BEHAVIOR T H E R A P Y 13, 702-714 (1982)

The Long-Term Effects of a Videotape Modeling Parent-Training Program: Comparison of Immediate and 1-Year Follow-up Results

C A R O L Y N W E B S T E R - S T R A T T O N

University of Washington

This s tudy evaluated the long-term effect iveness of a parent-training program based on videotape modeling. Thir ty- two mothers and their preschool children were evaluated prior to parent training and at 1 week and 1 year after t rea tment on the bases of videotaped observat ions of mother-child interact ions and parent at t i tudinal measures . Most of the significant behavioral changes noted for mothers and children immediately pos t t rea tment were either maintained or improved l year later. Parent report data also indicated that mothers cont inued to perceive a reduction in the intensity o f child behavior problems. Nonethe less , mother and child posit ive affect behaviors did decline f rom immediate pos t t rea tment to 1- year follow-up and mothers reported feeling less confident about their parenting skills, The meaning o f these discrepant findings as well as the social validity of the t rea tment program are d iscussed.

In recent years, there has been increased emphasis on developing new techniques for training parents. Performance training methods such as live modeling, videotape modeling, and individual videotape feedback have been proven to be effective techniques to alter parent-child behav- iors and attitudes (Bernal, Duryee, Pruett, & Burns, 1968; Bernal, Wil- liams, Miller, & Reagor, 1972; Goodwin & McCormick, Note 1; Johnson & Katz, 1973; Kogan & Gordon, 1975b; Nay, 1976; O'Dell, Mahoney, Horton, & Turner, 1979; Webster-Stratton, 1981b). Although the short- term efficacy of these parent-training methods has been demonstrated, whether these changes are maintained over longer periods of time is un- known. Research investigating the long-term effects, or temporal gener-

Appreciat ion is expressed to John R. Strat ton, M. D., for his ass is tance and support , and to Margaret Jarvis, for her ass is tance in data collection, and to Don Goldstein for his ass is tance in compute r programming. The au thor also thanks Barbara Hummel for her skillful ass is tance in preparat ion of the manuscr ipt . This paper was presented at the Amer- ican Psychological Associat ion, September 1980. Reques ts for reprints should be sent to Carolyn Webster -St ra t tan , Universi ty of Washington, School of Nurs ing, SC-74, Seattle, WA 98195. Videotape vignettes with accompanying training manual may also be obtained f rom the author .

702 igMi5-7894/8~'07023371451 .(xl,'~l Copyright t982 h v Assoeiatic, n for Advancement of Behavior Therapy

All riShtS of reproduelion ia airy form reserved.

PARENT TRAINING 703

ality, of various parent-training methods has been largely neglected or methodologically limited. Forehand and Atkeson (1977) found that only I2% of 146 studies evaluating parent-training programs reported data on the maintenance of treatment effects. Moreover, those studies which did evaluate long-term outcomes had serious methodological problems, mak- ing it difficult to draw any definite conclusions regarding the durability of treatment effects. One of the most common methodological limitations was the use of only one outcome measure, such as parents' verbal or written opinion, telephone contact, or questionnaire (Barrett, 1969; Ber- nal, Klinnert, & Schultz, 1980; Patterson & Reid, 1973; Rimm, Vernon, & Wise, I975). Few of the available follow-up studies have used direct observational measures of parent and child behaviors, which may be a more objective means of assessment than questionnaires.

Those studies of long-term follow-up which have employed more rig- orous methods of assessment have presented equivocal results. Fore- hand, Sturgis, McMahon, Aguar, Green, Wells, and Breiner (1979) re- ported maintenance of increased levels of child compliance at 1-year follow-up, but also reported that some parent behavior changes were not maintained. Patterson (1974) and Patterson and Reid (1973) systematically collected follow-up data over 1-year posttreatment. One-third of their 27 families dropped out of the study, and one-half of the remaining families needed additional treatment in the first month of follow-up due to con- tinued difficulties. Johnson and Christensen (1975) reported that deviant behavior observed in the home had actually increased to above baseline levels at 3.8 month follow-up. It has previously been suggested that the training of parents to act as behavior therapists may enhance the dura- bility of treatment effects (Berkowitz & Graziano, 1972). However, few studies have addressed this important issue, and those which have indi- cate that training parents does not guarantee lasting measurable effects (McMahon, Forehand, & Griest, in press).

