II 66 '389

AUTHORTr TL]!'

PUB DATENOTE

ED_ PRICEDESCRIPTORS

pocomin it ix

Adams, WayneMental Health IA- the Schools. ParenAug 7820p.: Paper presented at t e Annual convention of theAlerican PSychylogical A ciatitn, (Toronto, Ontario,CANADA, August, 1978)

013 197

Pl"-10.83 HC -$1.67 Plus P age.*Behavior Problems; Jun or 'High Schools; Junior HighSoho tudents; Menta Health; iarent ChildRelationship; *Parent ounseling;. *Parent.EducatiOn;*Parent Teacher Cooperaticr; *StudenCBehaviorr*Teacher Role

ABSTRACTA training program by teachers for paten t of school.

children who -e creating problems at school 'vat' investigated.-Parents (NJ10 uples) rated their child's at-hcme behavior= by _meansof a checklist, participated in group sessions led by the teachersith alocus on means.for dealing with studert behavioral problems,

and then rated their childes'at-Aome kehavicr after` the completion ofthe group session The control' group of ,six parental couplesCompleted- only the behavior chockliste at the beginning and end Ofthe fimal'gradieg period of the school year A correlated T-testbetween parental ratings before and after group involvement indicatedsignificant subjective positive changes by the Parente, while nosignificant changes occurred among the control group,. Additionally,teachers rated children whose parents attended the group sessionsmore positively in overall classroom behaviors whereas control groupchildren's ratings were uilchanged., (Author /RLK)

***** _************** ** -*********t*****Reproductions supplied by !DRS are the hest that oar t

from the origiral document.********************* ** ******** ******0******

*******made ,*

Mental Health in the ehcols : Parent Traini

-PERMISSION TO REPRODUCE THISMATERIAL HAS BEEN GRANTED BY

TO THE EDUCATIONAL RESOURCESINFORMATION CENTER (ERIC! ANDUSERS OF THE ERIC SYSTEM

U.S. DEPARTMENT OF NEALTH.EDUCATION WELPARNATIONAL INSTITUTE OP

EDUCATION

THIS DOCUMENT HAS SEEN REPRO-' DUCE° EXACTLY AS RECEIVED FROM

THE PERSON OR ORGANIZATION ORIGIN-ATING IT POINTS O VIEW OR OPINIONSSTATED DO NOT NECESSARILY REPRE-SENT OFFICIAL NATIONAL INSTITUTE OFEDUCATION POSITION OR POLICY

This paper was presented as part of the Symppsium entitled "Peldiat -c Psycho

-School as a Mental Health Provider", at the annul convention of the American

Psycholo4ical Association, ronto, Canada, 1978.

lth.

ls: Par Training

Wayne Adams

Wilfred . duPant institute

ric School could take a more aotivt

of the faMilies

e in the menta health-

A rationale and backgre and rilvided for thiS

as well as pilot data -gin one economical method of unplemntation°' It

was. found that teachers train

who were creating school problems.

eats can affect change in their children

th in __a; Parent Training

Al fry

For those of us world

I. duPont Ins

attic settings, laint o

ems" is common. Sometimes the phrase accompknies a referral standing

1

itself but more often along.with other diagnostic labelS such as hyperactivity,*,

encephalitis, or adjustment.reactioh of childhood. Parents' concerns usually

lude disruptive school behavior or, poor scholastic achievement and they and

.11from the school Are usually interested in how to proceed. In addition

to inf ormation about the behavioral aspects associated with the medical diag-/

nosis, nations are often given to teachers such as increased structure

, a particular set of

currricu a special class placement. However, teachers who often

in the classroom (perhaps through a contracting sy

lum materials,

'give extensive and high,guality.effOrts_in the classroom discouragingly admit

that they sometimes make limited progress since c es. in the classroom approach

411'

are only part of t solution,. Sometimes the missing component is sane home or

family change which would either improve

supplement the,teacher's efforts

overall emotional climate and/Or

Therefore, to help improve the home situation, a referral is sometime- made4

to a counseling agency,4,4but,there are a number of problems with such a referral.

