Program Profile: Parenting with Love and Limits®

This is a program that combines group therapy and family therapy to treat youth, ages 10–18, who have a primary diagnosis of oppositional defiant or conduct disorder. This program is rated Promising. Findings were mixed. Intervention youth showed statistically significant decreases in rates of recidivism and improvements in behavior, compared with control group youth. However, there were no significant differences between groups on measures of readiness to change.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes either 1) one study conducted in multiple sites; or 2) two or three studies, each conducted at a different site. Learn about how we make the multisite determination.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes either 1) one study conducted in multiple sites; or 2) two or three studies, each conducted at a different site. Learn about how we make the multisite determination.

Program Goals

Parenting with Love and Limits® (PLL) is designed for adolescent populations with the primary diagnosis of oppositional defiant or conduct disorder. PLL integrates group and family therapy into one system of care. Parents and teens learn specific skills in group therapy and then meet in individual family therapy to role-play and practice these new skills. This integration of group and family therapy enables parents to transfer these new skills to real-life situations.

Program Theory

PLL integrates principles of structural and strategic family therapy (Sells, Winokur-Early, and Smith 2011).

Program Components

During group therapy, teens and parents participate together in a small group, led by two facilitators. The group can include siblings and extended family. Each group consists of no more than 6 families and average between 12-15 people per group. Six 2-hour sessions are held weekly. Parents and teens meet together as a group for the first hour. During the second hour, the parents meet in one breakout group and the teens meet in another, with one facilitator leading each breakout. During family therapy, teens and parents meet individually with one of the group facilitators in between classes in an intensive 1- to 2-hour session to practice the new skills learned in group. Extensive role-plays are used along with the development of a typed-out, loophole-free contract. Four to six family therapy sessions are recommended for low- to moderate-risk adolescents and up to 20 sessions for person with a moderate- to high-risk of committing and offense within a residential, outpatient, or home-based setting.

Program Activities

The PLL program consists of six group therapy sessions plus four or more family therapy sessions, as shown below:

• Group Session 1. Understanding Why Your Teen Misbehaves: Parents learn why their teen commits acts of parent abuse. Parents and teens go into their respective breakout groups to vent their feelings.
• Group Session 2. Button-Pushing: Parents learn how their teen pushes their "hot buttons" (whining, disgusted look, swearing, etc.), and teens learn how parents push theirs (lecturing, criticizing, talking in chapters, etc.).

First family session. Parents and teens meet individually to practice anti–button-pushing strategies.

• Group Session 3. Ironclad Contracting: Parents learn how and why their old methods of contracting have failed, as well as the steps to assemble a contract that works. Teens meet in their breakout groups to help write their own contract.

Second family session. Parents and teens meet individually to create their own contract.

• Group Session 4. Troubleshooting: Parents learn how teens have a special ability called “enhanced social perception” to think two steps ahead.

Third family session. Parents and teens meet individually to review their contracts and troubleshoot any loopholes. Extensive role-plays are used to practice delivery of rewards and consequences.

• Group Session 5. Stopping the Seven Aces: Parents choose creative consequences to stop the seven “aces” of the youth who doesn’t have a serious psychological problem, but is acting out of control: disrespect, ditching or failing school, running away, drugs or alcohol, sexual promiscuity, violence, and threats of suicide.

Fourth family session. Parents and teens meet individually to review their progress.

• Group Session 6. Reclaiming Lost Love: Parents learn to understand how conflict hinders the parent–child relationship and strategies to repair it.

Fifth family session and beyond, as needed. Parents and teens begin to solidify nurturance and to address any underlying family dysfunction.

Study

Sells and colleagues (forthcoming) used a quasi-experimental, two-group design to evaluate Parenting with Love and Limits® (PLL). The sample consisted of youths in the juvenile justice system who responded to a referral by their probation officer. Of the 105 families who agreed to participate, 67 completed the PLL program and 38 did not finish all six modules. The average length of participation in the program was 36 days. Retention rate was 64 percent, a rate considered high given that participants were not court-ordered to attend the program.

