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Program Profile: GenerationPMTO (Parent Model Training Oregon)

Evidence Rating: Promising - More than one study Promising - More than one study

Date: This profile was posted on May 21, 2018

Program Summary

This is a parent-training program for parents who have gone through a recent marital separation and for their families. The program is rated Promising. The program was found to have a statistically significant effect on reducing measures of youths’ delinquency, arrests, and problem behaviors and improving measures of parenting skills. There was no effect, however, on parents’ use of appropriate discipline.

Program Description

Program Goals/Target Population
GenerationPMTO (Parent Model Training Oregon), formerly known as Parent Management Training–Oregon Model, targets parents who have gone through a recent marital separation and their families. The program is designed to prevent the development of conduct problems and a variety of correlated and theoretically related problem behaviors in youths, including academic difficulties, association with deviant peers, delinquency, early substance use, and early sexual behavior. The program aims to prevent youths’ antisocial and problematic behaviors by teaching family-management skills and promoting positive-parenting practices.
 
Program Components
The program consists of parent-training interventions that can be implemented in various family contexts, including two-parent, single-parent, re-partnered, grandparent, and foster families and in settings such as clinics, homes, schools, and community centers. The five parenting practices comprising the foundation of GenerationPMTO are 1) skill encouragement, 2) limit setting, 3) monitoring, 4) problem solving, and 5) positive involvement. 
 
The program consists of 14 sessions of parent group meetings held weekly. In Session 1, Working Through Change, parents are introduced to each other and to the program. Session 2, Encouraging Co­operation, teaches parents to provide children with effective directions (e.g., clear, firm, and respectful) to increase compliance. Session 3, Teaching Through Encouragement, details ways to promote prosocial behavior (e.g., cooperation, schoolwork, and chores) with skillful teaching techniques and contingent positive reinforcement.  
In Sessions 4 and 5 (Setting Limits and Following Through, respectively), parents learn noncoercive discipline strategies (e.g., timeout, work chores, and privilege removal). Sessions 6 and 12 (Promoting School Success and Building Skills, respectively) emphasize the use of positive involvement and reinforcement for school-related and other prosocial behavior (e.g., regular study, practice times). Session 7, Communicating With Children, teaches communication skills. 
 
Sessions 8 and 9 (Observing Emotions and Managing Emotions, respectively) focus on parents’ own emotional experiences and those of others. Session 10, Problem Solving, teaches specific skills for negotiating and resolving interpersonal problems. Strategies learned in the prior three sessions are applied in Session 11, Managing Conflict, which emphasizes ways to deal with conflict situations with adults (e.g., ex-spouses and coworkers) and with children. Session 13, Monitoring Children's Activities, introduces ways to track children while they are away from home (e.g., at school, with friends, and at child care). Finally, Session 14, Balancing Work and Play, reviews the entire curriculum and emphasizes the value of maintaining an adult life (Forgatch and DeGarmo 1999).  
In addition, the program has been adapted for use in Central America and is called Nuestras Familias. It was also shortened to include 12 instead of the original 14 sessions. Of the 12 sessions, Sessions 2, 4, and 6–11 were culturally adapted; however, their program content stayed largely the same since they are considered core components of the original GenerationPMTO program. Nuestras Familias, also added the following sessions to the original GenerationPMTO program: Session 1 (Strong Latino Roots), Session 3 (Our Many Roles in the Family), Session 5 (Bridging Cultures), and Session 12 (Dealing with Obstacles on the Road to Success).
 
Program Theory
GenerationPMTO is based on social interaction learning theory and eco-developmental theory. Social-interaction learning theory states that the moment-to-moment behaviors that occur between parents and children are the key mechanisms through which children are trained in basic “overt” problem behaviors, such as noncompliance and defiance. Behavioral patterns marked by such behaviors are thought to be refined and expanded in interactions the child has outside the home, both at school and with peers (Reid, Patterson, and Snyder 2002). The program incorporates this theory through helping families target youth problem behaviors. 
 
Eco-developmental theory (Szapocznik and Coatsworth 1999) expands on social interaction learning theory and focuses on the interrelationship across the following four interacting systems and their relationship to youth problem behaviors: 1) macrosystems, (e.g., cultural and societal values); 2) exosystems, (e.g., parents’ social support); 3) mesosystems (e.g., parental monitoring of peers), and 4) microsystems (e.g., family, school, and peers). Eco-developmental theory is incorporated through sessions that deal with each system (e.g., cultural pride, parental functioning, and school success).

Evaluation Outcomes

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Study 1
Teacher Ratings of Delinquency (Average TRF Levels) 
Forgatch and colleagues (2009) found that teacher ratings of delinquency were lower for boys enrolled in the GenerationPMTO (Parent Model Training Oregon) program, compared with boys not enrolled in the program. This finding was statistically significant.
 
Average Levels of Police Arrest
Similarly, boys enrolled in the PTMO program had lower average arrests over time, compared with boys not enrolled in the program. This finding was statistically significant.
 
