Parent Training for the Treatment of Oppositional Behavior in Young Children: Helping the Noncompliant Child
Noncompliance (i.e., excessive disobedience to adults) is consistently reported to be the most prevalent behavior problem for clinic-referred and non-referred “normal” children alike, and is currently viewed as a keystone behavior in the development and m
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CONCEPTUAL MODEL/OVERVIEW OF PROGRAM Noncompliance (i.e., excessive disobedience to adults) is consistently reported to be the most prevalent behavior problem for clinic-referred and non-referred “normal” children alike, and is currently viewed as a keystone behavior in the development and maintenance of conduct disorders. “Helping the Noncompliant Child” (HNC) (Forehand & McMahon, 1981; McMahon & Forehand, 2003) is based on a parent training program originally developed by Hanf at the University of Oregon Medical School in the late 1960s (e.g., Hanf & Kling, 1973) to treat noncompliance in young (3–8 years of age) children with a range of developmental disabilities (see Reitman & McMahon, 2010). While several independent groups of clinical
Robert J. McMahon ● University of Washington Nicholas Long ● University of Arkansas for Medical Sciences Rex L. Forehand ● University of Vermont
R.C. Murrihy et al. (eds.), Clinical Handbook of Assessing and Treating Conduct Problems in Youth, DOI 10.1007/978-1-4419-6297-3_7, © Springer Science+Business Media, LLC 2010
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researchers have adapted Hanf’s original program, the adaptation by the current authors (Forehand & McMahon, 1981; McMahon & Forehand, 2003) is one of the most formally operationalized and evaluated versions of this approach to working with young children with conduct problems. The purpose of this chapter is to provide a description of the theoretical assumptions that underlie HNC, an overview of the program, and a summary of its empirical support. We also provide a description of a typical HNC case, and conclude with remarks concerning future directions. Longitudinal studies have shown that there are multiple pathways that lead to the development of conduct problems (e.g., Moffitt, 1993, see Chap. 3). The “early-starter” (Patterson, Capaldi, & Bank, 1991) pathway is characterized by the onset of conduct problems in the preschool and early school-age years, and by a high degree of continuity throughout childhood and into adolescence and adulthood. It is thought that these children progress from relatively less serious (e.g., noncompliance, temper tantrums) to more serious (e.g., aggression, stealing, substance abuse) conduct problem behaviors over time; that overt behaviors (e.g., defiance, fighting) appear earlier than covert behaviors (e.g., lying, stealing); and that later conduct problem behaviors expand the children’s behavioral repertoire rather than replace earlier behaviors (e.g., McMahon, Wells, & Kotler, 2006; Patterson, Reid, & Dishion, 1992). Furthermore, there is an expansion of the settings in which the conduct problem behaviors occur over time, from the home to other settings such as the school and the broader community. The primary role of family socialization processes in the development of the early-starter pathway has been described and empirically demonstrated by Patterson and his colleagues (e.g., Chamberlain & Patterson, 1995; Patterson, 1982; Patterson et al., 1992). Patterson emphasizes the coer
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