GenerationPMTO was formerly known as Parent Management Training - the Oregon Model (PMTO ® ). GenerationPMTO (Individual Delivery Format) is a parent training intervention that can be used in family contexts including two biological parents, single-parent, re-partnered, grandparent-led, reunification, adoptive parents, and other primary caregivers. This behavioral family systems intervention can be used as a preventative program and a treatment program. It can be delivered through individual family treatment in agencies or home-based and via telephone/video conference delivery, books, audiotapes and video recordings. GenerationPMTO interventions have been tailored for specific child/youth clinical problems, such as externalizing and internalizing problems, school problems, antisocial behavior, conduct problems, deviant peer association, theft, delinquency, substance abuse, and child neglect and abuse. For the group version of GenerationPMTO, please see Parenting Through Change (PTC; GenerationPMTO Group).
The goals of GenerationPMTO (Individual Delivery Format) include:
The program representative did not provide information about a Logic Model for GenerationPMTO (Individual Delivery Format).
The essential components of the GenerationPMTO (Individual Delivery Format) include:
GenerationPMTO (Individual Delivery Format) directly provides services to parents/caregivers and addresses the following:
This program involves the family or other support systems in the individual's treatment: Children/adolescents participate in individual family sessions as appropriate or desired. Other family members can be part of the intervention in family sessions.
60-minute weekly individual/family sessions
10-25 individual/family sessions, depending on severity; 3-6 months or longer, depending on circumstances. For mild problems or prevention, 6-8 sessions.
This program is typically conducted in a(n):
GenerationPMTO (Individual Delivery Format) includes a homework component:
Weekly home practice assignments are tailored for family context; parents practice in session before trying it out at home. Mid-week calls are conducted to troubleshoot and promote success.
GenerationPMTO (Individual Delivery Format) has materials available in languages other than English:
Danish, Dutch, Icelandic, Norwegian, Spanish
For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).
The typical resources for implementing the program are:
All sessions are video recorded and uploaded to HIPAA-compliant website for coaching/supervision, fidelity rating, and certification. Thus, video recording equipment, computer, and high speed internet access are required.
Qualifications depend on the agencies that employ them. Practitioners may have Bachelor's, Master's, or Doctorate level degrees as entry qualifications. To become certified GenerationPMTO specialists, they must complete an extensive training program. No other specialized training is required. Practitioners serve in a wide variety of delivery systems including child welfare, juvenile justice, and child mental health.
There is a manual that describes how to deliver this program.
There is training available for this program.
During the workshop training, active teaching techniques provide abundant opportunity for practice (e.g., modeling, video demonstrations, role play, problem solving, experiential exercises, and video-recording of practice followed up with direct feedback). Throughout the course of training, candidates are required to record their sessions with training families. These video materials are uploaded onto a secure portal so that training mentors and coaches can view their sessions and provide detailed coaching feedback.
GenerationPMTO training is supported with regular coaching. Coaching takes place by phone, through videoconferencing, in written format, in person, individually, and in group. The strengths-based coaching is designed to provide the practitioner with support for effective practice in terms of content and therapeutic process using a suite of active teaching strategies. The group reflective coaching process benefits all in training who view video, identify strengths, and role play new strategies. Candidates receive a minimum of 12 coaching sessions based on direct observation of their therapy sessions with training families. There is also an extensive certification process to ensure fidelity.
A typical training program for GenerationPMTO specialists includes 3 workshops for a total of 10 workshop days plus up to 12 coaching sessions, booster workshops and completing the process of certification. The workshop training program, which is designed to promote competent adherence and sustained model fidelity, is tailored for the implementation site. See the implementation section below for more details.
There are pre-implementation materials to measure organizational or provider readiness for GenerationPMTO (Individual Delivery Format) as listed below:
Readiness checklists are tailored for various types of implementations. Additionally, an FAQ document is available that assists interested organizations in determining if GenerationPMTO (Individual Delivery Format) is a good fit. Contact the Director of Administration, Anna Snider, for pre-implementation materials at (541) 485-2711 or annas@generationpmto.org.