First, parents are often relilctnt to seek mental health services because of the

usual stigma associated with tc obtain this type of help.. Sometimes fin-,

ancial strain contributes to the h,sitancy. Then,,teo,.gaining sufficient 4hertia

to find.a new place and make new personal contacts defeats follow-through:

Apart from follow-through, even if the family does find its wly toa

seling agency, not every agency has staff who can adequately understand, --irdin-

ate and/or integra e medIcal, school aliod family concerns1

und a child : For

example, a youngster r ently seen with Familial pysau °nom a presented numerous,

Parent Training

(2)

Joel conditions n essitating a number of school concessions. A

referral has been the mai

ernstreamed spina bifida youngster about wham school per-

sonnel and parent* wander whether the child might be us urinary or ambulatory dif-

ficulties as a tool to avoid pertain school rules, activities or pcademic dnds.

However, sorting through and deciding which are realistic demands for

kinds of children would be difficult for a counselor outside a medical environmen1 1\,\

,,

,

Therefore, for whatever reaSOn, school problems which may have same etiologic ).basis in

the home and hospital seldan get - addressed appropriately. Wen so, if all child-

__iencing behavioral difficulties in the school because of aren

medica' condition Od/or home atmosphere were referred and went to mental health

teya, prrit counseling resources would be overwhe

A solution to these referral problems would be

prpgram offered the local sphobol. Ti the mental

f quality counseling

gma would be minimized

since counseling could be presented as another hoo) service. A minimal,

be requested since basic overhead expengeS already been paid.

Y,

School is a familiar setting for uneasy parents Therefore, it seems sensible

to arrange th coordination of educational and therapeutic services,wit*n

lbdal school.

Take for example, a _-1 age child diagnosed as; ctive". Stich a

child might be tried on Rtali.n, but as a numbet of studies seem to indicate,

tho4gh school behavior improvement is probable, home behavior is not ftexn e

fectbd (Wolraich, 1977; (Nioary and Pelham, 1978). "In addition, seldom are the

any real academic improvements despite the increased attentional skill or (V-

creased activity level effected by the Kedication. Perhipps s better

r2-pronged approach: (1) a tfal'on medication, objectively monitored

d be a

ci

is

teachers and

f

1

'clan and (2)

Training(3)

-icati- appropriate

or family counseling program which

sic child nwiag nth and communication skills, thereby enlisting

p, hopefully improving home relationships and making consistent

these rocedures us in the ham and at school.

'dal aspects of this particular exile are easily accomplished

school person knows about hyperactivity, knows how to use a validthe in

rating scale,. and can coordinate parent, physician and a monitoring system.

School colliultation by a pediatric psychologist has already been discussed by Dr.

hroeier and it is this unique working relationship with school, hospital and

family that often prove valuable. Here, the role of the pediatric psychol-

ogist is informational toncern _ the particulat medical - behavioral. difficulty as

well as prograMmatic. That is, using available capabilities deciding how

to d -1 with and ameliorate the problem in the

part of the 2-pronged approach is less laraightforwardo

Working info: ally with the parents or -r entire

particular medical, and/or school probl_ as important

cation. atric psycholooist should be Bile to rely

has' dons gam. job of making clear the

dn

make"behavioral c

Hover,

this else.

as

hool per

tion

is get in=

atric nor

psychologists, nor ether school people such as guidance counselors orN

-s could deal individually with the number of faits whose children are

creating school problems.

a likely a)

refore, a croup approach to family c u d

41

especially si 6 many of the problems and goals of partici-

pants wood be silar.

_cept 0 group _

Par- Training4)

training is not new. The first to

that I could find was pr fished in the early 1800's when such groups

were called "maternal associations" (Croake arjd Clover, 1977). Over the years

the content of parent groups has ,varied, focusing on such thi

Iapment norms, information about sly

as child de-

of child development such as

lity and rearing techniques (including'discipling methods) , aind

personal cammunicat on. Such groups ed in the influ- e exerted b' the-

leader, and in turn their formats ha ve ranged from highly didactic-training to

relatively --t 'I "leaderless" opinion shating.

