title: Parent training plus contingency management for substance abusing families: a Complier Average Causal Effects (CACE) analysis.
abstract: BACKGROUND
  Children of substance abusers are at risk for behavioral/emotional problems. To improve outcomes for these children, we developed and tested an intervention that integrated a novel contingency management (CM) program designed to enhance compliance with an empirically-validated parent training curriculum. CM provided incentives for daily monitoring of parenting and child behavior, completion of home practice assignments, and session attendance.
  
  
  METHODS
  Forty-seven mothers with substance abuse or dependence were randomly assigned to parent training+incentives (PTI) or parent training without incentives (PT). Children were 55% male, ages 2-7 years.
  
  
  RESULTS
  Homework completion and session attendance did not differ between PTI and PT mothers, but PTI mothers had higher rates of daily monitoring. PTI children had larger reductions in child externalizing problems in all models. Complier Average Causal Effects (CACE) analyses showed additional significant effects of PTI on child internalizing problems, parent problems and parenting. These effects were not significant in standard Intent-to-Treat analyses.
  
  
  CONCLUSIONS
  Results suggest our incentive program may offer a method for boosting outcomes.
authors.affiliation: University of Arkansas for Medical Sciences, Center for Addiction Research, 4301 West Markham St. #843, Little Rock, AR 72205, USA. cstanger@uams.edu
authors.forename: Catherine
authors.initials: C
authors.lastname: Stanger
authors.forename: Stacy R
authors.initials: SR
authors.lastname: Ryan
authors.forename: Hongyun
authors.initials: H
authors.lastname: Fu
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Budney
mesh_terms: D000328:Adult; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002653:Child Behavior Disorders / Q000523:psychology; D016241:Child of Impaired Parents / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000193:education*; D019966:Substance-Related Disorders / Q000523:psychology*