There is formal support available for implementation of GenerationPMTO (Individual Delivery Format) as listed below:
Prior to the start of implementation, the ISII model developer team may conduct on-site visits with agency leaders and supervisors. These pre-implementation meetings are an opportunity for sites to describe their specific context, for model developers to provide information about GenerationPMTO's research basis, intervention components, training program, engagement strategies, to advise about requirements, for collaboration about short- and long-term goals, and to ensure readiness. Implementation Sciences International, Inc. (ISII), which is a non-profit affiliate of the Oregon Social Learning Center, oversees the implementation of GenerationPMTO. The Director of Implementation and Training designs the training programs and infrastructure protocol. They also provide training, coaching, and coordination for implementation projects. The director leads a team of trainers and consultants who are available to provide support for all implementation objectives. The ISII website (www.generationpmto.org) provides individual descriptions and roles for staff, mentors, and associates.
There are fidelity measures for GenerationPMTO (Individual Delivery Format) as listed below:
Competent adherence to GenerationPMTO is assessed with the Fidelity of Implementation Rating System (FIMP). The Director of Fidelity, oversees fidelity operations for GenerationPMTO implementation sites. FIMP ratings are made by reliable certified GenerationPMTO specialists who assess the intervention as delivered with individual families in community or home settings. Ratings are based on direct observation of segments of sessions based on core parenting components and evaluate five theoretically relevant categories (i.e., Knowledge, Structure, Teaching, Process Skills, and Overall Development). Procedures, definitions of core parenting practices, and the rating scale are described in the FIMP manual. Interested parties can contact the Director of Administration, Anna Snider, for the fidelity measure. She is available at (541) 485-2711 or annas@generationpmto.org.
There are implementation guides or manuals for GenerationPMTO (Individual Delivery Format) as listed below:
Manuals are required for implementation and are provided (at workshops) to those who receive training in GenerationPMTO. Additionally, manuals are provided to clinicians who participate in training to become GenerationPMTO Coaches and Trainers.
Research has been conducted on how to implement GenerationPMTO (Individual Delivery Format) as listed below:
Child Welfare Outcome: Child/Family Well-Being
A meta-analysis, see citation following, has been conducted GenerationPMTO (Individual Delivery Format) though this article is not used for rating and therefore is not summarized:
The CEBC reviews all of the articles that have been published in peer-reviewed journals as part of the rating process. When there are more than 10 published, peer-reviewed articles, the CEBC identifies the most relevant articles, with a focus on randomized controlled trials (RCTs) and controlled studies that have an impact on the rating. The articles chosen for GenerationPMTO (Individual Delivery Format) are summarized below:
Patterson , G. R., Chamberlain, P., & Reid, J. B. (1982). A comparative evaluation of a parent-training program. Behavior Therapy, 13(5), 638–650. https://doi.org/10.1016/S0005-7894(82)80021-X
Type of Study: Randomized controlled trial
Number of Participants: 19 children and 19 parents
Population:
Location/Institution: Oregon
Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the effectiveness of the Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] in a sample of children with highly aggressive behavior. Participants were randomly assigned to PMTO or to a waiting-list comparison group. Measures utilized include the Family Interaction Coding System (FICS), Total Aversive Behavior (TAB) score, and the Parent Daily Report (PDR). Results indicate that relative to the changes in the comparison sample, the PMTO sample showed a significantly greater reduction in the observed rates of deviant child behavior. Limitations include the small sample size and lack of follow-up.
Length of controlled postintervention follow-up: None.
