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Principal Investigator: Kayla Herbell
Organization: OHIO STATE UNIVERSITY
Fiscal Year: 2024
Award: $275,625
Funding agency: National Institute of Mental Health
Project Summary
Although adolescents (ages 11 to 17) make treatment gains (e.g., reduced internalizing or externalizing
behaviors) in psychiatric residential treatment (RT), they experience significant difficulty adapting to the
community and often do not sustain treatment gains long term. After RT, 70% of adolescents discharge to their
family of origin. However, parents are not provided with the necessary support or behavior management
skillset to bridge the gap between RT and home. A new federal mandate will soon require parent training, an
evidence-based behavior management intervention, in the RT setting. Parents with adolescents admitted to RT
are a difficult-to-reach population, and technology may increase access and uptake of parent training.
Parenting Wisely (PW) is a web-based parent training with demonstrated efficacy in increasing effective
parenting practices to reduce adolescent behavior problems. We previously found that PW was highly feasible
for parents and the skills were perceived as useful. However, parents reported two unmet needs: (1) skill
individualization to apply the PW skills and (2) enhanced community to reduce isolation. In collaboration with
an advisory board (a partner in the proposed study), we augmented PW with clinician facilitated discussion
groups (referred to as PWRT). The discussion groups in PWRT supports program completion and parent
engagement, provides a venue to discuss individualizing PW strategies, reduces isolation, and support parents
by engaging in conversation about parenting in the RT context. The proposed study aims to: (1) establish
feasibility and acceptability of PWRT, (2) evaluate whether PWRT engages target mechanisms (parental self-
efficacy, parenting behaviors, social support, family function), and (3) determine the effects of PWRT on
adolescent outcomes (internalizing and externalizing behaviors, placement restrictiveness). Sixty parents (30
per condition) will be randomly assigned to PWRT or treatment-as-usual (TAU). Each week for six weeks,
parents will complete two PW modules (20 minutes each) and attend one discussion group via Zoom (90-
minutes). PWRT will be initiated towards the end of the RT admission and continue post-discharge to bridge the
transition from RT to the community. Adolescents (n=60) will not receive intervention; however, we will
evaluate the feasibility of adolescent data collection for future studies. Data from parents and adolescents will
be collected at baseline, 6-weeks, and 6-months post-baseline to allow for a robust understanding of the
longer-term effects of PWRT on treatment gain maintenance. Consistent with PAR-21-211, our team of
researchers and community partners is collecting the requisite data for a larger-scale effectiveness trial by
testing the feasibility, acceptability, and preliminary effects of PWRT vs. TAU. PWRT is among the first web-
based parent training augmented with supportive elements designed to engage parents with adolescents in
RT. By providing parents with tailored education and support in PWRT, parents will be equipped with the
behavior management skillset to provide structure in the home and ultimately maintain RT treatment gains.
Terms: <Access to Care><Active Follow-up><Admission><Admission activity><Adolescent><Adolescent Behavior><Adolescent Youth><Age><Aggression><Aggressive behavior><Behavior><Behavioral><Biological><Care Givers><Caregivers><Case Series><Child Rearing><Code><Coding System><Collaborations><Communities><Complex><Consent><County><Coupled><Data><Data Collection><Deliberate Self-Harm><Discipline><Dose><Dysfunction><Education><Educational aspects><Educational process of instructing><Elements><Emotional><Enrollment><Evidence based intervention><Exercise><Face><Family><Fostering><Frequencies><Functional disorder><Future><Goals><Health Services Accessibility><Healthcare><Home><Home environment><Intervention><Intervention Strategies><Investigators><Jail><Maintenance><NIMH><National Institute of Mental Health><On-Line Systems><Online Systems><Outcome><Parenting><Parenting behavior><Parents><Patient Self-Report><Physiopathology><Population><Problem behavior><Randomized><Reporting><Research Personnel><Researchers><Residential Treatment><Risk Factors><Sampling><Self Efficacy><Self-Injurious Behavior><Self-Report><Social support><Stigmatization><Structure><Survey Instrument><Surveys><Teaching><Technology><Testing><Time><Voice><acceptability and feasibility><access to health services><access to services><access to treatment><accessibility to health services><active followup><ages><availability of services><behavioral health><behavioral problem><biologic><care access><care as usual><childrearing><community partners><community-based partners><cost><deliberate self harm><design><designing><effectiveness trial><enroll><evidence base><experience><externalizing behavior><faces><facial><feasibility testing><follow up><follow-up><followed up><followup><health care><health service access><health services availability><homes><intentional self harm><intentional self injury><interventional strategy><juvenile><juvenile human><online computer><parent><parenting education intervention><parenting education programs><parenting intervention><parenting program><parenting skill training><parenting training><pathophysiology><prevention service><programs><randomisation><randomization><randomly assigned><recruit><residential care><retention rate><retention strategy><satisfaction><self harm><self injury><service availability><skills><social support network><treatment access><treatment as usual><uptake><usual care><videoconference><videoconferences><virtual><web based>