Study 2
P-CBCL Aggression
Martinez and Eddy (2005) found that children in the Nuestras Familias program scored better on the Parent-Child Behavior Checklist (P-CBCL), indicating less aggression at follow up, compared with children who were not enrolled in the program. This finding was statically significant.
 
P-CBCL Externalizing Behavioral Problems
Program participants also displayed fewer externalizing behavioral problems than nonparticipants. This finding was statistically significant.
 
Overall Effective Parenting
Parent participants showed greater frequency in applying overall effective parenting strategies. This finding was statistically significant.
 
General Parenting
Parent participants showed greater frequency in applying general parenting strategies. This finding was statistically significant.
 
Appropriate Discipline
There were no statistically significant differences between parent participants and nonparticipating parents on measures of appropriate discipline.
 
Skill Encouragement
Parent participants scored higher on the skill encouragement scale indicating that they were more likely to apply skill encouragement to their children, compared with nonparticipating parents. This finding was statistically significant.
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Evaluation Methodology

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Study 1
Forgatch and colleagues (2009) used a randomized controlled trial to test the effectiveness of the GenerationPMTO (Parent Model Training Oregon) program on measures of delinquency. This evaluation is a 9-year follow up to the 1999 study by Forgatch and DeGarmo. The sample comprised 238 recently separated single mothers and their sons residing in a medium-sized city in the Pacific Northwest. Families were randomly assigned to receive the PTMO program (n=153) or to serve as the no-intervention comparison (n=85). Unequal group assignment was used to provide sufficient sample size within the experimental condition to examine potential full implementation intervention effects.
 
Mothers in eligible families 1) had been separated from their partners within the prior 3 to 24 months, 2) resided with a biological son in grades 1 through 3, and 3) did not cohabit with a new partner. The average age of mothers and sons at baseline was 34 years and 7.8 years, respectively. The racial/ethnic composition of the boys was 86 percent white, 1 percent African American, 2 percent Latino, 2 percent Native American, and 9 percent from other racial/ethnic groups, including those belonging to more than one group. Seventy-six percent of the families received public assistance. Most mothers were classified within the lower and working-class ranges in terms of occupation: 32 percent unskilled, 21 percent semiskilled, 23 percent clerical/skilled, 22 percent minor professional to medium business, and 3 percent major business/major professional. There was a statistically significant difference between the experimental and control groups on number of months since separation and the age of the boys. Mothers in the experimental group had been separated 2.6 months longer than control group mothers, and boys in the experimental group were 4 months younger than control group boys.
 
Delinquency was evaluated using the delinquency T-score from the Teacher Report Form (TRF) of the Child Behavior Checklist. The T-score consisted of nine items rated on a 3-point scale. Arrest records were collected from official court records by searching the Oregon Circuit Court database, the Oregon State Police criminal database, and, where applicable, out-of-state databases on all known aliases. Latent variable growth models were used in the analyses. No subgroup analysis was conducted.
 
Study 2
Martinez and Eddy (2005) used a randomized controlled trial to evaluate a culturally adapted version of GenerationPMTO, called Nuestras Familias, to a Spanish-speaking Latino population. The sample comprised 73 families with middle-school-aged youths at risk for problem behaviors who were randomly assigned to receive Nuestras Families (n=37) or to receive no-intervention (n=36). Overall, 56 percent of the participating youths were boys, and 44 percent were girls. The youths’ average age at baseline was 13 years, the mothers’ average age was 36 years, and the fathers’ average age was 39 years. All participating mothers and all but one participating father were born outside the United States. Overall, 100 percent of families self-identified as Latino; 90 percent traced their origins to Mexico, with the remainder tracing their origins to Peru and Central America. No statistically significant differences were found between those who received Nuestras Familias and those in the control condition. Families that were currently receiving parenting intervention or family counseling were excluded from the study. For participating stepfamilies, study inclusion criteria required that they were in an established stepfamily (i.e., had been in a committed relationship and cohabiting for at least 2 years) and that each family member viewed the stepfather as having the sole fathering role in the family.

Intervention effects were evaluated approximately 5 months following the intervention. Assessment procedures included interviews with each family participant, self-report questionnaires, and family observations by staff. The Parent-Child Behavior Checklist (P-CBCL) was used to measure the program’s effect on youths’ aggression and externalizing behavior, as reported by parents. Measures of parenting practices were taken from responses to questions from the parent interview to assess overall effective parenting in addition to general parenting, appropriate discipline, and skill encouragement.

General parenting was assessed through an average scale score of eight items that reflected general use of effective parenting strategies during the past month with the youth (e.g., communicating calmly and clearly with the youth when there was a disagreement, negotiating emotional conflicts and working toward solutions, being consistent with discipline, and following through with consequences). Items were rated on 5-point Likert scales, with higher scores reflecting more frequent use of effective parenting strategies.
 
