Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Pilot Randomized Trial of a Technology-Assisted Parenting Intervention

Authors: Becker, S. J., Helseth, S. A., Janssen, T., Kelly, L. M., Escobar, K. I., Souza, T., Wright, T., & Spirito, A. (2021)

Published in: Journal of Substance Abuse Treatment, 127, 108457

This pilot randomized trial tested Parent SMART, a technology-assisted parenting intervention for caregivers of adolescents in residential treatment for substance use. Parents received access to an online parenting program (Parenting Wisely), brief coaching sessions, and a mobile networking forum in addition to treatment as usual. The study found that Parent SMART was highly feasible and acceptable, with promising signs that it may reduce teen drinking and school problems after discharge, particularly in short-term residential programs.

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Adolescents leaving residential substance use treatment are at high risk for relapse, and engaging parents in continuing care is both critical and difficult. Parent SMART was developed to overcome barriers such as transportation, time constraints, and limited access to specialized services by delivering support through a blend of technology-based tools. The intervention combined the Parenting Wisely online program (featuring skills-based video vignettes), up to four individualized coaching sessions, and a parent networking forum with “ask an expert” features and daily tips, all accessible via web or smartphone in English and Spanish.

Sixty-one parent–adolescent dyads from short- and long-term residential programs were randomized to receive Parent SMART plus treatment as usual or treatment as usual alone. All feasibility and acceptability benchmarks were met or exceeded, including strong enrollment, retention, and parent satisfaction. While pooled analyses did not show overall group differences, site-specific analyses indicated that teens in short-term residential care whose parents received Parent SMART had fewer days of alcohol use and fewer school-related problems over 24 weeks post-discharge than those in usual care. The authors conclude that a fully powered trial is warranted to more rigorously test Parent SMART and clarify how technology-assisted parenting support can improve youth outcomes after residential treatment.

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Parent Smart: Effects of a Technology-Assisted Intervention for Parents of Adolescents in Residential Substance Use Treatment on Parental Monitoring and Communication

Authors: Becker, S. J., Helseth, S. A., Janssen, T., Kelly, L. M., Escobar, K., & Spirito, A. (2021)

Published in: Evidence-Based Practice in Child and Adolescent Mental Health, 6(4), 459–472

This study examined whether Parent SMART—a technology-assisted parenting intervention used alongside adolescent residential substance use treatment—improves parental monitoring and parent–adolescent communication. Using multi-modal assessment over 24 weeks post-discharge, results showed consistent improvements in parenting behaviors for families assigned to Parent SMART. The intervention demonstrated promising effectiveness across both short- and long-term residential settings.

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Parent involvement is a core evidence-based principle in adolescent residential treatment, but engaging parents is often difficult. Parent SMART was developed to address this challenge by providing a blended technology-assisted model, including the Parenting Wisely online program, a moderated parent networking app, and up to four individualized coaching sessions. The intervention explicitly targeted two parenting processes—parental monitoring and communication—that research has repeatedly identified as protective against adolescent substance use. This study extended a prior pilot trial by examining whether Parent SMART improved these underlying parenting mechanisms.

Using data from 61 parent–adolescent dyads across both short-term and long-term residential programs, the authors found significant time-by-condition effects on all five behavioral interaction task scales, including limit setting, substance use–related communication, adolescent disclosure, and parental monitoring. Supplemental site analyses also revealed improvements on several questionnaire-based measures. Overall, parents receiving Parent SMART showed a shift from “moderate” to “strong” parenting behaviors over 24 weeks, while treatment-as-usual parents remained stable or worsened. The authors conclude that Parent SMART is a feasible, scalable adjunct to residential programs and merits a fully powered trial.

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Parenting Wisely Six Months Later: How Implementation Delivery Impacts Program Effects at Follow-Up

Authors: Stalker, K. C., Rose, R. A., Bacallao, M., & Smokowski, P. R. (2018)

Published in: Journal of Primary Prevention, 39, 129–153

This study examined Parenting Wisely’s effectiveness six months after program completion among 311 parents who used one of five delivery formats, plus a 53-parent comparison group. Across most formats, parents reported improved parenting confidence, reduced conflict with their adolescents, and decreases in adolescent externalizing and violent behavior. These positive outcomes were maintained over time and were consistent across formats, with the exception of the intensive workshop, which was less effective.

