The degree to which PMT components can be effectively delivered in integrated care settings for primary care pediatric patients who present with existing externalizing problems remains in question. Research by Axelrad et al. (2008) conducted in a behavioral outpatient clinic affiliated with a children’s hospital provides the closest evaluation of integrated-like PMT in the published literature to date. In this clinic, predoctoral psychology interns and pediatric medical residents provided brief treatment to children with externalizing

behavior problems. Most referrals were from children’s primary care physician. Sessions typically lasted 30 minutes and the number of sessions typically ranged between 2 and 18. Axelrad et al. conducted an exploratory analysis CAL-101 of their clinic by randomly sampling 550 patients, 276 of whom attended two or more sessions. Of these 276 children, 80% (a) presented for externalizing behavioral concerns and (b) were www.selleckchem.com/products/dabrafenib-gsk2118436.html provided interventions utilizing behavioral principles from empirically supported treatments for disruptive behaviors.

Information on treatment effectiveness was gathered from patient charts, specifically from student clinician’s session notes. According to archival data, 56% of children with an externalizing behavior problem who attended two or more appointments showed improvements, as indicated by therapist discontinuation of services due to amelioration of an initial presenting concern or premature termination of services with significant symptom reduction noted by the clinician. This study is encouraging in that there is preliminary support that behavioral problems can be successfully treated in a brief format in clinic settings. However, this study used qualitative information provided in patients’ charts to determine treatment effectiveness and did not have supporting quantitative data. A recent trend in the field is to adapt parenting interventions Tyrosine-protein kinase BLK in an effort to reach a larger and more diverse set of parents, especially those unlikely to access services in a specialty mental health clinic. One

such strategy involves culturally adapted protocols created from input provided by key population stakeholders (e.g., Dumas, Arriaga, Begle, & Longoria, 2011). Dumas and colleagues (2011) developed a Spanish-language PMT program for delivery in preschools and daycare settings that had integrated mental health services. Another approach for adapting and extending the reach of parenting interventions is the Family Check-Up, which is conducted primarily in the homes of disadvantaged families of young children at risk for conduct problems (Dishion et al., 2008). The Family Check-Up involves an extensive assessment, followed by feedback that combines motivational interviewing (Miller & Rollnick, 2002) and a menu of services for enhancing parents’ child management strategies.