Minimizing Harm by Edward Rubin

Author:Edward Rubin [Rubin, Edward]
Language: eng
Format: epub
Tags: Political Science, Law Enforcement, Public Affairs & Administration, Social Science, Criminology
ISBN: 9780813335360
Google: eoLaAAAAMAAJ
Publisher: Avalon Publishing
Published: 1999-01-15T04:43:26+00:00

Parent Training Is a Bargain

Among the most reasonable candidates for a prevention program, the RAND group concluded that parent training with young offenders (i.e., adolescents) was a relatively inexpensive and a highly effective preventive intervention for serious crime. Although their conclusion was well supported, several important qualifications are in order. First, it appears that the earlier parent training is applied, the more successful the outcome. For example, in an archival sample comprising all families who completed assessments before and after time-unlimited parent training in our clinic during the 1970s, 63 percent of children under six and one-half years of age versus 54 percent of children over six and one-half years of age evidenced “clinically significant” change following treatment (Dishion and Patterson 1992). Thus, not only is there a trend for child antisocial behaviors to be more difficult to change the longer the behaviors have been exhibited, but the behaviors of many children (up to 40 to 60 percent) may not change significantly despite time-unlimited family-focused treatment. When young offender adolescents are targeted by a program, the likelihood of many of the children having long histories of antisocial behaviors is high, and thus, treatment would be expected to be difficult.

Second, given the difficulty in treating adolescents exhibiting antisocial behavior problems, more time and resources will probably need to be expended than Greenwood et al. estimated. For example, in a study of chronically offending delinquents at our center (Bank, Marlowe, Reid, Patterson, and Weinrott 1991), participants in the parent training intervention received an average of twenty-two hours of face-to-face therapy and twenty-four hours of telephone contact. Further, approximately 50 percent of the families requested further treatment (i.e., “booster shot” therapy sessions) for an average of six hours of face-to-face contact in the year following treatment termination and an average of four hours the second year. Thus, although ten to twenty hours of treatment time might be adequate for children who are just beginning to demonstrate antisocial behavior problems, at least forty hours of time is probably a more realistic estimate for children who are farther along the antisocial behavior continuum. Doubling the original cost estimate would be more in the ballpark and would still put parent training as quite an economical “prevention” intervention option relative to the other alternatives.

Third, the likelihood of treatment dropout increases as child antisocial behavior problems become more chronic and severe (Kazdin and Mazurick 1994; Kazdin, Mazurick, and Bass 1993), and the prevalence of more problematic cases increases the older the target population. For example, 86 percent of the families who dropped out of treatment in the analyses by Dishion and Patterson (1992) had children in the “older” age group. When severe parenting problems coexist with child antisocial behavior, such as physical abuse, treatment dropout in nonmandated programs may be as high as 80 percent (Wolfe, Aragona, Kaufman, and Sandler 1980).

Treatment dropout occurs frequently enough that more accurate cost-benefit estimates would be obtained if cost estimates were adjusted by the number of anticipated dropouts. In the case of

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