SPRINGER BRIEFS IN PSYCHOLOGY

BEST PRACTICES IN COGNITIVE-BEHAVIORAL PSYCHOTHERAPY

Oana A. David
Raymond DiGiuseppe

The Rational
Positive Parenting
Program
SpringerBriefs in Psychology

Best Practices in Cognitive-Behavioral Psychotherapy

Series editors
Daniel David
Raymond A. DiGiuseppe
Kristene A. Doyle

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Epidemiological studies show that the prevalence of mental disorders is extremely
high across the globe (World Health Organization, 2011). Moreover, and what is
perhaps more concerning is the fact that, despite numerous existing evidence-based
treatments for various mental disorders, more than half of those in need of
specialized mental health services don’t access it and/or do not have access to these
treatments (Alonso et al., 2004c; Kohn, Saxena, Levav, & Saraceno, 2004; Wang
et al., 2005). Thus, developing and disseminating accessible evidence-based
protocols for various clinical conditions are key goals in mental health. This effort
would nicely complement the efforts of the American Psychological Association
(see Division 12’s List of evidence-based treatments), National Institute for Health
and Clinical Excellence (see NICE’s Guidelines) and Cochrane Reviews (see
Cochrane analyses of various clinical protocols) that identified evidence-based
treatments for various clinical conditions, based on rigorous literature analyses.
However, once identified, one needs a detailed published clinical protocol to deliver
those treatments in research, clinical practice, and/or training (see David &
Montgomery, 2011). Please submit your proposal to Series Editor Daniel David:
daniel.david@ubbcluj.ro.

More information about this series at http://www.springer.com/series/11896

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Oana A. David Raymond DiGiuseppe
•

The Rational Positive

Parenting Program

123
jreyes.psic@gmail.com
Oana A. David Raymond DiGiuseppe
Department of Clinical Psychology Department of Psychology
and Psychotherapy St. John’s University
Babes-Bolyai University Queens, NY
Cluj-Napoca, Cluj USA
Romania

ISSN 2192-8363 ISSN 2192-8371 (electronic)

SpringerBriefs in Psychology
ISSN 2365-077X ISSN 2365-0788 (electronic)
Best Practices in Cognitive-Behavioral Psychotherapy
ISBN 978-3-319-22338-4 ISBN 978-3-319-22339-1 (eBook)
DOI 10.1007/978-3-319-22339-1

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Preface

Cognitive-behavioral parenting interventions represent the treatment of choice for

addressing externalizing disorders of childhood (see NICE 2008; 2013), and their
effectiveness has been well documented by many research reviews (Thomas and
Zimmer-Gembeck 2007; Webster-Stratton 2002). However, some researchers
proposed (see Lovejoy et al. 2000) that integrating a focus on the
emotion-regulation strategies used by parents could enhance the effects of these
parenting programs, and such an addition would maximize the short-term and
long-term effects of these interventions. In this book, we describe how
Rational-Emotive & Cognitive-Behavioral Therapy (RE&CBT)-based parenting
interventions have historically addressed the emotional disturbances of parents
(Joyce 1995) that interfere with effective parenting, and how the recent advances in
clinical cognitive sciences are relevant to this topic (Gavita et al. 2011). We place a
special emphasis on the evidence-based status of the parenting programs for chil-
dren with externalizing disorders (Gavita et al. 2012). We present an overview
of the Rational Positive Parenting Program, describe its underlying evidence base,
and explain how it addresses externalizing disorders in children in clinical practice.
The research and contents of the curricula of the Rational Positive Parenting
Program (Gavita et al. 2013) are presented in detail, based on its standard format
(Gavita 2011), short format (Gavita et al. 2012), and self-help/online format (Gavita
and Calin 2013), each of which have been investigated in clinical trials. We present
the Rational Positive Parenting Program along with the evidence base that underlies
the approach and we explain how it addresses externalizing disorders in children in
clinical practice.

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Contents

1 Externalizing Disorders in Children, Etiological Factors,

and Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....... 1
Externalizing Disorders in Children . . . . . . . . . . . . . . . . . . ....... 1
Parenting as an Etiological Factor for Child Psychopathology ....... 2
Parenting Programs for the Treatment of Child Externalizing
Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....... 3

2 Cognitive-Behavioral Parenting Programs: Outcomes,

Approaches, and Future Directions . . . . . . . . . . . . . . .......... 5
Efficacy and Effectiveness of the Cognitive-Behavioral
Parenting Programs . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 5
The REBT Approach of the Parenting Programs . . . . . . .......... 7
Future Directions Based on Recent Findings . . . . . . . . . .......... 11

3 The Rational Positive Parenting Program . . . . . . . . . . . . . . . . . . . 15

Theoretical Assumptions of the rPPP . . . . . . . . . . . . . . . . . . . . . . . . 15
Program Content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Program Format. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Methods and the Therapeutic Process of the Program . . . . . . . . . . . 18
Group Leaders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Program Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Empirical Support of the Rational Positive Parenting Program . . . . . . . 19

vii

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viii Contents

The Protocol of the Rational Positive Parenting Program .......... 20

The Full-Length Version of the Rational Positive
Parenting Program . . . . . . . . . . . . . . . . . . . . . . . . . .......... 20
The Short Version of the Rational Positive Parenting
Program (s-rPPP) . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 31
The Online Version of the rPPP . . . . . . . . . . . . . . . .......... 35

Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

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Chapter 1
Externalizing Disorders in Children,
Etiological Factors, and Treatment

Substantial knowledge has accumulated on the nature and etiology of externalizing

disorders of children and adolescents. This first chapter focuses on describing these
etiological factors involved in these disorders and the present treatment approaches.
The relevance of the psychosocial interventions described in the next chapters will
be underlined.

Externalizing Disorders in Children

Mental health in youths is a serious issue worldwide (Remshmidt and Belfer 2005),
as the first onset of common mental disorders usually occurs in childhood or
adolescence (Kessler et al. 2005). Although psychopathology in children and
adolescents was estimated (Flouri et al. 2000) to be between 6 and 25 %, exter-
nalizing disorders represent the most frequent reason youth are referred to mental
health services (Kazdin 2003; Nock and Photos 2006). Moreover, they represent the
most severe childhood disorders (Lambert et al. 2001) in terms of child impairment
across multiple domains of functioning and quality of life.
Child externalizing disorders have been described in the literature using different
labels, such as misbehavior, non-compliant behaviors, disruptive, externalizing,
hyperactive, out-of-control, impulsive, deviant, behavior problems, behavior dis-
ordered, acting out, conduct problems, delinquency, and antisocial behaviors (see
also Nock and Kazdin 2002). However, misbehavior is not considered psy-
chopathology, as described in the Diagnostic and Statistical Manual of Mental
Disorders (5th edition; DSM-5; American Psychiatric Association; APA 2013) until
it becomes a stable pattern and produces significant impairment in everyday func-
tioning and quality of life at home or in school. The consequences of externalizing
disorders can be devastating for the child and its family. Currently, considerable
evidence demonstrates (Huesmann and Moise 1999; Stevenson and Goodman 2001)
that school-aged children who are diagnosed with comorbid disruptive behavior
disorders (e.g., oppositional defiant disorder and conduct disorder) showed similar
problems in their preschool years. Actually, the best predictor of later follow-up
diagnosis (i.e., at aged 6–7.5 years) found by Speltz et al. (1999) was the level of
© The Author(s) 2016 1
O.A. David and R. DiGiuseppe, The Rational Positive Parenting Program,
Best Practices in Cognitive-Behavioral Psychotherapy,
DOI 10.1007/978-3-319-22339-1_1

