Dr. Chloe Zachary, is our post-doctoral fellow specializing in coaching
caregivers to more effectively respond to challenging behaviors in youth.
We sat down with Chloe Zachary, PhD, the TAP Clinic’s post-doctoral fellow who has particular expertise in Behavioral Parent Training. We asked her 5 basic questions to better understand Behavioral Parent Training and how it can help parents whose children’s behaviors are getting more and more out of control.
Q: What is Behavioral Parent Training?
A: Behavioral Parent Training (BPT) is a broad term for a range of treatments designed to help caregivers manage challenging child and adolescent behaviors. At its core, BPT teaches caregivers how to increase desired behaviors in youth with positive reinforcement or praise. This could range from behaviors such as using “gentle hands” and an “inside voice” in younger children to cleaning one’s room independently and speaking respectfully in teens. Simultaneously, BPT assists caregivers in identifying how to respond to behaviors they would like to see less of from children and teens. Common targets range from behaviors as small as whining or being annoying to siblings to more severe behaviors such as physical aggression, self-harm and substance use. Effective caregiver responses may vary from intentionally ignoring behavior to using thoughtful, planned out consequences.
Q: Does it mean “I’m not a good parent” if I am referred for BPT?
A: Absolutely not! Parenting is one of the toughest jobs out there and comes with no guidebook. Some youth are simply more prone to challenging behaviors than others, and understanding the unique needs of your child in the context of your family is an effortful process. What works for one family may not work for another, and what worked for one child may not work for their sibling. BPT helps caregivers identify more effective ways of managing and responding to youth by carefully assessing the unique factors that caregivers and youth bring to the table.
Furthermore, teaching caregivers how to manage their children’s behavior is simply one of the most effective ways to intervene. Based on research, BPT is the standard-of-care treatment for young children with disruptive behaviors, such as defiance, attention-seeking, aggression and hyperactivity (Chorpita et al., 2011). In fact, completing BPT prior to pharmacological treatments (i.e., stimulant medications) for children with ADHD has been found to produce better outcomes at both school and home than simply starting with medication (Pelham et al., 2016).
Q: If my child already has an individual therapist, why would I benefit from BPT?
A: Even when youth are old enough to engage in individual therapy, intervening on the family system generally leads to greater improvements across the board. BPT helps caregivers better understand their child’s symptoms and the function of his or her behaviors, which allows parents to support the work that the youth is doing in individual therapy. Given that youth typically only spend 50 minutes a week with their individual therapist, caregivers play an essential role in generalizing their child’s treatment into everyday life. For example, when treating anxiety in youth, educating parents is critical to ensure the home environment is not accidentally helping children avoid situations that make them anxious. While this avoidance may reduce distress for both caregivers and youth in the short term, it actually makes anxiety worse in the long run. BPT teaches parents not only how to effectively coach their children to manage their anxiety and face their fears but also how to manage their own distress in the process. Educating caregivers in this way empowers parents to more effectively respond to challenging youth behavior as it evolves – even after therapy has ended.
Q: Parenting approaches are so personal, why would I want another person to tell me what to do?
A: BPT is based on the assumption that while the therapist has expertise in child psychology and behavioral principles, caregivers are the experts on their child and their family. Thus, this work is highly collaborative and is tailored to each family unit. Every family has their own set of values and expectations that guide their approach to parenting, shaped by a range of factors such as culture, religion, and personal history. In BPT, your therapist will work with you to identify how you might adapt parenting recommendations in a way that feels consistent with your family’s values. While your therapist will help you consider the implications of various choices, ultimately caregivers decide how to apply this guidance.
Additionally, navigating challenging youth behaviors is tricky and is typically stressful for caregivers. It is incredibly common for these behaviors to impact individual caregivers in different ways and for caregivers to have different opinions regarding the best ways to respond. Working with a neutral third party helps caregivers learn the most effective response based on your therapist’s clinical expertise. Not only can this decrease conflict between caregivers, but also allow caregivers to respond consistently and in a unified manner to youth behavior.
Q: What does BPT look like in action?
A: BPT at TAP is short-term treatment that helps parents learn the principles of behavior management, validation and communication strategies, and how to establish a behavioral contract and reward system. The mechanics of BPT vary based on a number of factors, including your child’s age, presenting problems and caregiver preferences. It is highly recommended that all adults who regularly care for the youth participate in BPT. When this is not possible, your BPT therapist will coach the participating party in how to share the information with other caregivers.
AT TAP, BPT services are based on a number of evidence-based programs, including Helping the Noncompliant Child (McMahon & Forehand, 2005), Defiant Teens, 2nd edition (Barkley, 2014), and DBT with Suicidal Adolescents (Miller, Rathus, & Linehan, 2006). For younger children, BPT often involves having the child present in sessions to live-coach caregivers in responding to youth. For older youth, BPT is typically conducted with parents only, with youth brought into session as needed.