Another facet of treatment outcome which has been considered to be relevant to the generality of a program is the concept of social validity (Kazdin, 1977; Wolf, 1978). Social validity, broadly defined, refers to the validation of treatment effects by demonstrating that therapeutic changes are "clinically or socially important for the client" (Kazdin, 1977, p. 429). Little data exist regarding the social validity of parent-training programs.

The author has previously described a performance-based parent-train- ing program based on videotape modeling and group discussion which led to highly significant changes in mother-child interactions immediately posttreatment (Webster-Stratton, 1981a, 198 lb). The present study (1) de- termined if the early effects were maintained after termination of the pro- gram by comparing 1-week and I-year follow-up results, and (2) deter- mined the social validity of the program by assessing whether subjects differed significantly from normative nontreated groups before or after treatment, and also by evaluating consumer satisfaction of the treatment program.

704 W EBS | E R-S'I RATTON

METHOD Subjects

The original prwticipants were 35 mothers and their 3- to 5-year-old children. The mothers were recruited by a flyer announcing a parent- training program designed to help parents manage child misbehavior . The mothers had a mean age of 33 years, 4 years of college education, and 2 children. Socioeconomic status ranged from lower middle to upper middle class. Study children included 23 boys and 12 girls, 21 firstborns, and 14 secondborns with an overall average age of 3 years, 11 months.

Procedure

Behavioral , attitudinal, social, and demographic data were collected on all mothers and children at the beginning of the study. The subjects were then randomly assigned to two exper imental groups, the early t rea tment group (n = 16) and the delayed t rea tment group (n = 19). After baseline data collection, the early t reatment group at tended a series of 4 weekly, 2-hour videotape modeling discussion sessions which were conducted over 4 consecut ive weeks. After the early t rea tment group had completed the program, both groups were again retested on all measures . Two weeks later the delayed t rea tment group at tended the same 4-week program, while the early t reatment group received no further t reatment . All sub- jects were then retesled to determine immediate pos t t rea tment results for the delayed t rea tment group and 6-week follow-up data for the early t rea tment group. Two months later both groups evaluated the training program by means of an extensive consumer satisfaction inventory. One year later, long-term effects were assessed by retesting 32 of the 35 orig- inal subjects on all measures . Three subjects were unavailable for re- testing (.one in the early t rea tment group who had moved and two in the delayed t rea tment group who had dropped out prior to the t reatment program). Thus, 97% (32 of 33) of the subjects who completed the pro- gram initially were re-evaluated at 1 year.

Treat men t

A complete description of the program content , development , and ex- ecution has been reported elsewhere (Webster-Strat ton, 1981a).

~easI tr~s

Attitudinal meast~re (PAS). The Parent Attitude Survey (PAS) is a 75- i tem parental atti tude instrument developed by Hereford (1963). The PAS was used to measure five dimensions which were felt to character ize the parents ' perceptions of the parent-child interaction: confidence, causa- tion, acceptance , understanding, and trust. Reliability coefficients for the scales ranged from .68 to .86 (split-hail) with a mean reliability of .80.

Eyberg Child Behavior Inventor)." (ECBI). The ECBI is a 36-item in- ventory applicable for children 2-16 years, which measures parental per- ceptions of their children's behavior problems. The response format is

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constructed to assess each of the 36 items on two dimensions: the fre- quency of its occurrence and its identification as a problem. The fre- quency ratings range from (1) "never occurs" to (7) "always occurs" and are summed to yield an overall problem behavior Intensity Score. Then the problem identification measure requires the parent to circle °'yes" or " n o " when asked, "Is this behavior a problem for you?" and is summed to give a total Problem Score, which is used in this study as an indicator of the number of children's behavior problems. Previous research has demonstrated reliability coefficients for the ECBI scales from .86 (test-retest) to .98 (internal consistency). The inventory has also been shown to correlate well with independent observations of children's behaviors and to differentiate clinic referred and nonclinic populations (Eyberg & Ross, 1978; Robinson, Eyberg & Ross, 1980).