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2 1 Externalizing Disorders in Children, Etiological Factors …

children’s externalizing behavior problems reported by their mothers two years

earlier. Due to their persistence, the prognosis in cases of early-onset disruptive
behavior problems has high rates or persistence of the problems across the life span
and poor prognoses. The outcomes in adolescence and adulthood include antisocial
and criminal behavior, psychiatric disorders, drug and alcohol abuse, greater
unemployment, family breakdown, and intergenerational transmission of conduct
problems to children (see Loeber et al. 2000).

Parenting as an Etiological Factor for Child

Psychopathology

A large body of literature (see Burke et al. 2004) has shown that poor parenting
practices are related to child psychopathology (e.g., McKee et al. 2008), while
positive parenting practices can function as protective factors for children
(Eisenberg et al. 2005). It has long been known that parents who engage in more
negative parenting practices, such as the use of harsh and inconsistent discipline,
often report higher externalizing and internalizing psychopathology in both their
children and adolescents (Frick et al. 1992; Rothbaum and Weisz 1994). Moreover,
compared to other parents, parents of children presenting disruptive behaviors or
other special needs experience a higher level of distress (Gupta 2007). Thus,
children’s psychopathology has been linked (e.g., McLeod et al. 2007; Weaver
et al. 2008) with multiple aspects of parenting, such as dysfunctional parenting
practices, parental distress, and parent thinking distortions.
In turn, when positive parenting is applied, parents are involved with their
children, they take part in joint activities with them (e.g., playing games), and
involve them in activities of daily living such as showing interest in homework set,
communicating about daily events (Desforges and Abouchaar 2003). Thus, children
of positive parents can establish good relationships with adults, siblings, and
friends, show better concentration, and display lower levels of aggressive behaviors
than children of less positive parents do (Burke et al. 2004). Desforges and
Abouchaar (2003) found strong association between positive parenting and chil-
dren’s educational attainment.
Parenting is now conceptualized (Patterson and Fisher 2002) within a bidirec-
tional model. Child–parent interactions are affected (Belsky 1984) by the config-
uration of parent characteristics, together with the contextual, genetic factors, and
child individual characteristics (see Fig. 1.1). Comprehensive models consider the
explanatory power of both risk and protective factors for explaining the relationship
between parenting practices and child disruptive behavior problems. Indeed,
research has shown that whether, how, and how much parenting influences the child
depends on her/his individual characteristics (e.g., child’s temperament, irritability;
Belsky et al. 2007). Burke et al. (2004) proposed a nonlinear effect concerning
discipline and child aggression, with mild physical punishment having a weak
relationship to disruptive behaviors.

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Parenting as an Etiological Factor for Child Psychopathology 3

Contextual
sources of
stress /
support

Parenting

Individual Individual
child parent
characteristics characteristics

Fig. 1.1 Parenting influences based on Belsky (1984)

Given the research documenting the role that parenting plays in child mental
health, parenting programs have become a main treatment for addressing child
disruptive behaviors.

Parenting Programs for the Treatment of Child

Externalizing Disorders

The term parenting program is often used to describe child behavior modification
programs where the parent participates in the treatment and the changes in the way
the parent responds to the child are the primary mechanism of treatment (Nixon
2002). Parenting programs first appeared in the 1960s, when the field of clinical
psychology shifted in addressing children’s negative behaviors from an individual
child therapy focus to a more contextual approach that changed the child’s negative
behaviors, by changing the environmental contingencies by focusing on changing
parents’ behavior. This change occurred based on research documented parenting
behaviors as the etiopatogenetic mechanism for child psychopathology and the
increased understanding of how parents could act as agents of children’s behavior
change (e.g., Bandura 1977, 1989; Kaminski et al. 2008).

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4 1 Externalizing Disorders in Children, Etiological Factors …

Parenting programs have become more popular in recent their years. However,
they vary in characteristics (Kaminski et al. 2008) such as (1) the content (e.g.,
knowledge about child development, parenting self-efficacy, communication skills,
discipline, and/or behavior management strategies), (2) the delivery contexts or
settings (e.g., clinic-based therapy, community-based group sessions, and individ-
ual home visits), (3) the delivery procedures used to engage parents and teach
relevant content (e.g., group discussions, homework assignments, and role playing),
and (4) the types of families served (e.g., children with identified behavior prob-
lems, low-income adolescent parents etc.).
Positive parenting programs based on the cognitive-behavioral therapy
(CBT) approach have been largely aimed at promoting child mental health. Such
programs are currently considered the treatment of choice for child conduct dis-
orders (NICE 2006, 2013). Studies have documented (Cartwright-Hatton et al.
2005) that they demonstrate comparable effectiveness for children with both
externalizing and internalizing disorders.
Cognitive-behavioral group-based parenting interventions are considered a
“skills-based” approach, combining the use of various techniques derived from
behavioral learning theory (operant and classical conditioning learning), social
learning theory (e.g., modeling, behavioral rehearsal), and cognitive theories of
learning (e.g., restructuring parental cognitions) (Dretzke et al. 2005;
Webster-Stratton 1990a, b). They typically use a psycho-educational, interactive,
and collaborative format where the program facilitators teach the participants key
behavioral principles and parenting skills. Parents receive homework tasks for
practicing the new skills with their children.
Most of the parenting programs teach parents how to increase positive interac-
tions with their children while reducing bad, poor, and inconsistent parenting
practices. Key elements of these programs include (Azar and Wolfe 2006;
Hutchings and Kelly 2004) observation, modeling, and behavior rehearsal of
positive parenting strategies (e.g., role-play). They also include discussion, peer
support, reframing cognitive distortions about the child, cognitive restructuring of
dysfunctional or irrational beliefs, and homework assignments. However,
cognitive-behavioral parenting programs vary in the extent to which they focus on
these components. They also vary on the extent to which they target those families
who are most at risk.

