Core Components

GenerationPMTO programme promotes positive parenting strategies for the purpose of preventing, reducing and reversing conduct problems in children and youth aged 2-17 years. This programme recognises that coercive parental practices can promote negative child outcomes. GenerationPMTO programme therefore aims to disrupt coercive transactional patterns between parents and children by strengthening positive parenting strategies. This translates to increased positive parent-child interactions; enhanced social competence in children; reduced problem behaviours; and positive family effects.

GenerationPMTO programme is a manualised intervention that has five core components; a) encouraging positive behaviour; b) family problem solving; c) positive involvement; d) limit setting and e) monitoring. Five supporting skills are also taught in the Generation PMTO programme. These include; a) effective communication; b) emotional regulation; c) giving clear directions; d) promoting school success and e) mindfulness. These core components and supporting skills are taught during GenerationPMTO programme sessions delivered to individual families or parent groups.

Individual family sessions are structured, but with enough room to tailor sessions to address unique family issues. Along with parents, children are included in these individual family sessions to varying extents, based on the needs and preferences of the family and therapist. To complete the programme, individual families usually attend 12-30 sessions, with number of sessions dependent on unique family needs, and severity of the problems within the family. Each weekly session lasts about 60 mins and consists of warm up phase; review of home practice assignment; trouble shooting and adjustment; introduction, practice and tailoring of new materials; and new home practice assignment. One practitioner delivers the programme per family. Group sessions have the same content, but are more highly structured with less room for individual attention. Ten to 14 group sessions are delivered to the parents only, with each weekly session lasting 90-120mins. Two to three practitioners deliver the programme per parent group. 

There is flexibility to the GenerationPMTO programme which is reflected in the different delivery modalities (home, clinic and telehealth); multiple delivery formats (individual families, parent groups); diverse populations addressed (such as at risk, homeless, immigrant, military) and family contexts (such as two biological parents, single parents, grandparents led).

Fidelity

The Director of Fidelity oversees fidelity operations for GenerationPMTO implementation sites by is ensuring adherence to the measures below:

1. Applying the Fidelity of Implementation Rating System (FIMP) for assessing practitioners’ competent adherence to GenerationPMTO model
2. Ensuring that FIMP raters are certified GenerationPMTO practitioners
3. Making certain implementation sites show competent adherence to the GenerationPMTO model through a successful reliability test taken annually by FIMP their teams

Modifiable Components

GenerationPMTO programme is available in English, Spanish, Norwegian, Icelandic, Danish, Dutch and Arabic. Programme training and materials have been adapted to the different cultural contexts. A pictorial format is available for non-literate families. As described in the core component the flexibility of delivery allows the programme to be modified to meet the needs of individual families.

Implementation Support

Implementation Sciences International, Inc. (ISII), is a not for profit, research organisation that oversees GenerationPMTO programme implementation. ISII is affiliated with Oregon Social Learning Center (OSLC). ISII trains all first-generation practitioners in GenerationPMTO delivery.   

ISII employs a five phase approach in fully transferring the GenerationPMTO programme to organisations/ communities. This is to ensure sustained fidelity in programme delivery. It also ensures that organisations have the capacity for continued training, coaching, certification, recertification, and fidelity evaluation.

1. Phase 1: In this preparation phase, ISII provides organisations with GenerationPMTO programme overview and programme materials. ISII conducts site visits, and carry out a structured interview to determine the potential fit of the GenerationPMTO programme for the organisation. ISII also make available a readiness checklist, discuss training options and provide support with budget estimation.
2. Phase 2: In this early adoption phase, ISII provides training, certification, technical assistance, troubleshooting services and other support to ease adoption of the GenerationPMTO model.
3. Phase 3: In this implementation phase, ISII helps organisations build infrastructure for onsite delivery of GenerationPMTO model, and sustain fidelity to programme model. They also provide troubleshooting and technical assistance, training, fidelity monitoring, and other implementation support.
4. Phase 4: In this sustainability phase, capacity is increased as implementation sites train the next generation of practitioners. ISII also provide support to programme leadership, certify fidelity raters, evaluate fidelity, and help organisations establish a recertification plan. In this phase, transfer of the programme to the organisation / community is complete.
5. Phase 5: In the continued collaborations phase, ISII and organisations negotiate long-term agreements, and extend programmes’ reach.