.0!number of approaches are currently popular including _ET (Gordon, 1970),

Dreikers approach-(Dreikers 1963), and behavior Modification,

kruMboltz & Krumboltz, 1972). ver, disappointingly with same except

little'good r eh is available to document the effectiveness of these approaches

tine chjldr? or their parents' b -hivir rs. Mast studies that have

sketchy reciardim the procedures used,

and were poorly -de_.'oned with _ poct-to how effe tivenss

emitting an appropriate ccupari-- -ntrol grot

program's font,

was measured with most

One exception to some of these methcdolo gical criticisms has been --o

parenting research associated with a behavioral apprca ch.

reviewed this area so well has concluded, traipting-parents

niques (more than general principle- ) is effecti in c

_ Dell (197 d)_ _

behavioral tech-

parental attitudes

toward children as well as home behaviors of those children. Fewer conviric

data exist on maintenance of the desired behavior or whether parents th-

chang_ behavior patterns. Nevertheless, it seems that professionals can teach

parents skills which they in.turn can employ in making charges in the behaviors

of their children.A

, lets return to the theme begun earlier to this papa

Parent Training(5)

y

W'pediatrio prychologist help resolve behavior and adjustment dffficu

in the school? The group approach. would seam to hold promise. .Tbrigoe (1977) has

rted some preliminary data which sugge t that the pa rer t 4roue format can

hool performance generalizing from home to schanl for both targeted

non-targeted home behaviors. Teacher= s subjective- rating

only the ex

positive for

(c. selaJ) group and acadanic gains re greater only for/that

group as well. Unfortunately, psychologists, espeosally those affiliated with health

care delivery systems, deer not offer their serviCe to many of ti parents whose

hildren are having home )d related school problems. Consequently, one wonders

whether the hool itself might not take a rmrrre aggre

In discussing this notion with 1

pproach in this area.

'pool people, a n response has been e_

we don't have people= with that kind _ training, or such people lust don't have the

As nrimicer are irnyTtant cure s- I rest--

ectiv-

Nevertheless nirrtl-rcr

of having sane type of olainse

thi s t-},vo o' pr

I

such as dou is cone;

lo

irxl -roKirc_- a'u 1ab1e ttlrOU 1 h

pose of such a program would bo twofold.

tent ial vino

DI. The pgr-

the district (fx rhaps in con-

junction with the local Department of Piental or Public Health) would of P-1

groups--lith a preventive emphasis, --king with interested parents whose ldr

'thin prescribed age groups eLample, during one month of the year, four-

year-olds h ght be the topic of discussion whereas fives and s --year olds might

be the focus the next month and your he next, etc. Developmental

norms, educational possibilities in the home as well as probl ffl-so1 qxrpr approaches

could be highlighted. In addition, district -wide speciality groups might meet to

discuss such topics as hyperactivity, learning disabilities, mental retardation,

or cerebral palsy [their releve to the school. The pediatric psychologist

could serve as consultant and/or model for such efforts."'

Parent Training6)

The second focus of _ y services" c1e rt rt within

be crises oriented to deal with families of those children who are cr

-haul behavioral problems, when it is thought the family could have some type

of ameliorating influence. of course, cal l y r -1 adjustMent problems

would also deserve this type of intervent iorr, useful with spinal _ rd

orthopedic

1- this Via assumi a parent surrcJiate,ro

the school would form an alli,owo. wit1, the parent3 j ro yid rxt infoimation, eels

ance, as well as a forum for fc usin ulx n behavioral and ad justrnenf

A mutually acceptable stratc ry e ~c rrlcl tx rlctermin nsistent prtxmlm of

intervention could be begun at home aril at the 4100 1. The teacher and parent

prob

f _x) r)"

would have a r 1_ y )nsult-int to deal with coordinating c ffe

as generatin i problem solrrt iorrs.