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Chapter 2
Cognitive-Behavioral Parenting
Programs: Outcomes, Approaches,
and Future Directions

This chapter focuses on presenting (1) the underlying principles of the

cognitive-behavioral parenting programs for child externalizing disorders, (2) the
contents of the tested parenting programs, and (3) the outcomes of the clinical trials
testing their efficacy. This chapter also presents the gaps in the literature on the
current cognitive-behavioral parenting programs, the limitations of the existing
parenting program curricula, and the directions for improvement.
Behavioral approaches to parent programs were the first implemented and
investigated for reducing child disruptive behavior (Barlow and Stewart-Brown
2000; Nixon 2002). They were based on behavioral (operant learning) theories and
they made use of strategies such as positive reinforcement, extinction, time-out, and
contingency contracting. The aim of using these strategies was to reinforce alter-
native positive behaviors, while at the same time they reduced unwanted inap-
propriate child behaviors. Based on research documenting the importance of
parental attitudes and emotions in changing parenting practices (e.g., Gavita et al.
2014; Ben-Porath 2010), cognitive strategies were currently implemented in
cognitive-behavioral parenting programs. Some parenting programs
(Webster-Stratton 1990) have integrated strategies from the cognitive theories of
emotional control that challenge misattributions about child behavior or stress
management. Although there is a great heterogeneity in focus of these curricula,
most of the published parenting programs rely mainly or solely on behavioral
strategies.

Efficacy and Effectiveness of the Cognitive-Behavioral

Parenting Programs

Many clinical trials have documented the efficacy of parenting programs for child
externalizing disorders. Meta-analyses (see Bradley and Mandell 2005; Kaminski
et al. 2008; Lundahl et al. 2006; Maughan et al. 2005) that have synthesized the
results of peer-reviewed studies concluded that the effects were small to moderate

© The Author(s) 2016 5

O.A. David and R. DiGiuseppe, The Rational Positive Parenting Program,
Best Practices in Cognitive-Behavioral Psychotherapy,
DOI 10.1007/978-3-319-22339-1_2

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6 2 Cognitive-Behavioral Parenting Programs …

immediately after treatment (overall d = 0.22–0.52, see Lundahl et al. 2006), and
the effect sizes were small at follow-up (overall d = 0.21).
The meta-analysis by Bradley and Mandell (2005) investigated the efficacy of
parenting programs that were mediated by a number of variables. Most of the
parenting programs included had a cognitive-behavioral approach. Bradley and
Mandell (2005) found a medium magnitude of changes in parent-reported child
behavior, while changes on measures that relied on direct observation were low in
magnitude. Different effect sizes were found depending on the children’s age range.
A low level of changes was found in children between the ages of 3 and 5
(d = 0.40), no effect was found for children aged between 6 and 8 years (d = 0.19),
and a high magnitude of change was reported for children between the ages of 9 and
11 years (d = 1.36). An interesting result reported by this review was related to the
impact of the mean number of treatment sessions. The highest effect size was
obtained for the programs using between 1 and 5 sessions (d = 0.96), while the
lowest magnitude of change occurred in programs using more than 15 sessions
(d = 0.08).
Although many parenting programs exist, their evidence-based status varies
largely. Various organizations promote standards for selecting efficacious and
promising interventions for youth mental health promotion (e.g., Blueprints for
Healthy Youth Development). According to Small et al. (2009, p. 1),
evidence-based programs (EBPs) are “well-defined programs that have demon-
strated their efficacy through rigorous, peer-reviewed evaluations and have been
endorsed by government agencies and well-respected research organizations.
EBP’s are not simply characterized by known effectiveness; they are also well
documented so that they are more easily disseminated.” There are parenting pro-
grams that meet these criteria for evidence-based practice.
Collins and Fetsch (2012) conducted a critical review that rated the
evidence-based status of 16 of the most well-documented parenting programs. They
developed a rating scale to assess the degree of empirical support of the programs
with values ranging from 0 to 5, where 0 indicated that no evidence was found that
the curriculum had been evaluated empirically; 1 indicated that the program was
being evaluated but without any published program evaluation research; 2 indicated
that the program was evaluated, but the quality of studies was low; 3 indicated that
the program had only process evaluations; 4 indicated that the program had positive
outcome data from one or two well-designed studies investigating its short-term
impact; and 5 indicated that the program had a strong empirical support. Thus, this
rating of five included in the criteria that a series of studies existed that showed
consistent efficacy over several years. The parenting programs in their top pro-
grams’ category included (1) the STAR Parenting, (2) Systematic Training for
Effective Parenting, (3) Strengthening Families Program for Parents and Youth
10–14, and (4) Triple P. They identified another three programs in the promising
category. The top programs included different dosages of sessions that ranged from
ten once-weekly sessions to four two-hour sessions. Some programs supplement
group interventions with individual sessions. However, a major limitation of this
review was that it included only 16 parenting programs.

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Efficacy and Effectiveness of the Cognitive-Behavioral Parenting Programs 7

Furlong et al. (2012) conducted a Cochrane review to document the efficacy

of group parenting programs for improving behavioral problems in children aged
3–12 years. They found that behavioral and cognitive-behavioral group-based
parenting programs were clinically effective and cost-effective in improving chil-
dren’s conduct problems, parents’ mental health, and parenting skills in the short
term. However, they suggested that the long-term outcomes of such programs need
further investigation.
Although many randomised clinical trials document the outcomes of parenting
programs, only a few of them document their mechanisms of change.
A meta-analysis by Kaminski et al. (2008) investigated the treatment components
related to better outcomes in parenting programs. The three components associated
with better outcomes were teaching parents emotional communication skills,
teaching parents positive parent–child interaction skills, and requiring parents to
practice with their child. Emotional communication skills had the greatest effect size
and were connected to relationship-building and improving parent–child bonding.
Emotional communication referred to using relationship-building communication
skills and coaching children to identify and appropriately express their emotions.
Another systematic Cochrane review (Barlow et al. 2014) was limited to ran-
domized controlled studies published up until 2011 and documented the effects of
group-based parenting programs on the parents’ psychosocial health. They identi-
fied 48 studies that included 4937 participants. Primary parental outcome measures
included measures of depression, anxiety, stress, self-esteem, anger, aggression, and
guilt. The authors coded the programs as being in one of three categories: behav-
ioral, cognitive-behavioral, and multimodal. The results showed that parenting
programs were effective in the short run with low-to-medium effect sizes, and they
were effective in the long run in producing effects for parents’ stress and confi-
dence. Among the cognitive-behavioral programs mentioned in this review was the
Rational-Emotive Parent Education program investigated by Joyce (1995).

The REBT Approach of the Parenting Programs

Rational-Emotive and Cognitive-Behavioral Therapy (RE&CBT; Ellis 1962) rep-

resents the first modern form of cognitive-behavioral therapy (CBT).
Psychopathology is conceptualized by RE&CBT (Ellis et al. 1966; DiGiuseppe et al.
2014) as changing dysfunctional emotional and behavioral responses that are thought
to be caused by irrational beliefs. Maladaptive patterns of beliefs and behaviors can
be learned from the environment and can serve as endogenous vulnerability factors
that lead to psychopathology. Ellis’ (1956, 1962, 1991, 1994) ABC(DE) model the
(known also the ABC model) represents the central theory of RE&CBT. The theory
states that parents’ behavioral and emotional reactions (C) are not determined by the
activating events (A) they face, such as their children’s behavior, but by the way they
think (believe) about these activating events (B) (Fig. 2.1).