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Parenting Wisely is an evidence-based, computer-guided parent training program designed to increase parenting skills and reduce adolescent problem behaviors. In this study, parents self-selected into one of five formats: an intensive workshop, two different 5-week group formats, a self-paced online format for parent–teen dyads, or a self-paced online parent-only option. Using a quasi-experimental design, outcomes were assessed at baseline, post-test, and six-month follow-up in a low-income rural county with high rates of youth violence. Results showed that Parenting Wisely significantly improved family problem solving, reduced parent-child conflict, and lowered adolescent externalizing and violent behaviors compared to the no-intervention comparison group.

A mechanisms-of-change analysis confirmed that improvements in youth behavior were driven by increases in parents’ sense of competence, improved problem-solving abilities, and greater parenting self-efficacy. Delivery format did not substantially affect outcomes—group, parent-only, and online formats all produced similar benefits—while the parents-only intensive workshop was notably less effective, possibly due to limited time for skill practice. Overall, the study provides strong evidence that Parenting Wisely has sustained effects and is flexible enough to be successfully delivered through multiple formats.

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Parenting Interventions Implementation Science: How Delivery Format Impacts the Parenting Wisely Program

Authors: Cotter, K. L., Bacallao, M., Smokowski, P. R., & Robertson, C. I. B. (2013)

Published in: Research on Social Work Practice

This study examined how four different delivery formats of the Parenting Wisely program influence parent, family, and adolescent outcomes in a rural, low-income, ethnically diverse community. Across formats, parents reported significant improvements in family functioning, parenting confidence, and reductions in adolescent violent behavior and externalizing problems. However, the results showed that delivery method matters: the 5-week facilitator-led groups produced the strongest and most consistent gains.

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Parenting Wisely (PW) is a technology-based, interactive parent-training program originally designed for independent online use, but often adapted into group or parent–adolescent formats. This study evaluated 144 parents who completed PW in one of four ways: a 1–2 day intensive workshop, a 5-week facilitator-led parents-only group, a 5-week parents-and-adolescents group, or a self-paced parent–teen online format. Using a quasi-experimental design with pre- and post-test assessments, the study measured changes in family problem solving, family roles, affective involvement, behavior control, parenting self-efficacy, parenting competence, parent–child conflict, and adolescent behavior. Significant improvements were found on nearly all outcomes for most formats, demonstrating PW’s effectiveness for disadvantaged rural families.

Delivery format substantially influenced program impact. The two 5-week group formats—especially the parents-only group—yielded the largest effect sizes across family functioning, parenting competence, and adolescent behavior. These group formats offered time for discussion, structured activities, and role-plays, which helped parents practice skills and receive feedback. In contrast, the intensive workshop produced weaker results, likely due to limited time for skill rehearsal, and the online parent–adolescent format showed moderate gains. Interestingly, including adolescents in the program enhanced reductions in teen violent and externalizing behaviors, though parents sometimes showed greater improvement when learning without their teens present. Satisfaction ratings were high across all formats. The results underscore that while Parenting Wisely is effective across multiple delivery methods, longer group-based formats with facilitator support produce the strongest outcomes.

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Parenting Wisely Evaluation Report: South Bay Youth Project (Redondo Beach, CA)

Author: Freedman, D. (2012)

Program funded by: Center for Substance Abuse Prevention (CSAP)

This evaluation examined Parenting Wisely as part of a family-strengthening initiative serving families in Redondo Beach and surrounding South Bay communities. Thirty families completed the full intervention, combining the Parenting Wisely CD-ROM with three to six therapist-led sessions. Parents reported reduced drug use, less yelling, clearer family rules, improved communication with partners, and meaningful reductions in depressive symptoms.

