Improving Delay Discounting to Decrease Harsh Parenting Among Parents Receiving Substance Use Treatment

June 21, 2023 updated by: Julia Felton, Henry Ford Health System

Improving Delay Discounting to Decrease Harsh Parenting Among Parents Receiving Substance Use Treatment in Low Income Community

Parents with substance use disorders are disproportionately more likely to engage in harsh physical discipline, which can lead to serious clinical outcomes, including child maltreatment and the intergenerational transmission of addictive disorders. One mechanism linking substance use and maladaptive parenting strategies is parental delay discounting, or the tendency to value smaller, immediate rewards (such as stopping children's misbehavior via physical punishment) relative to larger, but delayed rewards (like shaping adaptive child behaviors over time). This study will examine the efficacy of implementing a low-cost, brief intervention targeting the reduction of parental delay discounting to inform broader public health efforts aimed at reducing child maltreatment and interrupting intergenerational cycles of substance abuse in traditionally underserved communities.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Parents with substance use disorders (SUD) are significantly more likely to engage in harsh parenting practices, including spanking, hitting, and belittling their children, than parents without SUD. Punitive physical and emotional discipline is, in turn, associated with increased rates of child maltreatment and the subsequent intergenerational transmission of substance use disorders. Parents in residential substance use treatment facilities are among those at highest risk for perpetrating harsh and abusive parenting; yet most behaviorally based parenting interventions available within inpatient settings do not take into account the unique mechanisms linking parental substance use to harsh parenting. Specifically, parents with SUD may be at heightened risk for engaging in maladaptive parenting approaches given a tendency to prioritize immediate rewards (such as stopping a child's misbehavior using physical punishment) relative to larger, but delayed rewards (including shaping positive child behavior over a longer term). This behavioral tendency is known as delay discounting and recent findings suggest that rates of delay discounting predict parents' use of harsh physical discipline. Existing research also indicates a strong link between steeper (more problematic) rates of delay discounting and the severity of alcohol and illicit drug use across the lifespan. Thus, delay discounting may represent a specific vulnerability underlying both harsh parenting and disordered substance use. The current project proposes to pilot and feasibility test an adapted episodic future thinking (EFT) intervention to target the reduction of parenting-related delay discounting and examine its effects on parenting practices among families in a residential substance use treatment setting. The intervention will be delivered by peer recovery coaches who are already employed in the center.

Study Type

Interventional

Enrollment (Actual)

20

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • United States
    • Michigan
      • Flint, Michigan, United States, 48502
        • Odyssey Village

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Parent of child between 6-10 years of age
  • Able to provide informed consent and take part in all study procedures in English
  • Have current diagnosis of SUD
  • Currently reside with their child at least 50% of the time
  • Be willing to receive daily postcards

Exclusion Criteria:

  • Active suicidality/homicidally
  • Active bipolar disorder, schizophrenia, or psychosis.
  • Only one parent-child dyad from each family.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Episodic Future Thinking
Parents who are receiving residential substance use disorder (SUD) treatment will receive an adapted episodic future thinking focused condition. Parents will meet with peer recovery coaches (PRCs) who will administer the intervention, focused on generating future, pleasant events with their children. After the intervention session, parents will receive a daily postcard over the course of two weeks including a reminder cue generated as part of the episodic future thinking (EFT) intervention and a prompt to remember these episodes in vivid detail.
Behavioral: Episodic Future Thinking
The adapted episodic future thinking (EFT) intervention will focus on generation of vivid, substance-free, rewarding events that could happen in the future with their children.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Delay Discounting 5 Trial Adjusted Measure
Time Frame: Baseline, 1 week, and 4 weeks
The computer based adjusting amount discounting task uses an adjusting algorithm to determine the amount of immediately available money that is equivalent to a large sum that is delayed by seven discrete durations of time presented in a randomized order (i.e., 1 day, 1 week, 1 month, 6 months, 1 year, 5 years, and 25 years).At each delay, a choice is first presented between the delayed larger sum and a smaller sum available immediately. For each trial, the position of the delayed and immediate amounts are randomly assigned the left or right portion of the screen, and the participant chooses the preferred option by pressing the corresponding left or right response button. Change in the Delay Discounting score is measured by comparing baseline scores with scores at the intervention (approximately 1 week after baseline) and the post-intervention assessment (approximately 4 weeks after baseline)
Baseline, 1 week, and 4 weeks
Change in Consideration of Future Consequences Scale
Time Frame: Baseline, 4 weeks
The Consideration of Future Consequences Scale1 (CFCS-14) is a 14-item self-report questionnaire that assesses active consideration of longer-term implications of an individual's actions. Lower scores on the CFCS-14 are associated with a greater focus on immediate needs and have been found to be associated with less engagement in health behaviors1819 and greater substance use. The measure has been used extensively among adult samples and demonstrates strong reliability and validity. Research suggests modest but significant correlations with the MCQ. Change in CFCS-14 score is measured by comparing baseline scores with scores at the post-intervention assessment (approximately 4 weeks after baseline)
Baseline, 4 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Dyadic Parent-Child Interaction Coding System Scores
Time Frame: Baseline, 4 weeks
Parents and their children will complete a 20- minute interaction task, including five minutes of free play, a ten minute "homework" task in which children are given a math worksheet and parents are told to provide help "as you see fit," and a five minute clean up task. Interactions will be video recorded and coded using the Dyadic Parent-Child Interaction Coding System (DPICS) which yields to composite scores: positive parenting (including praise, positive affect, and physical positive interactions) and negative parenting (including negative commands, critical statements, and physical negative interactions). Change in positive parenting and negative parenting scores will be calculated by comparing baseline scores with scores at the post-intervention sessions (approximately 4 weeks after baseline)
Baseline, 4 weeks
Change in Alabama Parenting Questionnaire Scores
Time Frame: Baseline, 4 weeks
The Alabama Parenting Questionnaire (APQ) is a 42-item self-report measure of parenting behaviors. The questionnaire includes five subscales: (1) positive involvement with children, (2) supervision and monitoring, (3) use of positive discipline techniques, (4) consistent use of discipline, and (5) use of corporal punishment. The measure is widely used and has demonstrated excellent internal consistency and validity. Change in APQ scores will be measured by comparing post-intervention scores (approximately 4 weeks after baseline) with baseline scores.
Baseline, 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Henry Ford Health System

Collaborators

University of Kansas
University of Maryland, College Park

Investigators

  • Principal Investigator: Julia Felton, PhD, Henry Ford Health

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 7, 2022

Primary Completion (Actual)

February 10, 2023

Study Completion (Actual)

March 31, 2023

Study Registration Dates

First Submitted

January 18, 2022

First Submitted That Met QC Criteria

January 27, 2022

First Posted (Actual)

February 8, 2022

Study Record Updates

Last Update Posted (Actual)

June 23, 2023

Last Update Submitted That Met QC Criteria

June 21, 2023

Last Verified

June 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 14781

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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