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8 2 Cognitive-Behavioral Parenting Programs …

Fig. 2.1 The ABC model of RE&CBT (Ellis 1956, 1991)

The primary focus of RE&CBT is thus on changing irrational beliefs, which

represent a specific type of faulty cognitions hypothesized to lead to disturbance.
The most important of these is what Ellis called demandingness. Parents’ IBs
include unrealistic and absolutistic demands on themselves as parents, on others
such as their children, or on life, and are responsible for parents’ dysfunctional
emotional reactions to negative events (e.g., children’s misbehavior). To change
their dysfunctional emotions that are the consequences of their irrational beliefs,
parents learn to actively dispute (D), challenge, examine their beliefs and replace
them with more effective beliefs (E) to achieve a new functional (F) life philosophy
(Ellis 1962, 1994). To be irrational, a belief would meet one of the following
criteria. Irrational beliefs are illogical, inconsistent with empirical reality, or
inconsistent with accomplishing one’s long-term goals (Ellis 1994). Any one of
these three criteria is sufficient for a belief to be irrational; not all three are necessary
to meet the definition. DiGiuseppe et al. (2014) identify the following character-
istics of irrational beliefs: (1) An irrational belief is absolute, dichotomous, rigid,
and unbending; (2) it is illogical; (3) it is not consistent with reality; (4) it does not
help one to achieve one’s goal; and (5) it leads to unhealthy/dysfunctional emo-
tions. Consequently, the features of a rational belief are the opposite: (1) Rational
beliefs are flexible with (rational beliefs acknowledge that one could have many
possible possibilities or different shades between black and white); (2) They are
logical; (3) they are consistent with empirical reality; (4) they help one in pursuing
one’s goal; and (5) they lead to healthy, functional negative emotions even when
the person is facing negative event.
REBT theory maintains that “demandingness,” or absolutistic, rigid adherence to
an idea is the core of disturbance. However, other types of irrational thinking are
less central and are psychologically deduced from or created from demandingness.
The major irrational beliefs and explanations concerning what makes them irra-
tional appear below (David et al. 2014).
Demandingness (DEM) is an unrealistic and absolute expectation of events or
individuals being the way a person desires them to be. An example of a parent’s
demanding IB would be when a parent thinks, “I must be obeyed by my child.”
Awfulizing (AWF) is an exaggeration of the negative consequences of a situa-
tion to an extreme degree, so that an unfortunate occurrence becomes “terrible.”
An example of a parent’s awfulizing IB would be when a parent thinks, “If my child
does not obey me, it is awful.”

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The REBT Approach of the Parenting Programs 9

Frustration intolerance (FI) stems from demands for ease and comfort, and
reflects an intolerance of discomfort. An example of a parent’s frustration intol-
erance IB would be when a parent thinks, “I can’t stand when my child
misbehaves.”
Global evaluations of human worth, either of the self or others, imply that
human beings can be rated, and that some people are worthless, or at least less
valuable than others are. An example of a parent’s IB about global evaluation of
the self would be a parent thinking, “I am not respected and thus I am worthless.”
An example of a parent’s IB about global evaluation of others would be a parent
thinking, “I am not respected by my child, and they are worthless for not respecting
me.”
A vast literature (see David et al. 2010) has documented the empirical support
concerning the association between irrational beliefs and dysfunctional emotions and
maladaptive behavioral reactions. The rational alternative belief patterns thought by
REBT/CBT to promote healthy, adaptive albeit negative emotions in both adults and
children are preferences (PREF; e.g., “I prefer to be obeyed by my child”) rather
than DEM. Badness is the rational alternative to awfulizing (BAD; e.g., “When my
child does not obey, it is bad but not awful”.) Unconditional self-acceptance is the
rational alternative for global self-evaluation. An example of a parent’s RB about
self-acceptance would be, “If am not respected by my child, I can still accept myself
and recognize that I am not a worthless person.” The rational alternative to global
evaluation of others would be unconditional other acceptance. An example of a
parent’s RB concerning unconditional other acceptance (UOA) would be, “If am not
respected by my child I can accept him/her and recognize that they are worthwhile
even though they do not respect me now.” The rational alternative to frustration
intolerance would be frustration tolerance. An example of a parent’s RB concerning
frustration intolerance would be, “I do not like it when my child misbehaves, but I
can stand this situation even though it is unpleasant.”
When facing adverse life events (e.g., child misbehavior), irrational thinking is
associated with dysfunctional consequences (e.g., dysfunctional emotions), while
rational thinking is associated with functional, adaptive negative emotions (Dryden
2002). According to this binary model of emotions derived from REBT, functional
and dysfunctional emotions constitute qualitatively different emotional experiences
that are not only quantitatively different (e.g., intensity). Although functional
negative emotions constitute adaptive reactions to everyday adverse life events,
dysfunctional emotions correspond to subclinical and clinical type of problems and
reactions (David and Cramer 2010). Dysfunctional emotions and their functional
counterpart categories of emotions appear in Table 1.
The RE&CBT framework (see Ellis and Bernard 2006) conceptualizes rational
beliefs (RBs) and irrational beliefs IBs of parents and their children, as important
resiliency mechanisms (RBs) or vulnerability factors IBs, which have a strong
impact on their parenting practices and mental health (e.g., Bernard and Joyce
1984; DiGiuseppe and Kelter 2006; Terjesen and Kurasaki 2009) (Fig. 2.2).
Thus, rational parenting refers to parents’ endorsement of all four categories of
rational beliefs, with unconditional acceptance of self and other as the key

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10 2 Cognitive-Behavioral Parenting Programs …

Table 2.1 Functional and dysfunctional emotions and corresponding thinking based on Dryden
(2002)
Emotion Functionality of emotion Type of associated belief
Anxiety Dysfunctional Irrational
Concern/apprehension Functional Rational
Depression Dysfunctional Irrational
Sadness/disappointment Functional Rational
Anger Dysfunctional Irrational
Annoyance Functional Rational
Guilt Dysfunctional Irrational
Remorse Functional Rational

