Parent-Child Memory Study: Improving Future Thinking Among Mothers

Henry Ford Health

Status: Enrolling

Conditions: Behavior, Health

Treatments: Behavioral: Episodic Future Thinking (EFT); Behavioral: Episodic Recent Thinking (ERT)

Study type: Interventional

Funder types: Other

Identifiers

NCT06145919

NHRCT: 16828-01

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.

The aims of the current study are to conduct a Stage 1 parent-child dyad randomized control trial (RCT) (n = 72) examining the effectiveness of a brief, episodic future thinking (EFT) intervention in a community setting serving low-income mothers and additional implementation data. Participants will be randomized to receive either Episodic Future Thinking (EFT) or Episodic Recent Thinking (ERT) intervention arms. This case series will examine the efficacy of episodic future thinking (EFT) compared to episodic recent thinking (ERT) 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: 144 estimated patients

Sex: Female

Ages: 5+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Parent Inclusion Criteria:

1. A mother and or grandmother from the Flint area with a child/grandchild between the ages of 5-10 who can provide legal consent for that child
2. Self-report that they have consistent contact with the child/grandchild
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 if interested in virtual participation

Parent Exclusion Criteria:

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

Child Inclusion Criteria:

1. Children must be between the ages of 5-10 and have a mother/grandmother willing to provide consent for their participation
2. Willing to participate in parent-child observation sessions
3. Elementary proficiency in English
4. Willing to participate in study surveys

Child Exclusion criteria:

1. Self-disclosed active suicidality/homicidality
2. Self-disclosed current bipolar disorder, schizophrenia, or psychosis

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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144 participants in 2 patient groups

Episodic Future Thinking (EFT)

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. The participant will be asked to discuss their relationship with their child and to give examples of both positive and negative parenting from their personal experience. The "peer mother" will then ask the participant to think about their long-term parenting goals and will discuss how to create a vivid event that will be easy to remember. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, participants are asked to engage in messaging that will prompt them to think about future events.

Treatment:

Behavioral: Episodic Future Thinking (EFT)

Episodic Recent Thinking (ERT)

Active Comparator group

Description:

In the episodic recent thinking (ERT) condition, the participant will be asked to discuss their relationship with their child and to give examples of both positive and negative parenting from their personal experience. The "peer mother" will then ask the participant to think about the present and discuss how to focus on the present. Two positive recent events and two negative recent events will be used to create ERT scenes for the parent to envision their current relationship with their child. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, participants will receive messages over the course of two weeks helping parents to focus on recent events with their child.

Treatment:

Behavioral: Episodic Recent Thinking (ERT)