Bank, L., Marlowe, J. H., Reid, J. B., Patterson, G. R., & Weinrott, M. R. (1991). A comparative evaluation of parent-training interventions for families of chronic delinquents. Journal of Abnormal Child Psychology, 19(1), 15–33. https://doi.org/10.1007/BF00910562
Type of Study: Randomized controlled trial
Number of Participants: 55 children and 55 parents
Population:
Location/Institution: Oregon
Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the effectiveness of the Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] in a sample of chronically offending youth. Participants were randomly assigned to PMTO or a control group receiving services as usual. Measures utilized include official offense reports and two family measures to record behavior: the Family Interaction Coding System (FICS) and the Parent Daily Report (PDR). Results indicate that participants in the PMTO group experienced a reduction in serious crimes during the year of treatment, and both groups demonstrated reduced rates of offending during the follow-up years. Children in the PMTO group also spent significantly less time in institutional settings than did those in the control group. Parent training had a significant impact, but the reduction in offending was produced at a very high emotional cost to staff, as the work with these families was very difficult. Limitations include small sample size and lack of generalizability due to the gender of participants.
Length of controlled postintervention follow-up: 3 years.
Forgatch, M. S., DeGarmo, D. S., & Beldavs, Z. G. (2005). An efficacious theory-based intervention for stepfamilies. Behavior Therapy, 36(4), 357–365. https://doi.org/10.1016/S0005-7894(05)80117-0
Type of Study: Randomized controlled trial
Number of Participants: 110 families (mother, stepfather, and child[ren])
Population:
Location/Institution: Oregon
Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the effectiveness of the Oregon model of Parent Management Training (PMTO) [now called GenerationPMTO (Individual Delivery Format)] intervention in treating disruptive behaviors in children in a sample of families with stepfathers. Participants were randomly assigned to PMTO or to a no-treatment control group. Measures utilized include the Family and Peer Process Code (FPP). Results indicate that participants in the PMTO intervention group displayed a large effect in benefits to effective parenting practices with resultant decreases in child noncompliance and in home and school problem behaviors. Limitations include the small sample size and lack of diversity in the sample, which could limit the potential generalizability of the specific findings of this study.
Length of controlled postintervention follow-up: 2 years.
DeGarmo, D. S., & Forgatch, M. S. (2007). Efficacy of parent training for stepfathers: From playful spectator and polite stranger to effective stepfathering. Parenting Science and Practice, 7(4), 331–355. https://doi.org/10.1080/15295190701665631
Type of Study: Randomized controlled trial
Number of Participants: 110 families (mom, stepfather, and child[ren])
Population:
Location/Institution: Oregon
Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as Forgatch et al. (2005). The purpose of the study was to evaluate the effectiveness of the Oregon model of Parent Management Training (PMTO) [now called GenerationPMTO (Individual Delivery Format)] intervention in treating disruptive behaviors in children in a sample of families with stepfathers. Participants were randomly assigned to PMTO or a no-treatment control group. Measures utilized include structured interactions of mothers and stepfathers with children which were coded from videotapes using the Family and Peer Process Code. In addition, children were administered the Children's Depression Inventory (CDI) and the Loneliness in Children Scale. Results indicate that stepfathers in the PMTO condition showed improvements at 6 and 12 months, but that these diminished somewhat at 24 months. Limitations include the relatively small sample size and lack of diversity in the sample.
Length of controlled postintervention follow-up: 2 years.
Ogden, T., & Hagen, K. A. (2008). Treatment effectiveness of Parent Management Training in Norway: A randomized controlled trial of children with conduct problems. Journal of Consulting and Clinical Psychology, 76(4), 607–621. https://doi.org/10.1037/0022-006X.76.4.607
Type of Study: Randomized controlled trial
Number of Participants: 112 children and 112 parents
Population:
Location/Institution: Norway
Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the effectiveness of the Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] intervention in a sample of Norwegian families. Participants were randomly assigned to PMTO or to a regular services comparison group. Measures utilized include the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), Social Skills Rating System (SSRS), Family Satisfaction Survey, Parent Daily Report (PDR), Fidelity of Implementation System (FIMP), Coder’s Impression (CI), Structural Interaction Tasks (SIT), and the Family and Peer Process Code (FPPC). Results indicate that PMTO was effective in reducing parent-reported child externalizing problems, improving teacher-reported social competence, and enhancing parental discipline. Limitations include the small number of female children participants and the lack of postintervention follow-up.