Appropriate discipline was measured through an average scale score of 12 items reflecting the frequency of using effective limit-setting strategies in response to specific youth misbehavior (e.g., giving warnings of and following through with consequences, restricting privileges, giving a timeout, and giving extra chores). Skill encouragement was measured through an average parent-scale score of eight items reflecting the frequency of specific, contingent positive-reinforcement responses when the youth engaged in prosocial behavior (e.g., giving extra privileges, praising the youth, spending special time together, and offering small rewards). Individual items were rated on 5-point Likert scales, with higher values reflecting greater frequency of use for a particular encouragement strategy. Overall effective parenting was measured through an average scale score that aggregated the monitoring, skill encouragement, appropriate discipline, and general parenting scales described above.
 
A series of mixed factorial ANCOVAs were used in the analysis. No subgroup analysis was conducted.
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Cost

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There is no cost information available for this program.
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Implementation Information

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The manual for the GenerationPMTO (Parent Model Training Oregon) program, Parenting Through Change (Forgatch 1994), contains additional information for group leaders as well as parent materials. Parent materials include summaries of principles, home practice assignments, charts, and other necessities. A 30-minute videotape, The Divorce Workout (Forgatch and Marquez 1993), demonstrates families using program principles. The manual incorporates detailed session descriptions for leaders, including agenda, objectives, rationales, procedures, exercises, role plays, and group process suggestions.

Certified GenerationPMTO therapist candidates must submit four videos of full treatment sessions from their work with families. The sessions must be on the following: introducing encouragement, troubleshooting encouragement, introducing discipline, and troubleshooting discipline. These sessions are then viewed by Implementation Sciences International, Inc. (ISII) Mentors, who rate the sessions to evaluate the candidates’ fidelity to the method.

Practitioners must complete the certification process to be qualified to implement PMTO interventions independent of supervision and coaching. Following certification, coaching within the local PMTO community is required at a minimum of once monthly.
The amount of time to certification typically ranges from 18 to 24 months. For more information on GenerationPMTO, visit https://www.generationpmto.org    
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Forgatch, Marion S., Gerald R. Patterson, David S. DeGarmo, and Zintars G. Beldavs. 2009. “Testing the Oregon Delinquency Model with 9-year Follow-Up of the Oregon Divorce Study.” Development and Psychopathology 21:637–60.  


Study 2
Martinez, Charles R., and J. Mark Eddy. 2005. “Effects of Culturally Adapted Parent Management Training on Latino Youth Behavioral Health Outcomes.” Journal of Consulting and Clinical Psychology 73(4) 841–51.

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Additional References

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These sources were used in the development of the program profile:

Forgatch, Marion S. 1994. Parenting Through Change: A Programmed Intervention Curriculum for Groups of Single Mothers. Eugene, Ore: Oregon Social Learning Center.


Forgatch, Marion S., and David S. DeGarmo. 1999. “Parenting Through Change: An Effective Prevention Program for Single Mothers.” Journal of Consulting and Clinical Psychology 67(5):711–24.


Forgatch, Marion S., David S. DeGarmo, and Zintars G. Beldavs. 2005. “An Efficacious Theory-Based Intervention for Stepfamilies.” Behavior Therapy 36: 357–65.


Forgatch, Marion S., and B. Marquez. 1993. The Divorce Workout [Videotape]. Eugene, Ore.: Oregon Social Learning Center.


Hagen, Kristine Amlund, Terje Ogden, and Gunnar Bjornbekk. 2011. “Treatment Outcomes and Mediators of Parent Management Training: A One-Year Follow-Up of Children with Conduct Problems.” Journal of Clinical Child & Adolescent Psychology 40(2):165–78. (This study was reviewed but did not meet CrimeSolutions.gov criteria for inclusion in the overall program rating.)


Reid, John B., Gerald Patterson, and James Snyder. 2002. Antisocial Behavior in Children and Adolescents: A Developmental Analysis and Model for Intervention. Washington, D.C.: American Psychological Association.


Szapocznik, Jose, and Douglas J. Coatsworth. 1999. “An Ecodevelopmental Framework for Organizing the Influences on Drug Abuse: A Developmental Model of Risk and Protection.” In M. D. Glantz and C. R. Hartel (eds.). Drug Abuse: Origins & Interventions.  Washington, D.C.: American Psychological Association, 331–66. http://dx.doi.org/10.1037/10341-014
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Program Snapshot

Age: 8 - 12, 30 - 40

Gender: Both

Race/Ethnicity: Black, American Indians/Alaska Native, Hispanic, White, Other

Geography: Urban

Setting (Delivery): Other Community Setting

Program Type: Conflict Resolution/Interpersonal Skills, Family Therapy, Group Therapy, Parent Training

Targeted Population: Families

Current Program Status: Active

Listed by Other Directories: Model Programs Guide, Blueprints for Healthy Youth Development (formerly Blueprints for Violence Prevention)