Better Tools for Discipline: Pitt Teaches Family Counselors Proven Therapy to Reduce Abuse

In a community-based effort to promote effective discipline and foster positive parent-child interactions, the University of Pittsburgh is training counselors at local community agencies in Allegheny and Butler counties in an evidence-based intervention. This community-based effort, funded by the National Institute of Mental Health, titled “Partnerships for Families,” aims to teach focused Cognitive-Behavioral Therapy (CBT) to families who are concerned about how they use physical discipline or those who have a history of physical abuse. The project has the support of the Allegheny County Office of Children, Youth and Families, and Butler County Children and Youth Services.

Developed by a team at the University of Pittsburgh School of Medicine, led by David J. Kolko, Ph.D., professor of psychiatry, psychology and pediatrics, focused CBT is one of only a few scientifically proven interventions for families with identified problems with physical discipline and/or physical abuse. This intervention has been recognized as a promising practice by the U.S. Office for Victims of Crime and the Kauffman Foundation’s “Best Practices Project.”

The use of physical discipline is common and legally acceptable within certain limits in many states, including Pennsylvania. Physical discipline sometimes may become harsh, excessive, hurtful or injurious, even when a parent has good intentions. Physical abuse by caregivers has been associated in children with high morbidity and fatality rates, behavioral and emotional problems, an increased risk for long-term psychiatric conditions, deviant or criminal behavior and impaired relationships.

The focused CBT being used in this program helps children and their caregivers by integrating several complementary approaches to help families change the way they think, feel and act. This involves teaching specialized skills to children and parents, in both individual and joint sessions. The skills are designed to promote self-control and help families solve problems safely and effectively, with the main goal of encouraging alternative methods of interaction that can improve parent-child relationships and decrease the use of physical force within families.

While researchers have seen the benefits of such an intervention in a university setting, the current program is the first rigorous study to determine whether the therapy is feasible and effective when used in community settings. Therefore, in collaboration with local social service and mental health agencies, the University of Pittsburgh is providing a free, six-month training program in CBT to supervisors and counselors who work with families concerned about their use of physical discipline or who have a history of physically abusive behavior. The effectiveness of the intervention, as determined by the counselors and families, will be assessed at study intake, and then six months, one year and two years later.

“Often, we determine what treatments work well in the very controlled settings of university- and hospital-based clinics, but we don’t always investigate how well these therapies work in the real world,” said Dr. Kolko, principal investigator of the study. “In developing our treatment, it was important to bring what we have learned about helping parents and children to partners in the community who deal with these issues every day.”

Community agencies participating in the study in Allegheny County include Auberle, Every Child Inc., Family Links, Family Resources, Western Psychiatric Institute and Clinic of UPMC, Rankin Christian Center, and Northshore Community Alliance. Family Pathways is participating in Butler County. Additional community agencies are welcome to contact the project.

Co-investigators of the “Partnerships for Families” study include Barbara L. Baumann, Ph.D., and Amy D. Herschell, Ph.D., of the department of psychiatry, University of Pittsburgh School of Medicine, and Stephen Wisniewski, Ph.D., department of epidemiology, University of Pittsburgh Graduate School of Public Health. The study includes administrators Betsy Austin Holden, M.Ed., L.P.C., and Heather Bragg, B.S., community liaison Meghan Shaver, M.S.W., L.S.W., research associates Dawn Rone, M.S., and Carol Bush, B.A., and data manager Eric Hinrichsen, B.S.

The Partnerships for Families study will recruit family participants from all of its affiliated community agencies. However, for more information about the project, please call the study coordinator, Betsy Austin Holden, M.Ed., L.P.C., at 412-246-5886 or toll free at 1-800-518-0384, or access the project web site at www.partnershipsforfamilies.org.