Preventing Problems Among Children of Substance Abusers

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DESCRIPTION (provided by applicant): The aim of this R21 project is to develop and pilot test an intervention to improve parenting and family communication skills among substance-abusing parents, thereby reducing the risk of poor outcomes among their children. Children of substance abusers are at risk for conduct problems. Parent training is effective in reducing children's conduct problems, but parental substance abuse predicts poor outcomes in parent training trials. These findings suggest that parent training alone is less effective for substance abusing parents and that innovative strategies will be necessary for this population. This project will extend findings from Dr. Stanger's current epidemiologic research indicating that relations between parental substance abuse and children's outcomes are mediated by parental psychopathology, family conflict, and parenting problems. We will develop a new intervention integrating Webster-Stratton's empirically validated parenting treatment for conduct problems with an incentive-based, contingency-management intervention for substance dependent parents. We hypothesize that incentives will enhance compliance with the parenting intervention (daily monitoring of parenting and children's behavior, completion of between-group homework assignments) and increase treatment strength and retention (number of sessions attended, number of families completing treatment). Forty mothers with substance abuse histories and their partners will be randomly assigned to either: (1) behavioral parent training plus contingency management, or (2) parent training without contingency management. PTI and PT groups will be randomly assigned to receive either immediate or delayed treatment. Primary outcome measures will include: positive and negative parenting, family problems, and children's aggressive and delinquent behavior. We will also assess important mediators of treatment outcome, including parent substance use and psychopathology. An innovative telephone computer assisted interview system will collect daily ratings of parenting and children's aggressive and delinquent behavior in order to test the impact of daily variations in parenting on children's conduct problems. This study will provide an initial test of the efficacy of an innovative multicomponent intervention targeting parenting in a high-risk sample of substance abusing parents. Findings will advance understanding of developmental psychopathology by linking epidemiologic research on relations between parenting and children's problems to intervention research.