An issue often i=arsc 1 is hm; can school provide this type

without hiring a number of expensive profess1nals, ny of when are untanAliar

th hool pr Sure

is to :k with alrea,

eleased t from sore teaching and testing responsibilities, and who

ssed interest in lean -vino those skills that might prove helpful in wrirkin,

district

have

st.i

fcnirxl quite prcrusinJ

i.e. -.tieachers and psychologists, whose

th families. I've seer this approach tried with children both at the el46

school and junior high school level acid the results have teen errcou aging.

would like to briefly describe o, r uilot program though it should realized that

nu her of unant cipa di-r1.1,t still is being malified in order

.well as opportunities.

but t years ago, one of the local school districts in

t o e xplore the value of a family counsecounseling program under

district. taw-hex a wfre q I irrit releaac, f tuachitt(1 dtit

in order to teeth actru1 re hnsic rik I Is in lea( !ire. t s'

high t hcc 1 These tr.Ncht.t s first

It tr

tvori 41 par 01 rIt Tviorttql find t n

preceded to teoch A list It-01111 (T1 t 111.1 r (*.Al In t P 'h(

F'011coviing eAch of ti th'e te..tw.t!. ((lne 11 I IL 1114

would di FICUS S the 942 S S 4)4.1 with me and voe list t, r.r 1r+'tc i ix)rt rls (),

t h stipe4 V 1 r.

audiotApr of Ow, sessiuln.- ariliti.)n, wr-1 th' tiac him ceihtfrlt

the rboit. Re i n tiK tt r1 Vlri wtrrt1,1

ions wt .11.: t x r;1 .

our pi c'1s13tr 11r.11VI Of larr.nt

A lett

Pit& as

S Sf ()lit

tt 1t r qL r.'1c t 1

the i)tuIloso f,,-

1'

called

p

!..

Ily tiIt , ealuent ly anktl

414,t w!tIch 41,'

ch11

1r, X I . le iI,t

114! Lv, t 15

tw

it t he (I.1111 t the. t, .-t I hit sosr. 1, ,r 1 I

r(.till ,tt tr_Ar trix)rtients were

the parents

.trout`, 1t 1 le_

JeiA=

aE,s1e4ry-wIn. c-crli.1,=.

"Behaviora 1:41 t 1,

they %J) lit! I J-14 .

fates on well thcft,

during ser

ro_erpr-irt 1--,1

14.1parit . Ti II

I.

11 1r1<1 tilt` 1."

he

I : 1

r

or rel ev.i:

ern

rc r.it'St 1111

,11!-i. 71

111.1e tion i.Dr.

1: I, NO

,`lit

t grcxsp rtrxl In Taiolc I c1f t

can DSO it folly fitrly r1t Jut Lint Ix-tiny tot .-1 I Ai (vt( 'h.

do in till. inn 11

1 Pik 111R that tht to; itri,o Wheih fli

f (x-Aix . six Iv. um .111.1 .171 Atli .1 411 . 11.1w It I

[Air i nil he ?IOC( II! ft0 !=o!I st

t fit r.-tt iriphartim

t

nt Trnininq(N)

anti t r v.* !! r ro! h

'MU, petit 1

thr 1111 1 1i '1,1t1-. t;;;1

-h 11. .k'!

t a, ow s

f 11)5: X. )1 x if

etx_q_x_,r

cx.)"; 1 tOt l'tV

to.c. oti I.1 1 is t

This

eartotti f

in t o t h. ;

likely tc resp no/.

wX,rli .'.t t

,l hi. ik i -4-11 1 li ue.e. 1,

it s t.rt i It tit y

Orlo I I

.1 7.-; w.1 ; 1 t 111., ;,11,

(r-6i: 1. t

17-1!..-e!, 1 I I

11!11 .11

t 1:11111!;.: Alio; ol; !I.

.-tro 1

I: -' I .0..0 hI7 t; 1 1 1

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:

1 of ;

; I ' 7 . 1111 :

tlf

chock 1 1 It *fa

1

wtv 111 t

t (prey' 4111

fertyltettee.

NIA 1114%1. t

foi it,th t ! 17.1

.1t

for th.L. exi_c *

t retti wit

2

Tract-ti rat 17):`-

7'

1.1'

strut M Art

t

P41'

1111901entk 1 parrnt 01, AV f 1"it!A1 mn111rry nruI

T.11.11` vt.r% t r. Aftch par l i l t

.11.410 I h. 7 nt yi PI I 1 KIN11.

r11-

tw'y 1,111: Iv !Ill

the !ilitrrt

t ft ..1 ,.* 11-kin.

! 1'

inSt t 1tet

(VA re-try.A.'

