Behavioral Child-Management Cost-Effectiveness

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Abstract
This experiment contrasted the effectiveness and cost of three systems for training parents to use social learning techniques for child-management. Thirty self-referred parents of problem children were assigned randomly to either: (1)individual in-office, (2) individual in-home, (3)group in-office, or (4) measurement and contact control delivery systems. Two weeks of baseline data recording preceded five weeks of training and continued data collection and a four-month follow-up. From the parent perspective, effectiveness was measured by observation of target children's problem behavior frequencies , the number and in tensity of parent-child issues, and follow-up ratings. From the therapist's perspective, effectiveness was assessed by ratings of parenting improvement and adherence to training procedures. The value of resources used by each delivery system was assessed from operations, opportunity, and client costing perspectives. All experimental delivery systems produced strongly significant improvements over the control system: a mean 86% reduction in problem behavior frequencies compared to a mean 38% reduction in the control condition. The three experimental delivery systems did not differ in effectiveness on any measure. Non- behavioral measures showed no significant differences between the experimental and control delivery systems. Although operations costs favored group delivery, the more comprehensive opportunity and client costs favored individual in-home delivery.