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PMTO in The Netherlands

Corine de Ruiter, Maastricht University Ferko Öry, TNO Quality of Life. PMTO in The Netherlands. Parent Management Training Oregon model PMTO. A research-based effective intervention aimed at strenghtening the parenting skills of parents with children with externalizing behavior problems.

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PMTO in The Netherlands

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  1. Corine de Ruiter, Maastricht University Ferko Öry, TNO Quality of Life PMTO in The Netherlands

  2. Parent Management Training Oregon model PMTO A research-based effective intervention aimed at strenghtening the parenting skills of parents with children with externalizing behavior problems

  3. PMTO • Scientific foundation (Social Interaction Learning theory: Patterson, Reid, & Dishion) • Certified as an effective program by SAMHSA in the US

  4. Domains • Family • School • Neighborhood • Culture

  5. PMTO • For parents of children with serious externalizing behavior problems • Outpatient treatment program of 20-25 sessions on average

  6. Advantages PMTO • Few parents dropout of the program • Continuous monitoring of program integrity • Program empowers parents and therapists • Proven effectiveness in US • International collaboration

  7. The Netherlands- 2006: no effectiveness research on interventions for 4-12 yr old children with externalizing behavior problems • Violent crime among adolescents show steady increase since the mid-90’s (Wittebrood, 2001). • Systematic review by Trimbos-institute (2004): a lot of different interventions offered, but none are tested on effectiveness • Interventions imported from abroad show program drift

  8. Effects of PMTO • Decrease of internalizing en externalizing problems in the children • Less criminal offending, substance use at longer term follow up • Decrease in depression in parents; increase in competence

  9. Content of PMTO Parents are taught 5 key parenting skills: • Thuis samen problemen oplossen (problem solving) • Kinderen discipline bijbrengen (discipline) • Thuis een warme & liefdevolle omgeving scheppen • Kinderen volgen (monitoring) • Kinderen sociale vaardigheden leren (skill training)

  10. Organisation and design for PMTO in The Netherlands Partner institutions (1): • ISII Oregon/Oslo and Oregon Social Learning Center: training of therapists, training in fidelity checks and assistance with implementation • TNO Qaulity of Life (program management and implementation research) • Maastricht University: fidelity checks; Randomized Controlled Trial (RCT), Cost-Utility Analysis (CUA) and Health Technology Assessment (HTA) study

  11. Organisation and design for PMTO in The Netherlands Partner institutions (2): • PI-Research (translation of PMTO material; implementation research) • NIZW Youth: liaison with other “import” programs • De Bascule, Cardea, Rivierduinen, Jeugdzorg Drenthe: training, intervision and use of PMTO program • Trimbos-institute & Erasmus University: participation in RCT, KEA and HTA

  12. Financing • Now: 3,6 million euro via public–private partnership • Government: Ministries of Health and Justice, Provincies and City regions • Centraal Fonds RVVZ van de Zorgverzekeraars • Private funds: (o.a. Kinderpostzegels Nederland, VSB-fonds, Rabobank Foundation en Fonds Psychische Gezondheid) • In the future structural financing: via health insurance companies, (o.a. Diagnosis Behandel Combinaties DBC’s)

  13. Research on effectiveness • Treatment integrity: behandelintegriteit with fidelity checks • Modification of PMTO training material for ethnic minorities • Randomized Controlled Trial (RCT), Cost Utility Analysis (CUA of KEA) and Health Technology Assessment (HTA): vooraanmelding positief beoordeeld door Doelmatigheidsprogramma ZonMw • Research on Implementation

  14. Trainingplan for PMTO in The Netherlands • PMTO conference 12 january 2006 • Training 12 – 15 therapists March 2006 • Training 12 – 15 therapists September 2006 • Training fidelity coders during 2006 • Research on implementation starts February 2006 • RCT, CUA (KEA) and HTA start in 2007

  15. Concept Organisational structure PMTO in The Netherlands

  16. PMTO as a strategy • Evidence-based and effective • Preventing program drift by fidelity checks and intervision • Parents as partners, own strength based • Change in mentality of executing staff by using impact measures as guiding principle • Increased professional identity of professionals and managers of participatring institutions • New vision on implementation fed by research on implementation guided by impact & outcome data • Maximal commitment of field staff by their possibility to feed in the program content

  17. And now …..let’s hit the road!

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