I chi 171 1411.T t' ()IVY ,17fItti

7 1 .4 l'7,.',!1:1 ?Pp'

V.;.1 !!Yi

.1t

:*"

1',/ 0.

!t'

f

: .7'

i

t t wit s

Parent Thai--(10)

sessions wrere rated more positively in overall claksr n I havicrs, whereas

control group children's ra s w unchanged.

These data would suggest that parents felt -that the interaction

them and their children had improved as a result of

volvement. NO academic gains were apparent, but=then behavior change probably

was not beginning to occur at home until at least ha fway through the last narking

period therefore reversing:the academic trend at that point right have

,-.been-quite difficult.

Per se ken -cept for eti=ng homework in sane classes) but rather most

In addition, specific acadeMic skills were not Addressed

parents sed on

related. Examples of these would-be such things as stealing, keeping a room1

clean, being in at an agreed upon hour, and vari_ _q household chores There-

pecific behaviors which usually were not directly school

_B

fore, _ would seem reasonable that academic changes would not be immediately

evident with those types of behaviors being targeted. Getting along better

with adult authority figures at home was presumedly aehieved,,and perhaps was

seen at school in the lower number of misbehavior referrals made to school officials.

It can not be argued from these data thathe training these teachers re-

ceived was instrumental in the change which was produced. __thing here even

argues for the necessity of training at all. However, the teachers themseIVes

thought they needed it and, as the unbiased trainer of these teachers, I too0,

felt that-they acquired a nu r of valuable group leadership skills as well as

learned same effective techniques for dealing with a rnurnber of behavior prob-

lems often assthiated with this age group! It is an irical question of

whether training is helpful and .if so, which kind-of training the

best _match for a given trainee style or referral problem area.,

Perhaps, as important as the objective data are some of the subjective

es which were noted by the teachers of some of the rimental group

subjects, In a few instances teachers approached the parent group trainers-

13

ingufr

Parent Training(11)

what was being taught and mentioned that a student's work omits

and/or class demeanor had noticeably ehnged . Apparently because of notices

abletgea in their parents' behavior, some of the experimental group stu-

dents (and in some cases their siblings) asked parents what they were learning

and requested to attend a group session which they did during a pizza party at

an additional session.

It should be noted that at the end of the'greep sessions,all parents were

told that if other parenting, marital or personal counseling services were de-

sired to continue to improve things, the oup leaders should be told and the

parent (s) would ..be helped to obtain those services in available community ag-

parents initiated this type of contact though in same instances it

-opriate. A more direct suggestion to these parents did not result

in any known referral regOests for further assistance. Since in each ca

prior suggestions for professional help wer_ not followed, it \is felt that this

hesitancy Was not engendered.by the group experience. Rather, is of/interest.

that these hesitant parents availed themselves of this school sponsor] program.

The pilot data reported earlier would suggest then that invoblement in a.

I.-led parents' group can effect changes in parental and teacher attitudes

toward their children who had presented as behavior and/or academic problems

children at school.

Based upon these findings, it is a matter of some debate as to whether

school involvement of this type is appropriate since no significant academic

gains were forthcoming. Those holding a more traditional view may

argue the

11

-hoof has little business performing parent training or family ther-

apy. Rather it is the school's responsibility to help students learn a basic

corpus of material. tin the other hand, others would argue that such compart-

mentalization is very myopic since the areas of academic achievement and personal

and home life atmosphere certainly interact. It may be that academic.effects-will be

14

Tra_thing

(12)

as these students e rperience an knproved home milieu for a longer peria

think these data do support continuing efforts along this line in of

clarify whether academic gains can be realized with this approach. Therefi

are many other research areas which need to be e> e closely and in-

elude such things as the importance of many kinds of training, teacher trainee

characteristics, the problems lest treated by a group approach; and areas af-

fected Other than school grades, such as'self-image, peer relatianOti_psand

delinquency. On tuitive level, it would Seem that the latter areas have

rich dividends to pay if pursued. This approach would also get mental health

people working with eduCators and the hybrid product might be greater than the

sum of its Given the fact that a pilot program has had value, the

tential'for u-' an expanded approach as a way of generally increasing the

`quality ofilife for families is exciting.