Length of controlled postintervention follow-up: None.
Amlund Hagen, K., Ogden, T., & Bjørnebekk, G. (2011). Treatment outcomes and mediators of Parent Management Training: A one-year follow-up of children with conduct problems. Journal of Clinical Child & Adolescent Psychology, 40(2), 165–178. https://doi.org/10.1080/15374416.2011.546050
Type of Study: Randomized controlled trial
Number of Participants: 112 children and 112 parents
Population:
Location/Institution: Norway
Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as Ogden & Hagen 2008. The purpose of the study was to evaluate the effectiveness of the Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] intervention in a sample of Norwegian families. Participants were randomly assigned to the PMTO intervention or to a regular services comparison group. Measures utilized include the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), Social Skills Rating System (SSRS), Family Satisfaction Survey, Parent Daily Report (PDR), Fidelity of Implementation System (FIMP), Coder’s Impression (CI), Structural Interaction Tasks (SIT), and the Family and Peer Process Code (FPPC). Results indicate that PMTO was effective in reducing parent-reported child externalizing problems, improving teacher-reported social competence, and enhancing parental discipline. Limitations include the small number of female children participants and the high rate of attrition.
Length of controlled postintervention follow-up: 12 months.
Hukkelberg, S., & Ogden, T. (2013). Working alliance and treatment fidelity as predictors of externalizing problem behaviors in Parent Management Training. Journal of Consulting and Clinical Psychology, 81(6), 1010–1020. https://doi.org/10.1037/a0033825
Type of Study: Randomized controlled trial
Number of Participants: 331 children and their parents
Population:
Location/Institution: Norway
Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as Ogden & Hagen (2008). The purpose of the study was to investigate treatment fidelity and working alliance in the Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] and to also investigate how these relate to children’s externalizing problem behaviors, as reported by parents and teachers. Measures utilized include the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), Parent Daily Report (PDR), Working Alliance Inventory short form (WAI-S), and the Fidelity of Implementation Rating Scale (FIMP). Results indicate that parents reported high and stable levels of alliance and observers reported high levels of fidelity from Time 1 to Time 3, with no correlational or direct relations between the two measures. Treatment fidelity predicted reductions in parent-reported externalizing behavior, whereas working alliance was related to less change in problem behavior. Alliance and fidelity were unrelated to teacher-reported behavior problems. Limitations include attrition rates, possible rater bias, and lack of follow-up.
Length of controlled postintervention follow-up: None.
Akin, B. A., Testa, M. F., McDonald, T. P., Melz, H., Blase, K. A., & Barclay, A. (2014). Formative evaluation of an evidence-based intervention to reduce long-term foster care: Assessing readiness for summative evaluation. Journal of Public Child Welfare, 8(4), 354–374. https://doi.org/10.1080/15548732.2014.939250
Type of Study: Randomized controlled trial
Number of Participants: 60 parents and 59 children
Population:
Location/Institution: Not specified
Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to describe the Kansas Intensive Permanency Project (KIPP) effort to test the effectiveness of Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] on the well-being and permanency outcomes for families of children with serious emotional disturbance (SED). Participants were randomized into PMTO or services as usual. Measures utilized include the Child and Adolescent Functional Assessment Scale (CAFAS), the Preschool and Early Childhood Functional Scale (PECFAS), the Family Interaction Task (FIT), the North Carolina Family Assessment Scale (NCFAS), and the Social Skills Improvement System (SSIS). Results indicate that PMTO was associated with higher rates of reunification for treatment families as compared to families receiving services as usual at follow-up. Limitations include the small sample size, reliance on self-reported measures, and high attrition rate.
Length of controlled postintervention follow-up: 6 months.