Interpersonal Behavior Construct Scale (1BCS). Behavior observations were obtained at every assessment period by videotaping each mother- child dyad for 30 min in a playroom via a one-way mirror. The videotapes were analyzed according to the IBCS (Kogan, 1972; Kogan & Gordon, 1975), which consists of 23 categories of behaviors which are coded as either present or absent for each 40-see segment. Ratings in the 23 cat- egories for all time segments are summed to form seven main dimensions of the parent and child interactions (Kogan, Note 2). The first five di- mensions, positive "affect, negative affect, nonacceptance, dominance, and submissiveness, were analyzed for child behaviors. For mother be- haviors, the submissiveness dimension was not initially analyzed since no predictions were made for this behavior to change as a result of the program. A/so, the negative affect dimension could not be analyzed for mothers since these behaviors did not occur during baseline observations. The final two dimensions, leadtaking and watch, or attention, were ana- lyzed for mothers only. Thus, there were five behavior summary variables for children and five for mothers.

The videotapes were analyzed by four experienced coders who had originally been trained by the author of the IBCS measure and had a minimum of 4 years experience using the coding system. They were blind to the hypotheses and group membership of the subjects. Throughout the study they received weekly training sessions to maintain accuracy. All videotape analyses were rechecked by a second coder who independently analyzed 8 of the 45, 40-sec units, randomly selected from every individ- ual videotape. To determine interobserver reliability the records for both the primary coder and the reliability coder were compared interval by interval. An average overall interrater reliability of 91% was maintained by coders (number of agreements/number of agreements plus disagree- ments). Mean interrater reliabilities for each behavior dimension are re- ported in Table 1.

Consumer Satisfaction Questionnaire. This measure was prepared by the author and consisted of 41 items with a 4-point Likert scale re- sponse format. Statements are made to which the parent can respond on the basis of strongly agree to strongly disagree. Responses are trans-

706 WEBSTER-STRAIqON

TABLE 1 MEAN 1NTERRATER RELIABIt.ITIES FOR EACH DIMENSION (IF BEHAVIOR. MEAN

REI.TABII.ITIES FIGURE I~EFI.ECTS AGREEMENT ON OCCURRENCES AND NONOCCURRENCES

OF INDIVIDUAL BEHAVIORS IN THE SAME ]NTERVA1-S

Mother Mean Child Mean behavior categories reliabilities behavior categories reliabilitles

M. watches .92 C. positive affect 94 (.9(~.94) (.86-,98)

M, leadtaking .95 C. negative affect .98 (, 90-, 97 ) (. 98---. 99)

M. positive affect .90 C. nonacceptance ,94 (.82-.98) (.91-.98)

M. nnnacceptar~ce .90 C, dominance ,89 ( .92-. 99) ( .81-. 93)

M. dominance .91 C. submissiveness ,93 (.8J-.99) (.8t-.99)

M. submissiveness ,94 (.8g-.98)

formed into scores 1 to 4 with 4 being the most positive. The statements cover areas such as parent ' s feeling of confidence or inadequacy in han- dling current child problems; continued child behavior improvement or deterioration following termination of program; program generalization to novel situations and to other children; usability of techniques; and satisfaction with the program and the therapist. Half the items are scored in the reverse direction.

RESULTS The baseline and immediate post treatment results have been reported

elsewhere (Webster-Strat ton, 1981b). Therefore, the short-term results will only be briefly summarized here prior to describing in detail the l- year follow-up data. The previous analyses of the data consisted of ini- tially performing a multivariate analysis of variance (MANOVA). If the overall Hotelling's T was significant, analyses of covariance were then carried out using the pretest scores as covariate (Huck & McLean, 1975).

Baseline Differences No significant differences between the early and delayed treatment

groups were discerned on demographic and socioeconomic variables or dependent measures at baseline assessment.

