LARGE GROUP COMMUNITY-BASED PARENTING PROGRAMS FOR FAMILIES OF PRESCHOOLERS AT RISK FOR DISRUPTIVE BEHAVIOR DISORDERS - UTILIZATION, COST-EFFECTIVENESS, AND OUTCOME

A significant percentage of children with disruptive behaviour disorde rs do not receive mental health assistance. Utilization is lowest amon g groups whose children are at greatest risk. To increase the availabi lity, accessibility, and cost efficacy of parent training programs, th is prospective randomized trial compared a large group community-based parent training program to a clinic-based individual parent training (PT) program. All families of junior kindergartners in the Hamilton pu blic and separate school boards were sent a checklist regarding proble ms at home. Those returning questionnaires above the 90th percentile w ere block randomly assigned to: (I) a 12-week clinic-based individual parent training (Clinic/Individual), (2) a 12-week community-based lar ge group parent training (Community/Group), or (3) a waiting list cont rol condition. Immigrant families, those using English as a second lan guage, and parents of children with severe behaviour problems were sig nificantly more liklely to enrol in Community/Groups than Clinic/Indiv idual PT. Parents in Community/Groups reported greater improvements in behaviour problems at home and better maintenance of these gains at 6 -month follow-up. A cost analysis showed that,with groups of 18 famili es, Community/Groups are more than six times as cost effective as Clin ic/Individual programs.