Which Treatment do Parents Prefer?: A Randomized Preference Trial to Inform Personalization of a Parent Training Program

Abstract

Studies on personalized interventions suggest that the ‘one size fits all’ approach of most psychotherapeutic interventions fails to meet the needs of many healthcare consumers. Because parents ultimately decide upon treatment for their children, there is a growing recognition that parents should be involved in the selection of their children’s mental health treatments. The goal of this pilot study is to investigate the relationships among parent preference, treatment attendance, treatment modality, and parenting treatment outcomes using a doubly randomized preference trial. At baseline, 129 families with children ages 4 to 12 years presenting at community mental health clinics participated in a conduct problems intervention study. Families consenting to participate in the study were randomly assigned to preference (n = 64) or non-preference groups (n = 64). Those in the choice group were able to choose between four intervention options while families in the no-choice group were randomly assigned to one of those four options. The results of Study 1 showed that individual family home-based Parent Management Training Oregon Model (PMTO) was the most preferred treatment and parents who were randomized to the choice group were more likely to attend the interventions than parents in the no-choice group. Using data from baseline, post-intervention and 6-month follow-up, in Study 2, the results of mixed-effects models showed that parents in the choice group who selected PMTO interventions had better parental treatment outcomes over time compared to parents in the choice group who selected child therapy. Implications were discussed.