Fig. 2.2 The ABC model of

functional versus
dysfunctional reactions (Ellis
1956, 1991)

components that is fundamental for mental health and positive parenting. Rational
beliefs can be transmitted to and learned by children through the parents’ explicit
use of such irrational language. In addition, they can be learned implicitly by the
parents’ modeling of self-acceptance and showing unconditional acceptance of the
child and other when they engage in critical events.
The rational parenting concepts in the RE&CBT parenting programs (Gavita
et al. 2013) rest on the assumption that RBs and IBs lead to distinct adaptive or
maladaptive parenting styles, respectively. Indeed, demanding beliefs about one’s
self in the parenting role and non-acceptance of one’s self were found (Gavita et al.
2014; Joyce 2006) to be associated with dysfunctional emotions in parents and thus
led to maladaptive discipline.
Hauck (1967) proposed several types of parenting styles. These are the “unkind
and firm” and the “kind and not firm” parenting styles. Both of these are mal-
adaptive for child development, and both are based on low levels of parental self
and child unconditional acceptance. In turn, the “kind and firm” parenting style is
an adaptive form of parenting and is based on unconditional acceptance of both self
and child. Thus, a fundamental focus of the RE&CBT parenting interventions is to
help parents to identify their IBs that produce their maladaptive consequences

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The REBT Approach of the Parenting Programs 11

(the B–C connection) and then to learn the tools of cognitive restructuring/disputing
and rehearsal for the new rational thinking patterns.
The RE&CBT-based interventions applied to the parenting field have been
labeled with many terms. Some of these names include Rational-Emotive Parent
Education (Joyce 1995, 2006), Rational-Emotive Behavior Parent Consultation
(Vernon 1994), Rational-Emotive Family Therapy (Woulff 1983; Huber and Baruth
1989; DiGiuseppe and Kelter 2006), and more recently the enhanced parenting
program in the form of the Rational Positive Parenting Program (David 2014;
David et al. 2014; Gavita et al. 2013). The RE&CBT Parenting Program (Joyce
2005) was the first program tested in a rigorous study (Joyce 1995) using a com-
parison group of parents assigned to a waiting-list control group. The program
focused on a non-clinical population and treated parental distress by teaching
parents the ABC model, fostering rational thinking, and developing rational
problem-solving skills. The results showed that parents receiving the RE&CBT
parenting program reported significantly lower child behavior problems, endorsed
fewer parental irrational beliefs, and reported less parent guilt and parent anger at
the end of the program. The resulting decreases in both child behavior problems and
parental negative global evaluation/self-downing were maintained at a 10-month
follow-up.

Future Directions Based on Recent Findings

We now know that cognitive-behavioral parenting programs can successfully

address child behavior problems (i.e., 4–12-year-old children; Kaminski et al.
2008). However, up to half of all participating parents fail to derive benefits from
these programs (Kazdin 1993; Webster-Stratton 1990). Moreover, the attrition rate
for families of children with conduct disorder is more than 50 % (Fireston et al.
1980; Patterson 1974). Previously, Morrissey-Kane and Prinz (1999) proposed that
addressing the cognitions underlying parents’ negative emotions and maladaptive
behavior could represent an important addition in improving the treatment process.
Parental distress, poor parental emotion-regulation abilities, and parental psy-
chopathology represent serious risk factors for poor parenting, and they correlate
with child disruptive behavior (Burke et al. 2004; Hoza et al. 2000). Patterson and
Capaldi (1991) found that parents of children with conduct disorder
(CD) and oppositional defiant disorder (ODD) had poor abilities to regulate their
anger and reported a higher incidence of using corporal punishment and
abusive/excessive discipline. Moreover, Ben-Porath (2010) showed that parents
who presented with difficulties in anger regulation were also less effective in reg-
ulating their child’s affect when the child becomes emotionally upset. Kaiser et al.
(2010) found that changes in the parents’ dysfunctional cognitions improved par-
enting and child functioning. More specifically, self-efficacy, parents’ negative
attributions concerning their children’s problem behavior, and parents’ depressive
cognitions have been identified (see also Hoza et al. 2000, 2006) as important

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12 2 Cognitive-Behavioral Parenting Programs …

targets for parenting programs to improve the outcomes for the treatment of child
disruptive behavior. Thus, we proposed (Gavita et al. 2011, 2013) that parental
emotion-regulation components should be an important focus of parenting pro-
grams for preventing and/or treating child externalizing disorders. More recently,
such enhanced or cognitively enhanced versions of parenting programs have been
developed (see Gavita and Joyce 2008). Such programs focus more specifically on
both parental distress/psychopathology and their underlying cognitive
self-regulation mechanisms.
Cognitive theories of psychotherapy differ in whether they target inferential
(cold cognitions) or evaluative (hot cognitions) (DiGiuseppe et al. in press). Most of
the literature concerned with parental cognitions has focused on parental attribu-
tions for the child misbehavior, parental expectations of children’s behavior, and
parental perception of their own abilities. These types of cognitions represent the
“cold” cognitions that infer or describe some characteristic of the parent or the child
or some reason for the failure to change the child or labeling the parent as inef-
fective. Thus, most of the parenting programs have targeted parental distress by
identifying and challenging inferential cognitions. These thoughts are specific
examples of the negative automatic thoughts identified by Beck and Haigh (2014).
However, it was long noted by Ellis (1962, 2003) that such biased cognitions result
in distress only if these inferences are negatively appraised. Research in clinical
cognitive sciences and emotion-regulation paradigm supports this claim, showing
(Aldao et al. 2010) that reappraisal or the targeting of evaluative cognitions is the
most effective emotion-regulation strategy. Several recent studies (Gavita et al.
2014; Gavita 2011) have documented the relationships between parents’ irrational
beliefs (“hot”—evaluative cognitions) and unhealthy negative emotions. More
specifically, a mediation effect was obtained for the irrational cognitions on the
connection between self-efficacy (a cold cognition) and parent distress. Thus, we
maintain that evaluative (or hot) cognitions are the important cognitive structures to
target in parenting programs. These will be the targets of cognition change in this
program (Fig. 2.3).
Although the efficacy of the cognitive-behavioral parenting programs is well
established (Lundahl et al. 2006; Kaminsky et al. 2008), another limitation of these
programs from an evidence-based perspective is that we do not yet understand how
they work. Besides parenting skills, an important variable found across many
studies to moderate the efficacy of parent training regardless of the degree of child
psychopathology is difficulties in parental affect regulation and distress (Ben-Porath
2010; Webster-Stratton and Hammond 1990; David 2014). Thus, teaching parents
emotion-regulation strategies should be a key component of any parenting pro-
grams, based on the studies documenting its mediating role for the child outcomes.
This understanding is important if we are to select components to add to parenting
programs that are based on general and specific mechanisms that will improve their
effects.
The cost-effectiveness of delivering a program is yet another important aspect
concerning parenting programs. The cost of such programs becomes an essential
factor when planning to treat populations from underdeveloped countries or low

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Future Directions Based on Recent Findings 13

Fig. 2.3 The mediating effect of irrational beliefs based on the findings of Gavita et al. (2014)

SES backgrounds. The access to parenting programs is a limited resource that could
be expanded by the widespread access to Internet. We mentioned above that the
length of parenting programs was not related to their outcomes. Thus, shorter
programs that address the key documented mechanisms of change should be further
investigated so that cost-effective programs can be developed online to reach
underserved populations.
In conclusion, research in clinical cognitive sciences mentioned above (see also
Gavita et al. 2013) suggests that the following directions could be pursued in
developing parenting programs’ curricula to increase their efficacy and
cost-effectiveness: (1) Emotion regulation strategies need to be implemented in
parent programs for optimal results and improvement in children’s behavior and
(2) the emotion-regulation component should address parental evaluative
cognitions/appraisals (hot cognitions). The RE&CBT framework, that focuses on
rational and irrational beliefs of parents offers a coherent approach consistent with
recent advancements in parenting and core constructs involved in psychopathology,
and promotes a “kind and firm” parenting style.