Short-Term Treatment Effects There was no significant difference between the early and delayed treat-

ment groups on the five PAS attitudinal dimensions combined by Ho-

PARENq" TRAINING 707

telling's T, therefore no further univariate analysis was carried out with this measure. On the other hand, results of MANOVA revealed that there were significant ECBI and behavioral changes when the early treatment mothers and children were compared with the delayed treatment mothers and children prior to their receiving treatment. Further analyses of the ECBI indicated that the early treatment group mothers rated significantly less intense behavior problems in their children than did the delayed treatment mothers, F(1,33) = 5.92, p < .02. Behavioral data (IBCS) re- vealed that three out of five behavior summary variables for the early treatment children showed significant changes in the predicted direction. Eft.fly treatment children showed significantly fewer negative affect be- haviors, F(1,33) = 5.09, p < .03; and submissive behaviors, F(1,33) = 19.77, p < .001; and significantly increased positive affect behaviors, F(1,33) = 3.88, p < .05, when compared with the delayed treatment chil- dren. The difference between both groups of children in dominance and nonacceptance behaviors was not significant. Univariate analyses of co- variance further revealed that four of the five mother behavior summary variables changed in the predicted direction. When compared with the delayed treatment mothers, the early treatment mothers showed signifi- cantly fewer leadtaking behaviors, F(1,33) = 18.33, p < .001; dominance behaviors, F(1,33) = 50.I0, p < .00001; nonacceptance behaviors, F(I,33) = 31.78, p < .00001; and significantly increased positive affect behaviors, F(1,33) -- 19.05, p < .00i. There was no significant difference in mother watch behaviors.

The program's effectiveness on mother attitudes and mother-child in- teractions was nearly identically replicated with the delayed treatment group after they finally received the program. In addition, follow-up as- sessment of the early treatment group showed the program's effective- ness was maintained 6 weeks later. In fact, the tota/ number of child behavior problems continued to significantly decrease and observed child behaviors continued to improve. (See Table 2 for means and standard deviations for the early and delayed treatment groups prior to and fol- lowing their respective treatments.)

l-Year Treatment Effects

Since no significant differences existed between the early and delayed treatment groups on any measures prior to treatment and immediately following their respective treatment programs, the long-term follow-up data and analyses combined all 32 subjects from both groups at baseline, immediately posttreatment, and 1-year follow-up. For the attitudinal and behavioral data the following planned comparisons were performed: (l) Pretreatment vs. l-Year Posttreatment, and (2) Immediate 1-Week Post- treatment vs. l-Year Posttreatment. Paired t tests were performed to describe changes over these time periods, An overall experiment-wise error rate of .05 was considered acceptable. Therefore the criteria for significance of each of the individual tests was set at .001. This controls for the increased probability of obtaining significant results by chance

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PARENT TRAINING 709

T A B L E 3

COMPARISON OF BEHAVIORAL AND A'VrITUDINAL MEASURES~ PRETREATMENT, 1 WEEK AND 1 YEAR POSTTREA'iFMENT (N --- 32)

Immedia te Pre l rea tment post t rea tment 1-Year follow-up

Dependent measures Mean _+ SD Mean ± SD Mean ± SD

Eyberg Child Behavior Inventory ECBI

Problem Score 7.9 ± 4.4 4.2 ± 3.2

Intensity Score 118.5 _+ 21.5 106.68 +_ 19.7

Parent Attitude Sureey

Confidence 7.8 ± 6.5 9.4 ± 7.4 Causat ion 16.1 ± 4.8 t7.8 _+ 4,9 Acceptance 17.5 ± 4.5 16.6 ~- 5 .9 t t Unders tanding 20.8 ± 4.7 21.1 + 4.3 Trust 17.4 ± 6,4 18.2 ± 7.1