Sigmarsdóttir, M., Thorlacius, Ö., Guðmundsdóttir, E. V., & DeGarmo, D. S. (2015). Treatment effectiveness of PMTO for children's behavior problems in Iceland: Child outcomes in a nationwide randomized controlled trial. Family Process, 54(3), 498–517. https://doi.org/10.1111/famp.12109
Type of Study: Randomized controlled trial
Number of Participants: 102 parent-child pairs
Population:
Location/Institution: 5 municipalities throughout Iceland
Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to report the efficacy of Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] on children with behavior problems. Participants were randomly assigned to either PMTO or services usually offered in the communities (SAU). Measures utilized include the Child Behavior Checklist-Parent Report, the Social Skills Rating System (SSRS), the Children’s Depression Inventory (CDI), the TRF-Teacher Report of the Achenbach scales, and the Parent Daily Report (PDR). Results indicate that children whose parents received PMTO treatment showed greater improvement in the child adjustment construct in contrast to the families in the comparison group at follow-up. Results also indicate that at follow-up, PMTO treatment produced benefits to children’s adjustment assessing behavior problems, depressive symptoms, and social skills. Limitations include lack of generalizability due to ethnicity and the reliance on self-reported measures.
Length of controlled postintervention follow-up: 11 months.
Akin, B. A., Lang, K., Yan, Y., & McDonald, T. P. (2018). Randomized trial of PMTO in foster care: 12-month child well-being, parenting, and caregiver functioning outcomes. Children and Youth Services Review, 95, 49–63. https://doi.org/10.1016/j.childyouth.2018.10.018
Type of Study: Randomized controlled trial
Number of Participants: 918
Population:
Location/Institution: Not specified
Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the outcomes of in-home Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)]. Participants were randomized to either PMTO or services as usual. Measures utilized include the Child and Adolescent Functioning Assessment Scale (CAFAS) (ages 6–16), the Preschool and Early Childhood Functional Assessment Scale (PECFAS) (ages 3–5), the Social Skills Improvement System-Rating Scales (SSIS), the Family Interaction Task (FIT), and the North Carolina Family Assessment Scale (NCFAS). Results indicate that PMTO demonstrated linear improvements in children's social-emotional functioning, problem behaviors, and social skills. Although results for parenting were inconclusive, two of four caregiver functioning outcomes (parent mental health and readiness for reunification) were significantly improved in the PMTO group. Limitations include the lack of blinding of researchers, parents, and case managers; PMTO and services-as-usual were delivered by private, community-based foster care agencies under contract and monitoring by the state public child welfare agency; the post-randomized consent study design; and concerns about generalizability due to ethnicity.
Length of controlled postintervention follow-up: Approximately 6 months.
Forgatch, M. S., & Domenech Rodríguez, M. M. (2016). Interrupting coercion: The iterative loops among theory, science, and practice. In T. J. Dishion & J. J. Snyder (Eds.), Oxford handbook of coercive relationship dynamics (pp. 194–214). Oxford University Press. https://psycnet.apa.org/record/2016-08560-015
Forgatch, M. S., Patterson, G. R., & Friend, T. (2017). Raising cooperative kids: Proven practices for a connected, happy family. Conari Press.
Forgatch, M. S., Patterson, G. R., & Gewirtz, A. H. (2013). Looking forward: The promise of widespread implementation of parent training programs. Perspectives on Psychological Science, 8(6), 682–694. https://doi.org/10.1177/1745691613503478
Anna Snider, BS Agency/Affiliation: Implementation Sciences International, Inc. (ISII) Website: www.generationpmto.org Email: annas@generationpmto.org Phone: (541) 485-2711
Date Research Evidence Last Reviewed by CEBC: October 2023
Date Program Content Last Reviewed by Program Staff: March 2020
Date Program Originally Loaded onto CEBC: October 2009
The CEBC is funded by the California Department of Social Services’ (CDSS’) Office of Child Abuse Prevention and is one of their targeted efforts to improve the lives of children and families served within child welfare system.