After full-transfer, GenerationPMTO sites participate in annual reliability tests with ISII fidelity team.

Licence Requirements

A licence is required to deliver this programme

Start-up Costs

Costs vary depending on programme delivery modality (home, clinic and telehealth); delivery format (individual families, parent groups); number of practitioners being trained; and if full-transfer is the organisation’s goal. ISII trainers are sent to implementing sites for workshop training, and travel costs vary depending on the location. Hence the costs associated with implementing GenerationPMTO ranges roughly from $180,000 - $550,000 over 1-5 years.

Building Staff Competency

Qualifications Required

GenerationPMTO is designed to be delivered by practitioners who believe in families, and in families’ ability to change. While college degrees are not required for practitioners to learn, certify in, and deliver GenerationPMTO, most practitioners have or are working toward degrees in counselling, social work, marriage & family therapy, or education. Practitioner support of behaviour management theory enhances successful programme delivery. 

Training Requirements

Practitioner training is required for successful delivery of the GenerationPMTO programme. The training to certification process from workshop 1 to certification typically takes 12-18 months. Training for up to 18 practitioners includes 3 active workshops delivered over a total of 10 workshop days, plus up to 12 virtual or in-person coaching sessions based on observation of video recordings of family sessions. Sites receive a 1-day kick-off workshop for leaders.

Practitioners receive training manuals to enable effective delivery of the GenerationPMTO programme. Immediately after the first workshop, practitioners begin conducting GenerationPMTO sessions and receive observation-based coaching. During training, practitioners are required to video record sessions with a minimum of three families, and upload them via an online portal. Sessions are reviewed by training mentors and coaches, who provide coaching feedback which is delivered in person, via phone, video calls, or in writing. Practitioners receive about 12 pieces of coaching feedback, which focus on the conduct of therapy sessions. Coaching improves practitioners’ content delivery and teaching methods. Throughout this process, ISII rates practitioners’ work using FIMP, the fidelity monitoring system. After scores consistently appear in the “good” range, ISII invites the practitioners to apply for certification.

To obtain certification, practitioners are required to deliver the GenerationPMTO programme to at least two new families, and submit video recordings of the sessions. Two video recordings are submitted per family; hence four recordings are submitted in total. Sessions in the video recordings are scored for fidelity by ISII mentors, who are reliable FIMP raters. Practitioners must achieve a mean passing score of 6.0 (on a 9 point scale) for each session. Practitioners receive comprehensive feedback for all four certification sessions. Certification enables practitioners to deliver the GenerationPMTO programme with reduced coaching. Annual recertification is required for certified GenerationPMTO practitioners.  

Supervision Requirements

ISII provides training, coaching, feedback and support to practitioners throughout the training process. ISII conducts 3 workshops (10 days total), and provides observation-based coaching through written feedback, virtual meetings, and reflective team coaching sessions. Once certified, practitioners are recertified annually; requirements include a minimum of 3 coaching feedbacks, 1 in-person or virtual coaching session, and 1 full session review. 

Theory of Change

GenerationPMTO was developed by Gerald R. Patterson, and is based on the social interaction learning model (a merging of social interaction, social learning, behavioural and coercion theories). Social interaction learning theory examines the connections among family members, and how that influences healthy or impaired adjustment. It also addresses how behaviours become established through re-inforcement. Hence in this programme, parents are recognised as agents for change, and they are taught key parenting strategies to promote positive family effects.

 

Values

GenerationPMTO programme is a parenting programme that focuses on the prevention, reduction and treatment of conduct problems in children and youth aged 2-17 years. This programme identifies parents as agents of change, and aims to promote positive parenting strategies in these parents. Programme delivery is associated with significant improvements across several outcomes including child behaviours, social competence, parental discipline, and family cohesion.