Mother behaviors

M. watch 25.3 ± 8.7 34.1 ± 4.9 M. leadtaking 6.2 ± 4.5 1.5 ± 2.0

M. posi t ive affect 28,3 ± 10.3 49.9 ± |2 ,7~t~

M. nonacceptance 4,3 ± 2.7 2,8 ± 2.4"~? M. dominance 3 1 . 9 ± 8.9 13.5 -+ 8.7

M. submiss iveness 10.3 ± 6.8 11,7 ± 6.5"~?

Child behaviars

C, posi t ive affect 22.5 ± 9.3 31.0 ± 7.8~'t C. negative affect 1.1 ± 2.3 1.0 ± 1.9 C. nonacceptance 9.1 ± 5.6 6.9 ± 3.23' C. dominance 20.4 ± 9 3 19.5 ± 7 . 8 t t

C. submlss iveness 16.3 ± 6.8 7.6 ± 6.1

5.5 ± 4.6* 103.6 ± 22.9**

10.5 ± 6.9* 18.7 ± 5.3* 18,6 ± 5.1

22.3 ± 5.1"

19.4 ± 6,7

33.7 ± 7.9**

1.4 + 1.7"*

36.8 ± 11.1"*

1.3 ± 1.6"* 11.2 + 6.2**

7.6 ± 5,4

25,5 ± 8.9

0.40 ± .79 4.5 ± 3.6**

13.0 ± 8.2**

6.3 ± 3.9**

**p < .001, * p < ,01: 1-year follow-up vs, pre t reatment .

~?~ p < .0001, t ? P < ,001, t p < .01: Immediate pos t t rea tment vs. 1-year follow-up.

when multiple univariate tests are performed (Winer, 1971, p. 200). See Table 3 for the means and standard deviations for both groups combined at baseline, immediately post treatment, and 1-year follow-up.

Attitudinal data. On the PAS, the mothers did not report significantly increased attitudes on any of the subscales. However , there was a trend for all the attitudinal subscales to increase at the 1-year follow-up as- sessment in comparison to baseline and immediately post treatment.

On the ECBI, there was a significant reduction in the intensity, t(31) ~- 4.26, p < .001, and number of behavior problems, t(31) = 2.59, p < .01, reported by mothers at the 1-year follow-up compared to baseline. How- ever, the total number of behavior problems did show a nonsignificant increase from immediate post t reatment to 1-year follow-up.

Behavioral data. Analyses of mother-child interaction data (IBCS)

71 (I WE BSTER-STRA'I-TON

showed a significant decrease in mother nonacceptance behaviors, t(31) = 6.88, p < .0091; mother dominance behaviors , t(3t) = 12.0, p < .0001; and mother leadtaking behaviors , t(31) = 5.8, p < .0001; and a significant increase in mother positive "affect behaviors, t(31) =- -4 .26 , p < .0001, and mother watch behaviors , t(31) = - 6 . I 2 , p < .0001 when l -year fol- low-up data were compared with baseline. Child behaviors showed a significant decrease in nonacceptance , t(31) =- 4.89, p < .0001; domi- nance, t(31) = 3.43, p < .001; and submissiveness , t(31) = 8.39, p < .0001 f rom baseline to 1-year follow-up.

All the significant behavioral changes reported for both mothers and children immediately pos t t rea tment were maintained at 1-year follow-up except for posit ive affect behaviors. There was a significant drop in pos- itive affect behaviors for both mothers and children f rom immediate post- t rea tment to 1-year follow-up, t(31) = 6.84, p < .0001 and t(31) = 3.67, p < .001. On the other hand, child nonacceptance behaviors and child dominance behaviors, which had not changed significantly immediately pos t t rea tment , showed a significant (.001) drop at 1 year compared to early follow-up assessment . In addition, mothers ' nonacceptance behav- iors continued to decrease significantly f rom immediate pos t t rea tment to l -year follow-up.

Const~rner Sati,~faction

At t year, mothers felt significantly less able to manage behavior prob- lems in their children and were less satisfied with their children's behavior than they had reported at short- term follow-up, t(31) =- 2.75, p < .01. Fewer parents felt they had been successfully able to use the principles learned in the program in novel situations or with new behavior problems than at 2-month assessment . Parents also reported they felt less confident in their parenting skills at 1 year than at 2 months pos t t rea tment , t(31) = 2.30, p < .03. Of the total group, 96% stated they would like more classes and would at tend more classes ff they were offered again.