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Chapter 3
The Rational Positive Parenting Program

In this section, we describe (1) the theoretical assumptions of the Rational Positive
Parenting Program (rPPP); (2) the empirical support for the rPPP protocols; and
(3) the clinical protocol of the rPPP in its full-length, short version, and online
format including techniques, assignments, forms, and methods.

Theoretical Assumptions of the rPPP

The rPPP was developed by Gavita (2011a, b) and is cognitive-behavioral group

interventions for parents. The rPPP represents an application of the RE&CBT
approach (Ellis 1994) that has as its intermediary goal in changing of children’s
problematic behavior, the restructuring of parents’ irrational beliefs to improve their
emotional difficulties that will empower them to adopt the effective parenting skills
that can be taught. Thus, rPPP approaches parent’s emotional disturbance as the
first focus and a crucial target of the intervention. The rPPP can be conceptualized,
using parenting program field terminology, as a cognitively enhanced parenting
intervention addressing parental distress (including anger, depressed mood, anxiety,
guilt) by comprehensively targeting its relevant cognitive mechanisms, based
rational beliefs on the most recent advances in cognitive science (reappraisals in the
form of irrational thinking). During the program, parents learn a series of skills to
help them effectively promote parent–child positive relationship, enhance child
development, and manage misbehaviors.
The rPPP has the following characteristics in line with the RE&CBT theory and
research:
1. It has a strong focus on teaching parents effective emotion-regulation strategies
based on the evidence-based and ecological forms of reappraisal of perceived or
actual events (Gross and John 2003; Cramer and Buckland 2010; Cristea et al.
2012), which:
(a) are implemented initially in the architecture of the parental intervention and
(b) target the parents’ evaluative cognitions, in the form of irrational beliefs,
which are considered key regulatory mechanisms of parental distress.
© The Author(s) 2016 15
O.A. David and R. DiGiuseppe, The Rational Positive Parenting Program,
Best Practices in Cognitive-Behavioral Psychotherapy,
DOI 10.1007/978-3-319-22339-1_3

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16 3 The Rational Positive Parenting Program

2. It teaches parents relevant positive parenting strategies characteristic of the

“kind and firm” parenting style by using the most effective innovative educa-
tional tools and methods.
Thus, the most important features of the rPPP are its up-to-date contents,
methods, and techniques that are based on the state-of-the-art findings from clinical
cognitive sciences and the parenting program field and its strong evidence-based
orientation. The rPPP is committed to permanently updating and adapting its
contents based on the relevant findings regarding its effective mechanisms and
format.
Some important advantages of the rPPP include (a) the low costs as compared to
other similarly researched programs, (b) the already documented results for its
efficacy in several formats (Gavita et al. 2012; Gavita and Calin 2013; Joyce 1995),
(c) its inclusion of standard components (the positive parenting strategies of the
SOS Help for Parents curricula), and (d) its established efficacy in several cultures
(e.g., Iranian; Oveisi et al. 2010; Romanian; David 2014). The efficacy and effec-
tiveness of rPPP in the treatment of child externalizing behavior have been rigor-
ously evaluated (David 2014; David et al. 2014; Gavita and Calin 2013; Gavita
et al. 2012).

Program Content

The rPPP includes an initial module addressing parents’ emotion-regulation strate-

gies (rational parenting) followed by a positive parenting coaching module (i.e., the
positive parenting strategies; Gavita et al. 2013, 2012). The focus on the
emotion-regulation curriculum appears at the beginning of the program. Based on
the RE&CBT theory, the program aims to work first on parent’s emotional problems
and then teaches them strategies to improve their parenting skills to obtain
long-lasting results and build resilience to the difficulties of raising children
(DiGiuseppe and Kelter 2006; Ellis 1994; Joyce 1995). By training parents to
manage their own stress difficulties, the rPPP aims to use parents as
emotion-regulation agents for further coaching of their own children in emotional
self-regulation by using the same principles (see contributions of the emotional
communication variables to outcomes; Kaminsly et al. 2008). The program offers
specific tools for promoting this coaching process in the form of rational stories and
rational cartoons (e.g., RETMAN and the RETmagic; David 2010; www.retman.ro).
The program incorporates innovative methods and strategies, like the metaphor
of using “psychological pills” and attention bias modification (ABM; David and
Podina 2014) procedures for its online versions. Rational personalized-statements
are called “psychological pills” for parents (Gavita et al. 2013) and are based on
functional reappraisal strategies (see the PsyPills for Parents Forms). The parents
learn to use these self-statements on the anticipated critical situations they will

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Theoretical Assumptions of the rPPP 17

encounter with their children as emotion-regulation strategies. In this way, parents

become aware on the impact of their thinking on their emotions and behavior (the
B → C connection), and the rehearsal of prepared rational statements can help them
“override” the impact of their irrational beliefs in aversive child-rearing situations
(i.e., child misbehavior).
The positive parenting component focuses on promoting positive parent–child
relationship through techniques such as planned attention devoted to increasing
child positive behaviors, increasing joint activities with their children, engaging in
child-directed play, and coaching their children in emotional and social skills. The
rPPP also teaches parents effective child management strategies, such as assessing
family rules, prompting good behavior, using rewards and negative consequences
for misbehavior, effectively communicating with the child, problem solving, and
coping with specific child behaviors. Active training methods include parenting
skills modeling through the SOS Help for Parents resources (Clark 1996; video
vignettes (43), handouts and bibliotherapy based on the SOS Help for Parents
curricula), role-plays, feedback, and the use of specific homework tasks. The
content is delivered through a combination of within-session exercises and home-
work monitoring assignments. Practical tasks aim at transferring the acquired
emotion-regulation skills to the child through activities together, handouts, and
self-example that are occur through the entire course of the program. Issues of
maintenance, coping with risky situations, and follow-up are covered at the end of
the program.

Program Format

Each session of the program adheres to the following format:

• assessing the current status of child’s behavior;
• connecting the agenda for the present session with the previous session’s
content;
• discussing homework;
• setting the agenda for the session;
• discussing the content of the agenda;
• providing periodic summarizations;
• establishing the homework for the coming week; and
• finally, summarizing the skill sand content taught in the session and seeking
feedback from parents.

