Rural children referred for conduct problems: evaluation of a collaborative program

Abstract

Rural families can find it difficult to access mental health treatment for children’s conduct problems. The current program was designed to provide immediate assistance to families who faced extended waiting times in the south-eastern region of South Australia. In this collaborative project, a primary care professional delivered a telephone-guided version of a clinically based parent training program (Barkley’s Defiant Children) with program support from mental health services. The 12-week trial included 29 children aged 2–12 years who were referred for disruptive behaviour, attention-deficit hyperactivity and learning difficulties. Children were randomised to either a parent training group or a waiting list control group. Parents in the training program were generally satisfied (Therapy Attitude Inventory overall rating = 4.3 measured on a 5-point Likert scale). The main behavioural measure showed significantly better outcomes for the training program (Eyberg Child Behaviour Inventory (ECBI): Intensity scale (F1,27 = 11.39, P < 0.01) and Problem scale (F1,27 = 11.64, P < 0.01). For the parent training group, the mean score for the ECBI Intensity scale was reduced from above the clinical cut-off before treatment to below the cut-off after treatment. The effect sizes were 0.45 for the ECBI Intensity scale and 0.31 for the ECBI Problem scale. This suggests that the Defiant Children parent training can be adapted successfully for use by primary care professionals.