Comparison of Treated Mothers with "Normals" on ECBI and 1BCS

In order to socially v',didate t rea tment effects, the behavioral data of the mother-child interactions and the ECBI data were compared with normat ive data compiled by Kogan (Note 3) and Eyberg and Ross (1978) on similar populations of untreated mothers and children of comparable age, sex, education, and socioeconomic status.

At baseline the mean ECBI Problem Score for all children in this sam- ple was 7.9 ± 4.4 (1 SD) and the mean Intensi ty Score was 118.5 _+ 21.5 (1 SD). These means did not fall within the range of four-year-old clinic conduct-disordered children described by Eyberg and Ross (1978). None- theless, at baseline the overall means for the current sample were signif- icantly higher, t(52) = 2.85, p < .01, than the "no rma l four year o lds" reported by Eyberg and Ross (1978) who had a mean Problem Score of 4.1 + 5.4 and a mean Intensi ty Score of 100 _+ 26.8. Thus, at baseline

PARENT ' ] 'RAINING 711

this sample represented children with a wide range of behavior problems, with 38% of the group being more than one standard deviation above the mean for total number and intensity of behavior problems in the normal population.

One year later, after treatment, the experimental mothers and children were again compared with " target normals" for children aged 5 years. On the ECBI, there was no longer a significant difference between the two groups, indicating that the treated children fell within the normal range of behavior problems.

On the behavioral data, at baseline, the sample mothers were signifi- cantly less positive, t(126) = -3 .82, p < .001; took the lead less, t(126) -- -11.91, p < .001; and were less nonaccepting, t(126) = -4 .28 , p < .001, than the normative data compiled by Kogan (Note 3). Post hoc analyses of the mother submissiveness dimension also revealed the interesting finding that these mothers were significantly more submissive, t(126) -- 3.18, p < .001, than normative behavioral data. The only significant dif- ference in the sample children's baseline behavior f rom the normative behavioral data was lower child positive affect behaviors, t(t26) -- -3 .81, p < .00t. At 1-year follow-up, mother positive affect had increased and submissiveness had decreased to fall within the normal range. For the children, there were significantly fewer dominance, nonacceptance, and submissive behaviors, and significantly more positive affect behaviors when the treated children were compared with the nontreated normal sample of 5-year-old children.

DISCUSSION This study provides multiple outcome assessments of 32 families, who

received a standardized parenting program, at four different times over a 1-year span. All but one of the families who received the original parent training program were reevaluated at I year. The importance of investi- gations into the generalizability of parent training effects over time is readily apparent. Certain training methods may produce large initial changes in parent and child behaviors or attitudes but no durable results or vice versa. The results of this study indicate that most of the behavioral changes noted during the short-term evaluation were maintained. At I- year follow-up, mother-child interactions were significantly more posi- tive, and significantly less negative, nonaecepting, and domineering than at baseline assessment. Analysis of the ECBI parent report data also revealed a significant reduction in behavior problems at l-year follow-up compared to baseline. This finding is important in light of the fact that Eyberg and Ross (1978) have reported that there is a natural increase in behavioral problems in normal children between the ages of 4 and 6 years. The most significant behavioral deterioration from immediate to l-year follow-up was the drop in positive affect behaviors by both mothers and children. However , despite this drop, positive affect behaviors were still significantly higher than at baseline data collection and still fell within the normal range reported by Kogan (Kogan, Note 3).

712 w E ttSIF.R-SIRAIFON

In addition, this study also assessed the social validity of the impact of the t rea tment program. Social comparison of the treated mothers with " n o r m a t i v e " data revealed that these mothers perceived their children as having significantly more behavior problems than " n o r m a l " mothers prior to t reatment , but not t year after t reatment . Mother-child interac- tions showed significantly less positive affect behaviors and mothers were significantly more submissive pre t rea tment than normat ive data on moth- er-child interactions, but this was not the case 1 year postintervention. These data are particularly interesting, not only because they suggest the t reatment had the desired ou tcome, but because they provide some in- formation about mot ivated nonclinic parents who seek parenting pro- grams. This compar ison suggests that these middle class mothers were unskilled in their use of positive consequences and used control and neg- ative consequences ineffectively. The data also suggest that although such parents may not have problems as severe as clinic populations, they are not without significant concerns about their parenting skills and, at least in this study, did not fall into the " n o r m a l " range on several scales. It could be postulated that such parents and children are a "p re re fe r r a t " group, at risk for developing more serious problems but early intervention prevents further maladjustment f rom occurring.

