Behav Ther. 2026 May;57(3):546-562. doi: 10.1016/j.beth.2025.10.001. Epub 2025 Oct 17.
ABSTRACT
Evaluating treatment acceptability is crucial, as higher acceptability is associated with better adherence and lower dropout rates, a particular concern in treating youth with disruptive behavior disorders. This study built upon previous randomized controlled trials that demonstrated the efficacy of treatment for youth with oppositional defiant disorder (ODD) by comparing the acceptability of Collaborative and Proactive Solutions (CPS), an innovative approach, with Parent Management Training (PMT), a well-established intervention. This exploratory study aimed to determine whether families in the CPS group found the treatment acceptable and whether there were differences in parent-reported treatment acceptability between CPS and PMT. This comparison may assist clinicians in distinguishing the suitability of treatments. One hundred and sixty youth aged 7-14 years diagnosed with ODD were randomized to CPS (n = 81) or PMT (n = 79) for up to 16 weekly sessions at a community clinic in Australia. Treatment adherence, acceptability, satisfaction, and barriers to participation (relevance, therapeutic alliance, treatment demands) were assessed using parent and therapist-rated questionnaires. An intent-to-treat approach was employed, and analysis of variance tests were conducted. CPS demonstrated very high acceptability ratings, comparable to PMT. While both treatments were highly acceptable, PMT showed a small but statistically significant advantage in satisfaction, adherence, perceived relevance, and treatment demands. These results provide reassurance to clinicians that both CPS and PMT interventions, alongside their similar efficacy, are highly acceptable interventions for youth with ODD. Future research should replicate these findings and explore why PMT may hold slight advantages, potentially related to child engagement.
PMID:42097793 | DOI:10.1016/j.beth.2025.10.001
