Biopsychosocial-based versus behavioral-based parenting model: A clinical trial for adoptive parents with attachment-challenged children.

摘要

This study compared three groups, 2 treatment groups and a control group, to examine whether caregivers who adopted children with attachment challenges from the foster care system would report behavioral changes in their adopted children after participating in parenting programs and which program was more effective. Children with attachment trauma historically have been treated using behavioral modification, forced eye contact, and talk therapy. The problem with traditional treatment is that it does not educate the caregiver about the underlying issues or the neurobiology of attachment trauma, which can cause the child to react out of need for survival. Historical treatment has also focused on controlling the child's behavior rather than helping the caregiver create a relationship with the child.In this study, two well-known parenting programs were tested: The Benjamin Interactive Parenting Model (BIPM), a biopsychosocial based model, and the Love and Logic Parenting model (LLP), a behavioral based model. The BIPM is based on the stress model of parenting, which addresses the neurology of a child after experiencing attachment trauma and incorporates caregivers' psychological introspection of their own historical traumas that can interfere with the attachment process. The BIPM adds an interactive component using kinesthetic bilateral stimulation as a means to build relationship between parent and child, as well as to enhance areas of the brain that are depleted when a child experiences trauma due to neglect or abuse. The behavioral model LLP integrates love and kindness in parenting skills while creating discipline through naturalistic consequences. Outcomes were measured by the Child Behavior Checklist and the Revised Adult Attachment Scale. A multivariate analysis of covariance showed that there were no significant differences in the caregivers' reports of children's behavior or in levels of attachment among the three groups after controlling the pretest differences.One major limitation of the study was that not enough time was allowed for complete changes in behavior or attachment to take place. Caregivers who attended the parenting programs did report feeling more confident in their parenting.