Does Size Matter? Determining Differences in Family Outcomes Based on Cohort Size of HOT DOCS Parent Behavior Management Groups

Disruptive behavior in youth is a common challenge for caregivers. Behavioral parent management training (BPMT) is an effective way to intervene with disruptive behaviors of childhood. Dissemination of BPMT is needed considering the prevalence of disruptive behavior. Group formatted BPMT is one way to provide efficacious strategies for managing challenging behaviors to wider audiences. Still, questions remain as to the impact of group factors, namely cohort size, on group outcomes. The purpose of this study was to examine whether group size was related to self-reported parenting stress, the intensity of parent-reported child disruptive behaviors, and overall satisfaction amongst caregivers who completed the Helping Our Toddlers, Developing Our Children’s Skills (HOT DOCS) BPMT. Participants (N = 631) were grouped by cohort size (smaller, recommended, or larger size). Analyses compared pre- to post-intervention change across groups on parenting stress and disruptive behavior. Additional analyses evaluated post-test program satisfaction between groups. The results demonstrated that HOT DOCS was effective at reducing parent stress and the intensity of problematic behavior in children. There was no effect of group size on outcomes, nor was there an interaction between HOT DOCS participation and group size on these outcomes. Still, participants from smaller groups had greater satisfaction with the program, albeit this difference lacked clinical meaningfulness. These results indicated that group size neither enhanced nor detracted from the success of caregivers in managing their own stress and their child’s behaviors. Findings from this study may inform the implementation of similar behavior-focused parent training programs.