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Parenting Wisely was implemented as a hybrid model: families completed the CD-ROM first, followed by several weeks of workbook-based therapy sessions. Parents showed notable improvements in multiple areas, including decreased use of prescription drugs, increased disapproval of risky adult substance use, clearer family expectations, and greater confidence discussing parenting issues with their partner. Several parenting behaviors improved, such as the likelihood of asking children about late arrivals and maintaining consistent rules about alcohol and drug use. Parents also reported significantly less depression after completing the program. Family-relationship measures showed positive shifts as well, with parents finding it easier to think of things to do together, feeling more available to each other, and reporting lower conflict and criticism.

Youth outcomes were more modest, largely because many scores were already high at baseline or because youth reported little substance use prior to the program. Even so, youths’ perceived risk of heavy drinking increased, and follow-up interviews showed additional improvements in family cohesion, parent monitoring, homework support, and positive reinforcement. Both parents and youth reported that family rules—especially around alcohol and drugs—became much clearer. Although the small sample size limited statistical significance, the overall pattern suggested that Parenting Wisely strengthened family relationships, improved communication, and contributed to healthier home environments.

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Parenting Wisely in British Columbia: Individual vs. Group Delivery at Penticton Mental Health

Author: Pushak, R. (2002)

Evaluation report, Penticton Mental Health, British Columbia

This evaluation compared individual and group delivery formats of Parenting Wisely with 47 children ages 6–12 who met diagnostic criteria for a Disruptive Disorder. Parents completed the Eyberg Child Behaviour Inventory (ECBI) before and after the intervention, with some families using the CD-ROM individually plus brief therapist support and others participating in a parent group that used alternate versions of Parenting Wisely to stimulate discussion. Both formats produced substantial reductions in child behavior problems, with the group program showing particularly strong gains.

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In the individual format, parents used the Parenting Wisely CD-ROM with one to four therapist sessions focused on workbook-based homework and troubleshooting skill use. Some of these parents later joined a group program in which two therapists led structured discussions using alternate Parenting Wisely scenarios, while other group participants only experienced the group format. Across all participating families, the children had relatively severe behavior problems at baseline, making the clinical changes especially noteworthy.

Average ECBI Total Problem scores decreased by 29% for families using Parenting Wisely individually and by 43% for the group program—stronger effects than reported in many other Parenting Wisely evaluations. The effect size was 0.64 for individual use and 1.1 for the group format, and in the group program 6 children (17%) showed more than three standard deviations of change on the ECBI, without any of these children starting or changing medication during treatment. Among parents in the group program, 71% said they would strongly recommend it to others and another 22% said they would recommend it. Penticton Mental Health began using Parenting Wisely in March 2001, and within 18 months the positive feedback led 12 agencies and 7 nearby communities to adopt various versions of the program. For context, on the ECBI Total Problem scale a score of 19 marks the cutoff for clinically significant behavior problems, while a score of 8 reflects the level of behavior problems seen in the average child.

The Parenting Wisely Parent Training Program: An Evaluation With an Australian Sample

Authors: Cefai, J., Smith, D., & Pushak, R. E. (2002)

Published in: RMIT University / Child & Youth Mental Health evaluation study

This randomized evaluation tested Parenting Wisely with 116 Australian families assigned to an individual format, a group format, or a waitlist control. Both intervention formats significantly improved parenting knowledge, parenting satisfaction, parenting efficacy, and child problem behavior, with gains maintained at three-month follow-up. The individual format produced the strongest improvements, with larger increases in parenting competence and greater reductions in child behavior problems.

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Parents and children ages 9–15 were randomly assigned to a two-session group format, a two-session individual format, or a waitlist control group. Outcome measures included the Parenting Sense of Competence Scale (efficacy & satisfaction), the Eyberg Child Behaviour Inventory (problem intensity and frequency), and the Parenting Knowledge Questionnaire. Results showed significant gains for both treatment formats: parents increased knowledge by 32–40%, improved satisfaction and efficacy, and reported reduced child behavior problems. As shown in Table 2 on page 19, both treatment formats produced substantial decreases in ECBI intensity and problem scores, while the waitlist group’s scores worsened. Parents in both formats also demonstrated strong maintenance of gains, with three-month follow-up scores showing stability across parenting knowledge, parenting competence, and reductions in child behavior problems.