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18 3 The Rational Positive Parenting Program

Methods and the Therapeutic Process of the Program

The main methods used within the program include:

• watching video modeling vignettes,
• participating in group exercises,
• role-playing exercises,
• using self-help resources (use of the books SOS Help for Parents and SOS Help
for Emotions; Clark 1996),
• negotiating weekly homework assignments, and
• providing the opportunity of weekly evaluations.
The therapeutic process involves a group-training program, which enhances
collaboration among the participants. The leader works together with the parent in a
relationship that builds on the strengths of both partners for attaining the goals
established. These collaborative relationships are fostered by the leader’s expres-
sions of empathy, acceptance, support, feedback, and encouragement to the parents.
Both parents of the children are encouraged to participate in the program. In cases
with single or separated parents, the parents are encouraged to bring their parents
(the grandparents) or a supporting friend to the sessions.

Group Leaders

The group format for 8–14 parents involves two group leaders for managing both
group discussions and the materials needed. In case only one group leader is
available, the group can be reduced to 6–10 parents.

Program Evaluation

Asessment for inclusion and outcomes considered when implementing the rPPP are
presented below.
• Evaluation procedure
– Family background information (e.g., interview on demographic informa-
tion, structural and trans-generational family information)
– Child adjustment [parent report, self-report, and teacher report of behavior
problems (e.g., ASEBA system; Achenbach 1991; Connors CBRS, Connors
2008), child report (Functional and Dysfunctional Child Mood Scale; David
2014)]
– Parenting [e.g., knowledge (Child Management Skills Test; Clark 1996),
practices (Parenting Scale; Arnold et al. 1993), affect (Parent Anger Scale;
Gavita et al. 2011b)]

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Theoretical Assumptions of the rPPP 19

– Parental distress and psychopathology (e.g., Parent Stress Scale; Berry and
Jones 1995; see at: http://www.personal.utulsa.edu/*judy-berry/parent.htm)
– Parental cognitions (e.g., Parent-Rational and Irrational Beliefs Scale; Gavita
et al. 2011a)
• Outcome variables
– Child adjustment,
– Parenting behaviors,
– Parental distress and psychopathology,
– Parental cognitions,
– Parental expectations,
– Therapeutic relationship,
– Satisfaction with the program,
– Parent Group Rating Scale.
The main measures were developed for the rPPP, and they appear in the
appendices.

Empirical Support of the Rational Positive Parenting

Program

The rPPP was investigated to date in three published clinical trials, and its online
version is currently under investigation in another trial. The efficacy of the rPPP
full-length version has been investigated both in terms of outcomes and mecha-
nisms of change by David and collaborators (David et al. 2014; David 2014).
The main clinical outcome study was conducted by David et al. (2014) and
included 130 parents and their children aged 4–12 years old. The parents were
randomly assigned to either the rPPP (enhanced program), to the standard parenting
program (based on the main SOS Help for Parents curricula), or a waiting-list
control group. The children whose parents participated in the study presented with
externalizing behavior problems according to the ASEBA system. Parents assigned
to parenting programs, the rPPP and the SOS curricula, attended ten 90-min group
sessions (15 h of intervention). Each group had two group leaders. The programs
were delivered at the counseling offices within the schools and kindergartens
included in the study.
The results obtained showed that the rPPP was effective in reducing child
externalizing behavior problems as reported by parents. More importantly, the rPPP
showed specific greater improvements at 1-month follow-up on measures of
Oppositional Defiant Problems as rated by both the parents and the teachers, and on
the parent-rated Attention Deficit/Hyperactivity Problems and Conduct Problems
scales compared to the standard parenting program. Significant improvements in
Oppositional Defiant Problems were reported by external observers (teachers) for
the rPPP condition. Thus, this trial showed that the rPPP proved to be more

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20 3 The Rational Positive Parenting Program

efficacious than a standard parenting program having the same length in terms of
more generalized reductions in child externalizing disorders and gains maintenance.
The mechanisms of change analyses (David 2014) showed that parental distress
worked as mediator of change together with parenting behaviors for the rPPP, while
only parenting behaviors was a mechanism in the standard parenting program.
The short-length version of the (s-rPPP) was investigated in two trials. The first trial
(Gavita et al. 2012) showed that the four-session protocol of the rPPP is effective in
reducing disruptive behavior in the foster care children (N = 97, aged 5 through
18 years), parenting and parental distress, compared to a waiting-list group. The
changes were maintained at 3-month follow-up. Interesting results were obtained for
the children versus adolescent groups, with different paths of improvement. The group
of children registered greater improvements in their externalizing behavior at
post-treatment, losing some of the gains, however, at follow-up. The adolescents
group in turn registered less improvement in behavior at post-treatment, but the
improvement was maintained and continued at the 3-month follow-up.
The second trial (Gavita and Calin 2013) documented the efficacy of the short
rPPP compared to therapeutic stories for children. The sample included in this study
consisted of 32 children with externalizing and internalizing problems, assigned
either to the RETMAN rational stories group (15 children) or to the short Rational
Positive Parenting Program (s-rPPP) group (parents of 17 children). Both types of
interventions were effective in reducing child affective and behavioral difficulties,
with the rPPP being more effective in changing parenting skills (the laxness and
verbosity dimensions), and reducing both teacher- and parent-reported externalizing
syndromes. The s-rPPP was also effective in reducing child-reported anger and
building frustration tolerance.
Currently, the rPPP is being investigated in its online format, with both a
full-length (eight sessions) and short-length (four sessions and one session) formats.
Moreover, state-of-the-art procedures are investigated as components of the pro-
gram: online rPPP complimented with ABM procedures; RPPP compared with
online support group; and short online rPPP augmented with a parent child inter-
action coaching session.

The Protocol of the Rational Positive Parenting Program

The Full-Length Version of the Rational Positive Parenting

Program

Overview

The full-length rPPP consists of ten sessions, one session per week, each of 90 min.
Session 1 is an introductory session that aims at familiarizing parents with the
program, with the group, and assessing their baseline difficulties and objectives.

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The Protocol of the Rational Positive Parenting Program 21

Sessions 2 and 3 focus on personal adjustment strategies to overcome depres-

sion, anger, anxiety, and stress that interfere with their parenting ability, which are
based on a tested curriculum (Gavita et al. 2012). Using a cognitive conceptual-
ization, parents learn how to identify and challenge maladaptive cognitions about
their child, themselves, child management routines, or other stressful situations
(emotion-regulation strategies). Parents are then encouraged to prepare a set of
personal rational self-statements for potentially stressful situations (psychological
pills). Psychotherapists who are unfamiliar with the RE&CBT model and find it
difficult to implement can consult the detailed treatment manual by DiGiuseppe
et al. (2014).
The content of the module is as follows:
Session 2 focuses on identifying the parents’ stress cues, teaching the parents the
connection between irrational and dysfunctional thoughts and feelings, identifying
their own irrational beliefs, and teaching techniques for changing irrational thinking
patterns (the cognitive ABC model; Ellis 1994).
Session 3 focuses on challenging low frustration tolerance concerning their
child’s behavior; strengthening their own unconditional self-acceptance; strength-
ening their acceptance of their children; and learning to coach their children to
develop increased rational thinking, frustration tolerance, and unconditional
self-acceptance. In average, this module constitutes 3 h of the 15 h of the rPPP.
Sessions 4–10 cover the positive parenting strategies or child management skills.
Sessions 4–7 focus on child attending skills, monitoring child behavior, setting goals
for the child’s behavior, focusing parental attention on positive behaviors and activ-
ities with their child, using effective rewards, and setting family rules. The next three
sessions focus on setting family rules, communicating with the child and play.
Sessions 7–9 focus on acquiring effective techniques for managing child
unwanted behavior, with a great emphasis on time out and inviting teachers as
collaborators, problem solving, coaching their children in problem-solving skills,
and coping with specific child behaviors.
Session 10 focuses on issues of maintenance and closure which are covered in.