The mothers" subjective evaluat ions also provided important informa- tion about the t rea tment program. At l -year follow-up mothers reported feeling less confident and less able to manage behavior problems. These data corrobora te the notable drop in mother and child positive affect behaviors on direct observat ions at t year. It could be postulated that the t rea tment program was not successful in helping parents generalize the skills learned to new behavior problems which emerged over the year. Nonetheless , this information, plus the fact that so many parents wanted more classes, seems to suggest the need for periodic " b o o s t e r " training, as has been suggested by Pat terson (1974) for clinic populations.

Several limitations of the present study should be noted. The most serious limitation is that at f year there was no untreated control group, and therefore it cannot be stated with certainty that the continued changes compared with baseline were due to the t rea tment program alone. How- ever, the highly significant differences, when the early t reatment group was compared to the delayed t rea tment group, suggest that the long-term changes may have been secondary to the program. In addition, the com- parisons of the behavioral and ECBI data of the subjects in this s tudy with normat ive data support the contention that the changes were most likely due to the treatment program rather than maturation effects. Another related [imitation to the study is that it is not known what aspect of the t rea tment was responsible for the behavioral and attitudinal changes. The t rea tment results may have been due to such factors as nonspecific "p la- c e b o " factors, therapist effects, group discussion and support , or vid- eotape modeling, in order to control for these variables and to determine if v ideotape modeling significantly enhances parent-training programs, future studies should include at least one other compar ison controt group.

PARENT TRAINING 713

A third potential study limitation is the problem of selection or volunteer bias. While this study's sample is probably representative of the increas- ing number of motivated parents, mostly middle class, who are enrolling in parent education classes across the country, it is not currently known whether the videotape program described here would be appropriate with other raci',d or socioeconomic populations or with clinic populations.

REFERENCE NOTES 1. Goodwin, D., & McCormick, J. Videotape feedback and behavior rehearsal in group

training o f parents in behavior modification techniques: An experimental evaluation. Paper presented at the meeting of the Western Psychological Association, Los Angeles, April 1970.

2. Kogan, K. Interpersonal behavior eonstructs: A means for analyzing video-taped dyadic interaction. Laboratory Manual, 1975. For a complete descdpfion of the behaviors com- prising each of these dimensions, please refer to this manual

3. Table o f normative data and t scores derived from normal samples o f 96 mothers o f children aged3-5 years. (Avail'able from K. Kogan, Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195.)

REFERENCES Barrett, B. H. Behavior modification in the home: Parents adapt laboratory-developed

tactics to bowel-train a 5-½-year-old, Psychotherapy: Theory, Research and Practice, 1%9, 6, 172-176.

Berkowitz, D. P., & Graziano, A, M, Training parents as behavior therapists: A review. Behaviour Research and Jherapy, 1972, 10, 297-317.

Ben]at, M. E., Duryee, J, S,, Pruett, H. L., & Burns, B. L Behavior modification and the brat syndrome. Journal of Consulting and Clinical Psychology, 1968, 32, 447455.

Bernal, M, E., Kllnnert, M. D., & Schultz, L .A. Outcome evaluation of behavioral parent training and client-centered parent counseling for children with conduct problems. Journal o f Applied Behavior Analysis, 1980, 13, 677-691.

Bernal, M. E., Williams, D, E., Miller, W. H., & Reagor, P, A, The use of videotape feedback and operant learning principles in training parents in management of deviant children. In R. Rubin, H. F, Fensterheim, J. Anderson, & L, Ullmann (Eds.}, Advances in behavior therapy. New York: Academic Press, 1972.