A major finding of this study is the difference in impact between treatment formats. The individual format produced the largest and most consistent improvements: parents showed greater increases in satisfaction (+16.6%), efficacy (+13.5%), and the largest reductions in child behavior problems (up to 42% improvement). Group-format participants improved as well, but with smaller gains, and parenting competence improvements were not maintained at the 3-month follow-up. Qualitative feedback revealed that individual-format parents were more satisfied overall—93% rated the program enjoyable versus 85% for group participants—and more individual-format participants reported having no criticisms. However, group participants valued peer discussion and shared experience. Despite format differences, the study concludes that Parenting Wisely is a highly effective, low-cost, easy-to-use program that produces measurable and meaningful improvements in both parenting and child outcomes.

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Evaluation of the Parenting Wisely CD-ROM Parent-Training Programme: An Irish Replication

Authors: O’Neill, H., & Woodward, R. (2002)

Published by: South Eastern Health Board, Ireland & University of Ulster

This randomized evaluation tested Parenting Wisely with 15 Irish families referred for child behavior management problems. Parents showed significant reductions in the number and intensity of child behavior problems within two weeks of using the program, along with increases in parenting knowledge and use of effective parenting skills. Parents also reported high satisfaction with the CD-ROM format, finding it easy to follow, non-judgmental, and useful for learning practical strategies.

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Families were randomly assigned to either an early-treatment or delayed-treatment group. Parents completed the interactive Parenting Wisely CD-ROM individually in a clinic setting, typically in a single 2–3 hour session. As shown in Table 2 on page 21, both groups demonstrated significant decreases in Eyberg Child Behaviour Inventory (ECBI) scores across time, with intensity and problem scores improving reliably at 2- and 4-week follow-ups. Parents also reported significantly greater use of adaptive parenting skills, with Parent Behaviour Questionnaire scores increasing at both post-treatment checkpoints (p = .0015 at two weeks; p < .001 at four weeks). The study likewise found marked increases in parenting knowledge, confirming that parents learned and retained the core skills taught in the program.

Satisfaction ratings were strongly positive. According to the Consumer Satisfaction Questionnaire (Table 3 on page 22), parents felt more confident managing current and future behavior problems, believed the program was appropriate and helpful, and said they would recommend it to others. They particularly liked the video clips, quiz format, ability to review material, and the privacy and control of working independently. Critiques focused on the American accents, the simplicity of some video resolutions, and the density of material when completed in a single sitting. Despite limitations—including the absence of a control group and short follow-up window—the study concludes that Parenting Wisely is an effective and accessible tool for Irish clinical practice, with strong potential for home-based and preventive applications.

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Final Evaluation Report: Family Plus Program (Des Moines, Iowa)

Authors: Hein, M. L., & Martin, T. J. (2002)

Published for: Employee & Family Resources (EFR), funded by SAMHSA Family Strengthening Grants Program

This two-year evaluation examined Family Plus, a three-session family-skills program built around the Parenting Wisely curriculum and implemented in Des Moines middle schools. Parents and youth showed meaningful improvements in key areas of family functioning—including mentoring confidence, monitoring, family strengths, and reduced interfamilial conflict. Both groups also demonstrated significant gains in knowledge about the effects of chemical dependency, although increases in prevention and refusal-skills knowledge were more modest.

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Family Plus brought families together across three weekly 2.5-hour sessions integrating Parenting Wisely CD-ROM scenarios, workbook activities, facilitated discussions, youth prevention groups, and joint parent–child skill practice. Parents showed significant improvement in mentoring confidence, helping with schoolwork, monitoring homework, and discussing academics. Youth reported parallel improvements in areas such as parental awareness of serious behaviors. Parents also reported increased perceptions of family strengths, including family organization and discipline style. Interfamilial conflict decreased for both parents and youth, with better handling of disagreements, improved ability to “get along,” and reductions in aggressive behaviors during conflict.

