Behaviorally Focused Parental Training: A Key Driver to Reducing Stress and Increasing Confidence in Parents

By: Angela Nelson, Ed.D., BCBA

Rear back view mother and daughter embrace sitting on bed at home

Parenting is arguably one of the most challenging jobs. While often rewarding and fun, it can take a toll on our bodies- physically, mentally, and psychologically. Stress, in particular, weighs heavily on parents. During March, 2022, the American Psychological Association (n.d.) assessed stress in the United States and findings suggest parents are one of the most stressed groups. For example, the majority of parents are worried Covid-19 had adverse impacts on their kids’ social, academic, cognitive, emotional, and physical development. Across parent groups, stress levels are especially prevalent and elevated among families raising children with behavioral challenges (Ben-Naim et al., 2019; Woodman et al., 2015).

There can even be a bidirectional relationship between parental stress and child behavioral problems (Woodman et al., 2015). That is, behavioral problems can increase parental stress and parental stress can exacerbate behavioral problems. Therefore, it is critical for parents’ wellbeing, particularly parents raising children with developmental disabilities associated with challenging behaviors, to examine approaches to mitigating stress.

Confidence, Stress, and Motivation

Beyond stress, a lesser discussed topic to examine among parents is self-efficacy. Psychologist Albert Bandura (1982) explained this concept as our belief in our ability to complete a task or achieve a goal. Though not absolute, higher self-efficacy is often linked to higher motivation. As it relates to parenting, if parents are not feeling confident in their abilities to successfully manage challenging behaviors, teach skills their kids are struggling to learn, or navigate the general stressors that come with having children, this can affect their motivation and overall morale.

Studies show that higher levels of self-efficacy can decrease the possibility of feeling stressed (Mo et al., 2021; Shahrour & Dardas, 2020) and increase feelings of being in control (Bandura, 1977). Parents are not just caregivers, but also individuals who need to care for their own needs to parent optimally. Thus, resources for parents should examine not only ways to support their kids but improve their own self-efficacy as well.

Benefits of Parent Training

Research into the best ways to equip parents with tools to raise kids is plentiful. However, not all approaches are created equal. For example, Bearss et al. (2015) compared two models to support parents in addressing their kids’ disruptive behaviors in a 24-week randomized clinical trial. One model was parent education, consisting of 12 sessions where parents received handouts and information about educational planning, developmental changes, current treatment options, etc. The other model was parent training, consisting of 11 sessions where parents learned how to identify why their kids’ behaviors occur, strategies to address behaviors, how to prevent disruptive behaviors, etc. This model utilized role plays, video models, direct instruction, practice, and homework. The researchers found the parent training model to be superior to the parent education model at addressing disruptive behaviors. Successful parent training models extend beyond families raising kids with behavioral challenges as well.

For example, researchers found parent training can be as effective at addressing anxiety in kids as traditional cognitive behavioral therapy (Lebowitz et al., 2020). Providing parents not just with information in a passive learning format but giving them time to practice specific strategies with progress tracking and feedback is both an efficacious model and one with high parental satisfaction (Tsami et al., 2019).

Researchers and clinicians build upon the successes seen from parent training models to specifically target parental stress and self-efficacy (Ben-Naim et al., 2019; Heath et al., 2015). Not only did Heath et al. (2015) find their behavioral parent training led to improvements in both parental stress and self-efficacy, but they posed important linkages among training, stress, and self-efficacy. For example, stress and self-efficacy levels will likely influence parents’ ability to maintain the recommendations from the training after it ends.

Also, since self-efficacy is related to motivation to start and persist with tasks, training that addresses self-efficacy can help parents push through when parenting becomes particularly difficult. Parenting stress can decrease as they learn skills and are more confident in their abilities to manage challenging behaviors. As kids’ behaviors improve, this creates a positive cycle for both kids and parents.

RethinkCare’s Focus

At RethinkCare, we place a large emphasis on empowering parents to build sustainable practices at home through behavioral parent training. Kids’ time with teachers and therapists is unbelievably valuable but it is critical to elevate the focus on parents’ needs to see maximum gains. Live consultations with Board Certified Behavior Analysts (BCBAs) using role plays, rehearsal, breaking skills down, modeling, positive reinforcement, and progress tracking are central to moving parents beyond passive learning to behavioral change.