Eyberg, S. M., & Ross, A. W, Assessment of child behavior problems: The validation of a new inventory. Journal o f Clinical Child Psychology. 1978, 16, 113-116.

Forehand, R., & Atkeson, B .M. Generality of treatment effects with parents as therapists: A review of assessment and implementation procedures. Behavior Therapy, 1977, 8, 575-593.

Forehand, R,, Sturgis, E. T., McMahon, R, J,, Aguar, D., Green, K., Wells, K., & Breiner, J. Parent behavioral training to modify child noncompliance: Treatment generatiza- tion across time and from home to school. Behavior Madification, 1979, 3, 3-25.

Hereford, C.F. Changing parental attltudes through group discussion. Austin: University of Texas Press, 1%3,

Huck, S, W., & McLean, R .A. Doing a repeated measures ANOVA to analyze the data from a pretest-posttest design: A potentially conlhsing task. Psychological Bulletin, 1975, 82, 511-518.

Johnson, C, A., & Katz, R.C. Using parents as change agents for their children: A review. Journal t~t'Ct'iM Psychology anti Psychiatry, 1973, 14, 181-200.

714 WEBSTER-STRATTON

Johnson, S. M., & Christensen. A. Multiple criterion follow-up of behavior modification with families. Journal afAbnormal Chiht Psychology, 1975, 3, 135-154÷

Kazdin, A. E. Assessing the clinical or applied importance of behavior change through soci',d validation. Behavior Modification, 1977, 17 427452.

Kogan, K .L . Specificity and stability of mother-child interaction styles. Child Psychiatry attd Human Development, 1972, 2, 160-168.

Kogan, K, L., & Gordon, B. M. Interpersonal behavior constrnets: A revised approach to defining dyadic interaction styles. Psychological Rep~rtx, 1975, 36, 835~46. (a)

Kngan, K. L., & Gordon, B .M. A mother-instruction program: Documenting change in mother-child interactions. Child t'sychiatry and Human Development, 1975, 5, 189- 200. (b)

McMahon, R. J , Forehand, R., & Griest, D.L . Parent behavioral training to modify child noncompliance: Factors in generalization and maintenance. In R. B. Stuart & P. O. Davidson (Eds.), Behavioral medicine: Therapeutic compliance, generalization and maintenance. New York: Brunner/Mazel, in press.

Nay, R. W, A systematic comparison of instructional techniques for parents. Behavior Therapy, 1976, 6, 14-21.

O'DelI, S. L., Mahoney, N. D., Herren, N, G., & Turner, P . E . Media assisted parent training: Alternative models. Behavior Therapy, 1979, 10~ 103-110.

Patterson, G . R . Interventions for boys with conduct problems: Multiple settings, treat- ments and criteria. Journal of Consulting and Clinical Psychology, 1974, 42~ 471-481.

Patterson, G. R., & Reid, J. B, Intervention for families of aggressive boys: A replication study. Behaviour Research and Theral)y, 1973, 11~ 383-394.

Rimm, R. C., Vernon, J. C.. & Wise. M. 1. Training parents of behaviorally disordered children in groups: A three years' program evaluation. Behavior Therapy, 1975, 6, 378- 387.

Robinson, E. A., Eyberg, S. M., & Ross, A .W. The standardization of an inventory of child conduct problem behaviors. Journal of Clinical ChiM Psychology, 1980. 8, 22- 29.

Webster-Stratton, C, Videotape modeling: A method of parent education. Journal of Clin- ical Child Psychology, 1981, ltl, 93-98. (a)

Webster-Stratton, C. Modification of mothers' behaviors and attitudes through a video- tape modeling group discussion program. Behavior Therapy, 1981, 12, 634-642. (b)

Wirier, B .J . Statisticalprinciplcs in e_rperimeataldesign (2rid ed.). New York: McGraw- Hill, 1971.

Wolf, M.M. Social validity: The case for subjective measurement or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 1978, I1, 2113-2t4.

REC~tWD: January 21, 1982 ]["[NAL ACCEFIAnCE: May 3, 1982