Improving Future Thinking Among Mothers to Reduce Harsh Parenting and Improve Child Outcomes

Henry Ford Health

Status: Completed

Conditions: Behavioral Health

Treatments: Behavioral: Episodic Future Thinking

Study type: Interventional

Funder types: Other

Identifiers

NCT05229146

NHP: 15407-31

Details and patient eligibility

About

Parents of children from impoverished communities are disproportionately more likely to engage in harsh physical discipline, which can lead to serious clinical outcomes, including suicidal ideation and attempts. One mechanism linking low resource environments and maladaptive parenting strategies is maternal delay discounting, or the tendency to value smaller, immediate rewards (such as stopping children's misbehavior via physical means) relative to larger, but delayed rewards (like improving the parent-child relationship). This study will examine the efficacy of implementing a low-cost, brief intervention targeting the reduction of maternal delay discounting to inform broader public health efforts aimed at improving adolescent mental health outcomes in traditionally underserved communities.

Full description

Harsh parenting is associated with serious and costly mental health problems among youth, including substance use, mood disorders, and suicidal ideation and behaviors. Of concern, these parenting practices are most common among families from impoverished communities; however, many behaviorally-based parenting interventions do not take into account the unique mechanisms linking environmental disadvantage to parenting approaches. While the causes of harsh parenting are complex and varied, one such mechanism may be parents' tendencies to prioritize immediate rewards (such as stopping a child's misbehavior via physical punishment like spanking and hitting) relative to larger, but delayed rewards (including improved parent-child relationship quality), known as delay discounting. This case series will examine the efficacy of episodic future thinking (EFT) to target reduction of parenting-related delay discounting. Outcomes will evaluate the effect of EFT on reducing maternal delay discounting and harsh parenting, and improving child clinical outcomes.

Enrollment: 48 patients

Sex: Female

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Be the mother from the Flint area of a child between the ages of 5-10 who can provide legal consent for that child to participate in this study
2. Self-report that the child lives with them for at least 50% of the time
3. Willing to participate in the study
4. Able to participate in written assessments and an intervention conducted in English
5. Have a working cell phone that can receive and send text messages and be willing to receive/send text messages as part of the study
6. Have a phone or device that's able to use video conferencing software

Exclusion criteria

1. Self-disclosed active suicidality/homicidality
2. Self-disclosed current bipolar disorder, schizophrenia, or psychosis
3. Current and ongoing involvement with child protective services

Trial design

Primary purpose: Prevention

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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48 participants in 1 patient group

Episodic Future Thinking

Experimental group

Description:

Mothers will receive episodic future thinking (EFT). Mothers will meet with a "peer mother" who will administer the EFT intervention, including generation of several specific future events reflecting positive interactions with their child. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, mothers will receive daily text messages over the course of two weeks including a reminder cue generated as part of the EFT and a prompt to remember these episodes in vivid detail.

Treatment:

Behavioral: Episodic Future Thinking