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Mothers with Internalizing Problems Benefit More from Group versus Individual Behavior Management Treatment for Children's Disruptive Behavior

Background: Comparing the efficacy of psychotherapy services for different family needs is critical for advancing more personalized treatment approaches. We examined maternal internalizing mental health problems as a predictor of treatment response for individualized treatment for mothers and their child, versus Coping Power (CP), a manualized group-based program, for children with disruptive behavior. Methods: Families were recruited from a large hospital setting and randomized to 15 weeks of parent and child individualized treatment or CP. Of the 133 families who began treatment, 103 returned for follow-up of which 93 provided baseline data on maternal internalizing mental health problems (defined as scores of 3 or above on the GAIN-SS internalizing subscale). Outcomes included primary treatment targets across child (conduct problems, emotional symptoms, and prosocial skills) and parenting (inconsistent discipline, positive parenting, and parenting sense of competence) factors. Results: Repeated measure ANOVAS indicate that group-based CP was either similar or better than individualized treatment for families with maternal-internalizing status. For both child conduct problems and parent inconsistent discipline, families with maternal-internalizing status only improved in CP (not individualized treatment). For child emotional symptoms and parenting sense of competence outcomes, families in both CP and individualized treatment exhibited similar improvements over time. Main effects indicated maternal-internalizing status was linked to lower parenting satisfaction and higher child emotional symptoms. No changes over time were observed for child prosocial symptoms or positive parenting. Conclusions: Results highlight the efficacy of group-based CP, compared to individualized treatment, for addressing child behavioral problems and parenting needs in families with maternal internalizing problems.