents make of their importance in the process of change. This study aims to explore the role that parents assign to the facilitators of the Incredible Years (IY) program in enabling long-term life changes, as well as the association between parents' evaluation of the practitioners' skills and specific changes perceived after the intervention. In this longitudinal study, we applied 1 survey to 80 community parents who had participated in an IY group 2 years before, and we retrieved archival data to assess changes in parents' ratings of sense of competence and in children's behaviors immediately after the end of the intervention. Two years after the intervention, parents perceived significant improvements, especially in their parenting and their children's behaviors, and they recognized that their IY practitioners had played a significant role in these life changes. Parents who attributed a greater role to the practitioners' skills reported a greater number of improvements in parental sense of competence and in children's behaviors. The practitioners' skills relating more broadly to these specific changes are the practitioners' sensitivity and flexibility towards parents' needs and the practitioners' ability to clearly share knowledge with parents. The practitioner's assigned role when implementing an evidence-based parenting program seems to go far beyond the mere conveyance of the program's specific contents and methods and deserves to be researched further.