Knowledge of chemical dependency improved significantly for adults and youth. Prevention-specific knowledge showed smaller gains, but overall patterns remained stable or slightly improved. Youth substance use remained relatively low throughout the program period, with no increases in heavier drug use. Program satisfaction was high: adults rated the program an average of 3.41 out of 4, and youth rated it 3.19 out of 4, with strong praise for the discussions and facilitators. The report concludes that Family Plus effectively strengthened family communication, functioning, and safety, with group interaction and parent–child collaboration serving as core drivers of impact.

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“Parenting Wisely” Family Strengthening Program: Final Evaluation Report (SSTAR, Fall River, MA)

Author: Caldwell, D. (2001)

Submitted to: Center for Substance Abuse Prevention (CSAP)

This evaluation report studied the implementation and outcomes of the Parenting Wisely program delivered to 153 SSTAR outpatient clients in Fall River, Massachusetts—primarily parents with significant socioeconomic stress and high rates of substance use histories. Parents showed high satisfaction with the program, strong engagement, and meaningful improvements in several parent–child bonding behaviors, particularly reduced yelling, greater affection, and improved emotional availability. Although baseline family cohesion scores were already high, positive changes were seen at 3- and 6-month follow-ups, with many parents attributing improvements directly to the program.

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Parenting Wisely was offered as a short-term, self-paced CD-ROM intervention designed to strengthen parenting practices among a high-risk population, including many parents with current or past substance use. Participants spent an average of three hours completing the scenarios, after which follow-ups were conducted at 3 and 6 months. According to *Table 7 on page 22*, parents rated the program extremely highly—finding it easy to understand (mean=4.55), useful (4.53), and relevant (4.31). Baseline scores on family cohesion were already strong, leaving limited room for improvement, but one item (“I am available when others in the family want to talk”) showed statistically significant gains at both follow-up points (*Table 13, page 26*). The strongest measurable changes occurred in parent–child bonding behaviors. As shown in *Table 16 on page 28*, parents reported significantly less shouting at 3 months (p=.047), greater affection at 6 months (p=.050), and more consistent positive appreciation of their children (p=.046).

Despite the challenges of working with an outpatient substance-use population, the intervention achieved solid follow-up engagement for nearly half of participants. Of those reached, 38% later enrolled in additional parenting programs—suggesting the CD-ROM format helped motivate further skill development. Qualitative comments reflected increased patience, better consistency, and improved communication with children. However, the report notes limitations: a lack of a control group, significant attrition, and ceiling effects on several measures. Even so, the program’s low cost, high scalability, and strong fidelity—combined with significant improvements in multiple bonding behaviors—led CSAP to fund further expansion and a more rigorous future study.

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Determining the Effectiveness of the Parenting Wisely Program in Wichita, Kansas

Author: Parish, T. S. (2001)

Published by: Wichita Public Schools Evaluation Report

This evaluation examined whether Parenting Wisely improved parenting knowledge among 64 Wichita Public Schools parents. Participants completed a pre-test, used the Parenting Wisely CD-ROM with facilitator support, and then took the same test again. Parents showed a statistically significant improvement in overall knowledge, with mean scores rising from 16.64 to 19.70 on the parenting skills questionnaire.

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Parenting Wisely was delivered as a combined CD-ROM and trainer-supported learning session. After completing a 34-item multiple-choice questionnaire, parents worked through the program’s nine video-based case scenarios and received guidance from trained professionals. A paired t-test revealed a significant gain in knowledge (t = –3.161, p < .005), confirming that the program helped parents learn core skills in communication, assertive discipline, contingency management, and supervision. However, as shown in Table 1 on pages 3–5, improvement was uneven across individual items. Only nine items showed significant positive gains—including active listening, giving clear chores, managing back talk, and understanding contingency management—while many items showed no change. A few items were answered correctly less often post-training, though none reached statistical significance.

The report concludes that Parenting Wisely achieved a “moderate level of success” in this school-based implementation, providing meaningful but incomplete improvements in parenting knowledge. Importantly, several parent trainers noted potential issues with the test instrument itself—such as confusing wording and questionable recommended answers—suggesting some of the limited gains may reflect measurement flaws rather than program shortcomings. The study recommends refining the knowledge test and using item-level feedback to strengthen future program delivery, particularly in areas where parents continued to struggle after training.

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