Internet-based Parent Training with Telephone Coaching on Managing Disruptive Behavior in Children During The COVID-19 Pandemic (Preprint)

Abstract

There is growing concern about the short-term and long-term impact that the COVID-19 pandemic will have on the mental health and psychosocial well-being of children and families. There are no existing studies about feasibility and outcomes using Internet-based Parent training programs with telephone coaching for disruptive behavioral problems in childhood during COVID-19 pandemic in clinical settings.

This study explored how the Strongest Families Smart Website (SFSW) parent training program, with telephone coaching, provided support during COVID-19 pandemic at specialist family counselling centers in Helsinki, when restrictions made face-to-face counselling impossible. This study followed the success of an RCT and its implementation study of the SFSW parent training program by primary care child health clinics. The aim was to improve parenting skills, so that they could tackle disruptive behavior by developing positive parent-child relationships. It started in May 2020, when the COVID-19 pandemic was at its height in Finland.

Eight family counselling centers in Helsinki, Finland, identified 50 referrals aged 3-8 years with high levels of parent-reported disruptive behavioral problems. Child psychopathology and functioning and parental skills and well-being were measured at baseline, post-treatment and six months later using a range of tools. The data were extracted from questionnaires completed by the parents.

We found that 44 (88%) families completed the whole 11 session parent training program. Most of the children (96%) had definitive or severe behavioral problems when they were initially screened by the centers, but this dropped to 58% at the six-month follow-up assessment. There were significant changes from baseline to 6 month follow up in most of the child psychopathology measures, including CBCL externalizing score (change in mean score 16.3, 95% Cl 10.2 to 22.3; P <.001) and total score (7.0, 95% Cl 4.9 to 9.0; P<.001). When parenting skills were measured with the Parenting Scale, they showed significant changes from baseline to six-month follow-up in total scores (0.5, 95% Cl 0.4 to 0.7; P<.001). Parents showed significant change in stress sub score (3.9, 95% Cl 2.2 to 5.6; (P<.001). They reported high satisfaction, varying from 93.3%-97.8%, in the skills and professionalism of the telephone coaches.

The program proved to be an effective method for improving parenting skills and child psychopathology and functioning. The parents were very satisfied with the program and the drop-out rate was exceptionally low. The study shows that the training program could be implemented in specialist clinical settings and during crisis conditions like the COVID-19 pandemic.