• Is your organisation looking to deliver a parenting programme that addresses conduct problems in children and youths aged 2-17 years?

Priorities

GenerationPMTO programme is flexible and can be delivered in different settings (home, clinic and telehealth); formats (individual families, parent groups); populations (at risk, homeless, immigrant) and family contexts (two parents, single parents, grandparents led).

• Is providing a targeted parenting programme that promotes positive parenting strategies priority for your organisation?
• What populations and family contexts would your organisation prioritise for programme delivery, or would the programme be delivered across all populations and family contexts?
• In what setting would your organisation be looking to deliver the GenerationPMTO programme? Would your organisation prefer programme delivery to individual families or parent groups?

Existing Initiatives

• Does your agency have existing parenting programmes that promote positive parenting strategies?
• Do your existing programmes prevent, reduce and treat conduct problems in children and youth aged 2-17 years?
• Are the existing initiatives effective? Do the existing initiatives fit your current and anticipated future requirements?
• Are the existing programmes delivered across all populations or to specific populations? In what settings are the existing programmes delivered?
• Do the existing initiatives address similar outcomes as GenerationPMTO? Are there components within the GenerationPMTO programme that are not met by existing programmes?

Workforce

College degrees are not required for practitioners to learn, certify in, and deliver GenerationPMTO. However most GenerationPMTO practitioners have or are working toward degrees in counselling, social work, marriage & family therapy, or education. The training to certification process from workshop 1 to certification typically takes 12-18 months.

• Does your organisation have practitioners who are interested in the programme? Do they have time within their job plans to undertake the recommended training, and deliver the programme?
• Is your organisation committed to supporting the training of practitioners in this programme? Can your organisation support the training of certified GenerationPMTO practitioners?
• How many families will your organisation support in the first year? Based on this number, how many practitioners will require training in the GenerationPMTO programme model?

Technology Support

During training, practitioners are required to video record their sessions with families. Video recordings are uploaded onto a secure portal, then accessed and reviewed by training mentors and coaches. Mentors and coaches then provide coaching and feedback in different formats, including video conferencing and phone. After training, practitioners deliver GenerationPMTO programme to families in different settings including home, clinic and telehealth.

• Can your organisation provide the technology for practitioners to record videos and upload these recordings for review?
• Can your organisation provide the technology for practitioners to consult remotely with training mentors and coaches?
• Will telehealth be used to deliver this programme? Does your organisation have the telecommunications and virtual technology to support programme delivery?

Administrative Support

During training, practitioners are required to record video sessions and upload them for review. The programme can be delivered to families in different settings/ modalities including home, clinic and telehealth.

• Are there policies and procedures in place regarding gaining consent for video recording, and uploading of these recordings?
• What delivery modality (home, clinic, telehealth) will be used to deliver this programme to families?
• Can your organisation provide the administrative support to deliver the programme in the chosen setting/modality?

Financial Support

Implementation costs range from $180000 - $550000 depending on programme delivery modality, delivery format, number of practitioners being trained, and if full-transfer is the organisations’ goal.

• How many practitioners would your organisation like to train? How many will be certified GenerationPMTO practitioners? Can your organisation financially support this?
• What delivery modality would your organisation use in delivering GenerationPMTO?
• If a full transfer of GenerationPMTO is your organisations’ goal, do you have the financial budget to support this?
• Does your organisation have the technology needed for this programme? If not, can the technology be purchased?

Comparable Population

GenerationPMTO programme is a parenting programme that is designed to improve positive parenting strategies. The programme aims to prevent, reduce and treat conduct problems in children and youth aged 2-17 years.

• Is this comparable to the population your organisation would like to serve?
• Has your organisation identified a need for a parenting programme that targets this population?

Desired Outcome

GenerationPMTO programme delivery is associated with significant improvements across several outcomes including child behaviours, social competence, parental discipline, and family cohesion.

• Are the above outcomes priorities for your organisation? Are there other outcomes that your organisation would like to achieve, which are outside the premise of the GenerationPMTO programme?
• Does your organisation have other systems in place that effectively and efficiency address the above outcomes?