The Incredible Years Basic Parent Training for Iranian Mothers of Children with Behavioral and Emotional Problems: A Randomized Controlled Trial and Process Evaluation.

Abstract

Although empirical evidence supports the effectiveness of the Incredible Years intervention in Western countries, few studies have investigated its effectiveness in Asian countries and no study has evaluated the implementation process of the program in Iran. The present randomized controlled trial (RCT) study aimed to examine the effects of the Incredible Years Basic Parent Training (IYPT BASIC) with mothers of children with behavioral and emotional problems. For this purpose, mothers of 77 preschool children with behavioral and emotional problems were randomly assigned to intervention (n = 39) and control (n = 38) groups. The intervention group underwent 15 IYPT BASIC intervention sessions. RCT data were analyzed by repeated measures analysis of variance. A process evaluation was conducted exploring the delivery of the intervention in the Iranian context using adherence data, questionnaires with parents, and staff interviews to evaluate implementation challenges. Interview data were analyzed thematically. The program reduced children's behavioral and emotional problems (η²_p = .45, p = .000 & η²_p = .50, p = .000) and enhanced children's social skills (η²_p = .08, p = .015). The study also demonstrated reductions in parenting stress of mothers (η²_p = .59, p = .000), improved parent-child relationships (η²_p = .80, p = .000), and enhanced quality of family life (η²_p = .48, p = .000). Two main themes emerged in relation to the intervention process: cultural challenges and implementation challenges. Sub-themes included compatibility of IYPT elements with traditional Iranian parenting, cultural gap, motives and expectations of mothers, strict rules and cultural sensitivities, lack of financial support, fidelity to protocol, and preservation and maintenance. IYPT can be used as an effective intervention to promote the mental health of Iranian children and mothers. The implementation challenges and recommendations are discussed.