The average age of adolescents was 16 years, with a range of 11 to 17 years. All participants were diagnosed with either oppositional defiant or conduct disorder and were currently on probation through juvenile court. The 65 participants of the control group were also under court supervision and were matched with the intervention group by the county court administrator on similar family structure, age, race, and gender. Study participants were primarily Hispanic (38.1 percent), white (36.1 percent), and African American (21.9 percent). Males accounted for 67.1 percent of the participants. Family composition of the group included single-parent families (65.8 percent), dual families (31.6 percent), and kinship care families or youths raised by extended family members (2.6 percent).

Outcome measures consisted of recidivism (defined as at least one rearrest for a status or delinquent offence within 12 months following completion of PLL); changes in attitudes and behaviors of parents measured with the survey Prevention and Early Intervention Protective Factor Survey for Caregivers; and changes in attitudes and behaviors of adolescents measured with the survey Prevention and Early Intervention Protective Factor Survey for Youth.

Data was collected immediately before the first PLL group meeting and immediately following the last group meeting. Recidivism data for both groups was through juvenile court records by the court administrator at the local juvenile court 12 months after the completion of the parenting group. Data was analyzed using paired t–tests. No subgroup analyses were conducted.

Study

Sells, Winokur-Early, and Smith (2011) used an experimental design with random assignment of youths within the juvenile court system. Youths who were diagnosed with oppositional defiant or conduct disorder were eligible to participate. A total of 38 adolescents adjudicated for a delinquent offense and disposed to probation through the juvenile court were matched on type of offense, gender, age, and socioeconomic status and then randomly assigned to a PLL treatment group and a control group that received customary probation services. The large majority of youths were African American (82 percent), along with 12 percent white, and 1 percent Hispanic. Fifty-seven percent of the adolescents were male. The youths committed a variety of crimes, with shoplifting the most commonly occurring offense. No information is given on the equivalence of the groups on demographic and criminal offenses.

The treatment group received the 6-week PLL program in small groups of no more than 12 people per therapy group during six 2-hour classes. The control group received parole services and other services such as outpatient counseling or community service.

The measures used in the study included the Child Behavior Checklist, the Index of Parental Attitudes, the Parent Adolescent Communication Scale, and the Parent Readiness Scale. Both the parents and adolescents in the treatment group received the pretest measures in an interview before the treatment and again immediately following the final PLL class. No subgroup analyses were conducted.

In both group and family therapy, counselors are provided with detailed treatment manuals and the parents and teenagers are provided with workbooks and a study guide (Sells, Winokur-Early, and Smith 2011).

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Sells, Scott P. 2001. Parenting Your Out-of-Control Teenager. New York, N.Y.: St. Martin’s Press.

Sells, Scott P., Thomas Edward Smith, and Jeffrey Rodman. 2003. “Reducing Adolescent Substance Abuse and Delinquency: Pilot Research of a Family-Oriented Psycho-Education Curriculum.” Journal of Child and Adolescent Substance Abuse 15(4):105–15.

Winkour, Kristin. 2010. Parenting With Love and Limits® (PLL) Research Evaluation: 2009–10 Outcomes. Tallahassee, Fla.: Justice Research Center.

Winkour, Kristin. 2010. Parenting With Love and Limits (PLL) Champaign County, Ill., Mental Health Board Research Evaluation: 2009–10 Outcomes. Tallahassee, Fla.: Justice Research Center.

Winokur Early, Kristin, Steven F. Chapman, and Gregory A. Hand. 2013. “Family-Focused Juvenile Reentry Services: A Quasi-Experimental Design Evaluation of Recidivism Outcomes.” OJJDP Journal of Juvenile Justice 2(2):1–22. (This study was reviewed but did not meet CrimeSolutions criteria for inclusion in the overall program rating.)