RethinkCare is dedicated to helping parents see results not only with their children but within themselves as well. Two assessments- The Parental Stress Scale (Berry & Jones, 1995) and The Parenting Sense of Competence Scale (Gibaud-Wallston & Wandersman, 1978)- were adapted and implemented to help assess change in parental stress and self-efficacy.

This effort is part of our ongoing commitment to assess outcomes and use data-based decisions to continuously improve our program. To learn more about RethinkCare and how it can benefit you, request a demo today.

References

American Psychological Association. (n.d.). Stress in America.

Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological Review84(2), 191.

Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist37(2), 122.

Bearss, K., Johnson, C., Smith, T., Lecavalier, L., Swiezy, N., Aman, M., McAdam, D.B., Butter, E., Stillitano, C., Minsha­wi, N., Sukhodolsky, D.G., Mruzek, D.W., Turner, K., Neal, T., Hallett, V., Mulick, J.A., Green, B., Handen, B., Deng, Y., Dziura, J., Scahill, L. (2015). Effect of Parent Training vs Parent Education on Behavioral Problems in Chil­dren With Autism Spectrum Disorder. A Randomized Clinical Trial. JAMA, 313(15):1524-1533.

Ben-Naim, S., Gill, N., Laslo-Roth, R., & Einav, M. (2019). Parental stress and parental self-efficacy as mediators of the association between children’s ADHD and marital satisfaction. Journal of Attention Disorders, 23(5), 506-516.

Berry, J. O., & Jones, W. H. (1995). The parental stress scale: Initial psychometric evidence. Journal of Social and Personal Relationships, 12(3), 463-472.

Gibaud-Wallston, J., & Wandersman, L. P. (1978). Parenting sense of competence scale. Canadian Journal of Behavioural Science.

Heath, C. L., Curtis, D. F., Fan, W., & McPherson, R. (2015). The association between parenting stress, parenting self-efficacy, and the clinical significance of child ADHD symptom change following behavior therapy. Child Psychiatry & Human Development46, 118-129.

Lebowitz, E. R., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W. K. (2020). Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child & Adolescent Psychiatry, 59(3), 362-372.

Mo, Y., Deng, L., Zhang, L., Lang, Q., Pang, H., Liao, C., … & Huang, H. (2021). Anxiety of Nurses to support Wuhan in fighting against COVID‐19 Epidemic and its Correlation With Work Stress and Self‐efficacy. Journal of Clinical Nursing30(3-4), 397-405.

Shahrour, G., & Dardas, L. A. (2020). Acute stress disorder, coping self‐efficacy and subsequent psychological distress among nurses amid COVID‐19. Journal of Nursing Management28(7), 1686-1695.

Tsami, L., Lerman, D., & Toper‐Korkmaz, O. (2019). Effectiveness and acceptability of parent training via telehealth among families around the world. Journal of Applied Behavior Analysis52(4), 1113-1129.

Woodman, A. C., Mawdsley, H. P., & Hauser-Cram, P. (2015). Parenting stress and child behavior problems within families of children with developmental disabilities: Transactional relations across 15 years. Research in Developmental Disabilities, 36, 264-276.

About the Author

Black and white headshot of Angela Nelson

Angela Nelson, Ed.D., BCBA

Executive Director, Clinical Services

Dr. Angela Nelson is the Vice President of Operations & Executive Director of Clinical Services for RethinkCare. Dr. Nelson oversees RethinkCare’s consultation services and content generation for the Parenting and Professional solutions. She began at Rethink in 2011 and specializes in working with parents raising children and teens with learning, social, and behavioral challenges, as well as organizations motivated to expand their neurodiversity efforts. Dr. Nelson holds a doctorate in education from the University of Southern California (USC), master’s degree in counseling from California State University, Northridge, a bachelor’s degree in psychology from UCLA, and is a Board Certified Behavior Analyst (BCBA).

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