Until now, attention has been given to training teachers to lead parent

groups. Another approach would be to encourage and, if necessary, help train

school psychologists to both lead such groups as well as train teachers in their

districts to become so involved since, it seems unlikely that school psychologists

would be able to lead tilt number of parent groups necessary. The role of the

hool psychologist varies greatly from district to district but in many is that

of a portable, perpetual I.Q. generating device about which teachers and administrators

have little understanding. Consequently, it would seem appropriate for the school

psychologist to exercise leadership in the formation and evaluation of mental health

programs in the school.

P haps'it should be stated that any pareht group program (or any other

initiated in a school should have built into it same type of monitoring systAT

which will allow evaluation of botlit'the overall program as we 11 as individual

group leaders. Same people make groups work and others don't. he need to know

haw to discriMiAate between. these types of people so as to make the programs

15

effective as as rnodel

of a behavioral persuasion.

How does a

Parent Training(1

Ap you honest" procedure advocated

_atric psychologist fit into all this? AS has.already been

noted, the pediatric psychologist often already has input to teachers and various

Jmoof psychologists and administrators. As an objective, non-school; a-:

political professional, his/her influence could foster careful thinkingthinking ut

the role of mental health in the school, and better insure appropriate iRiple-

mentation if a plan were accepted. Of course, the pediatric psychologist would

contribute his medical -psychological expertise as consultant to school and

family so that appropriate behavior remediation programs would be designed in

the group or classroom. Having parent training groups as an available option

for medically related school problems as well as more traditional learning dis-

ability and behavioral difficulties would mae less wide the qult_between clinic

diagnosis and school or home improvement.

In this paper I have described a possible mecharii : to help improve the

quality of mental health for students, both at home and in the school. To do

this, I have advocated the inclusion of a school based "family services" departmen_

which would offer at 1-- t parenting instruction. Because of budgetary restraints,

people being hired exclusively for the delivery of this service seems unlikely,

but it does appear possibl train ecisting staff to provide this service

and pediatric psychologists are in a-unique position to be germinal in this effort.

In terms of priorities, it seems proper that the institution which 'demonstrated

innovative leadership offering driver's education, tennis lessons, and job training,

should now show similar leadership in assisting their graduates in the more impor-

tant learn activity of parenting.

1 t;

A

REFERENCES

Cr ki, J. nd Clover. K.E. A history and evaluation of parent

ordinator, 1977, 26, 1517158.

ikons, R. 6 Soltz, V. Children the challenge. N.Y.: Meredith, 1964.

Parent Train ng14?.

_on. The Family Co-

ectfveness tra

children. New York: Wyden, 1970.

Krumboltz, J.D. and Krumboltz, N.B. Changing children's behavior. Englewood C

N.J. 1972.

D'Dell, S. Training parents in behavior modification: A review. Psychological Bulletin,

Abp

D9Let S. and Pelham, W.E. Behavior therapy and withdrawal of stimulant medication ins

hyperactive children. Pediatrics, 1978, 61, 211 -217.

Patterson, G.R. Families: Application social learning family life. Champaign,

IL: Research Press, 1975.

14744 81, 418-433.

4Dorigoe, R.Y. Effecting behavioral affective, and cognitive changes in children through

the involvement and training of significant others: A low cast program in collaboration

with the school. Catalog of _Selected Documents in Psychology, 1977, 7, 18.

Joiraich, M.L. Stimulant drug therapy in hyperactive children: Research and clinical

implications. Pediatrics, 1977, 60, 512-518.

1st W

3rd Week

4th W9

5th Week

6th Week

7th Week

lntru

More

When

More

No Session

tack:

Step, 4:

Patent GrOup Curriculum

Why

Steps 1 and

=

The Things We'DO(includii-- ddvelopnental

What's the Problem and Haw Big a

Problem is it? (Defining and pouncing Behavior)

no

the Things We to: Reward Principles

Step 3: Designing an Intervention Plan

Enough I

oint Systerris

Punishment Principles

Contracting

Behaviors and Feelings

uate and fret ileshoot

Not at all itclerate Ite a

can't sit tlf.orC

or 0

yes o

kyexits at

dtUni

We c ass

u_sxve

.4 f