Sessions’ Topic

Session 1 Introduction
Session 2 Rational parenting—Parental distress;
Session 3 Rational parenting—Unconditional parenting;
Session 4 Positive parenting: Praise and reward;
Session 5 Communication, attachment, and play;
Session 6 Setting boundaries;
Session 7 Fostering positive behaviors;
Session 8 Time-out;
Session 9 Problem-solving and coping skills; and
Session 10 Rational positive parenting.

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22 3 The Rational Positive Parenting Program

The following section will detail each session, with its objectives, activities, and
materials. The sessions include readings from the SOS Help for Parents and SOS
Help for Emotions (Clark 1996) self-help books, the SOS Help for Parents video
vignettes and handouts (http://sosprograms.com/), the stories for children and car-
toons of RETMAN (http://retman.ro/; see Fig. 3.1), and “psychological pills” with
their mobile version PsyPills (see Fig. 3.2).
Session 1: Introduction

Objectives
• Education about the rPPP and child behavior problems;
• Introducing the members to each other and establishing the group functioning
rules;
• Exploring the parents’ expectancies and establishing individual goals; and

Fig. 3.1 The RETMAN tools

for coaching children
emotional skills

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The Protocol of the Rational Positive Parenting Program 23

Fig. 3.2 The PsyPills app

• Assessing the problems by using the measures designed for the program (see the
section “Program Evaluation”. Evaluation procedure above).
Materials
• Child behavior monitoring forms.
Homework
• Monitoring child behaviors and
• Setting a bank account of parent–child positive relationship: special time with
the child.
Session activities
1. Welcome and introduction;
2. Setting the agenda for the session;
3. Educating the parents about the rPPP;
4. Setting group rules;

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24 3 The Rational Positive Parenting Program

5. Getting to know each other;

6. Educating the parent about child behavior and relationship-building activities;
7. Exploring parent expectancies and establishing individual goals;
8. Summarizing the session and feedback; and
9. Establishing homework.
Exercises
• Share one positive thing about my child;
• Draw my child misbehavior;
• Share some realistic expectations with your peers; and
• Discuss the bank account of parent–child positive relationship.

Session 2: Rational Parenting—Parental Distress

Objectives
• Parents will recognize their own and their child’s emotions and activating
events;
• Parents will understand the ABC model and accept responsibility for one’s own
emotions;
• Parents can identify their own irrational beliefs; and
• Parents will know what activities to do with their children: coaching the children
to identify and express his/her own emotions.
Materials
• Child behavior monitoring forms;
• ABC monitoring forms; and
• Video vignettes B–C connection.
Homework
• Monitoring child behaviors (home and at school);
• Monitoring dysfunctional emotions based on the ABC form; and
• Completing the emotions form for child.
Session activities
1. Discussing homework;
2. Setting the agenda for the session;
3. Identifying their stress—adaptive and maladaptive reactions;
4. Applying the ABC model to parent’s emotional reactions;
5. Distinguishing between rational and irrational thinking;
6. Coaching their children in emotion-recognition skills;
7. Summarizing the session and asking the parents for feedback; and
8. Establishing homework.

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The Protocol of the Rational Positive Parenting Program 25

Exercises
• Vignette with a stressful situation for identifying emotion;
• Small group activities presenting double figures and discussion on perspective
taking;
• Video demonstration of B–C connection; and
• Role-play for coaching emotion-recognition skills.

Session 3: Rational Parenting—Unconditional Parenting

Objectives
• Use different strategies to dispute relevant parental irrational beliefs;
• Prepare personalized “psychological pills” for managing the parent’s anger,
anxiety, and depression; and
• Identify activities to do with the children: coaching the children to build
unconditional self-/other/life acceptance.
Materials
• Child behavior monitoring forms;
• ABC monitoring forms (own and child);
• Rational therapeutic stories RETMAN; and
• Psychological pills.
Homework
• Monitoring child’s behaviors;
• Monitoring and changing one’s own negative dysfunctional emotions (ABCDE
model); and
• Developing individualized parent “psychological pills.”
Session activities
1. Discussing homework;
2. Setting the agenda of the session;
3. Challenging irrational thinking;
4. Developing rational thinking coping strategies—parental “psychological pills”;
5. Coaching emotion-regulation skills in children;
6. Summarizing the session and asking the parents for feedback; and
7. Establishing homework.
Exercises
• Role-playing—arguments supporting identified irrational/rational thinking and
• Developing one’s own personalized “psychological pills.”

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26 3 The Rational Positive Parenting Program

Session 4: Positive Parenting: Praise and Reward

Objectives
• Build a positivity in the parent–child relationship;
• Understand and implement the use of effective commands and prompts with
children;
• Understand and implement the use of effective rewards and praise for your
children’s positive behaviors; and
• Understand and implement the use of ignoring for specific unwanted behaviors.
Materials
• Relationship bank account: unconditional accepting and validating statements;
• Steps for efficient commands and instructions handout;
• Monitoring form for child positive behaviors and rewards; and
• Video vignettes.
Homework
• Creating and expressing own unconditional accepting and validating statements
and
• Monitoring child behaviors, rewards, and ignoring.
Session activities
1. Discussing homework;
2. Setting the agenda for the session;
3. Using the relationship bank account: unconditional accepting and validating
statements;
4. Practicing the steps for effective commands and prompts;
5. Using rewards, praising;
6. Using active ignoring;
7. Summarizing the session and asking the parents for feedback; and
8. Establishing homework.
Exercises
• Formulating one’s own statements for your children’s unconditional acceptance
and validation;
• Demonstrating and role-playing using efficient instructions, praising, and
ignoring;
• Establishing a rewards menu; and
• Role-playing the use of active ignoring.

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The Protocol of the Rational Positive Parenting Program 27

Session 5: Communication, Attachment, and Play

Objectives
• Understand and implement effective communication with your children;
• Understand and implement how to play with your children; and
• Understand and implement strategies to coach children to increase their emo-
tional and social skills.
Materials
• Handout for effective communication with the child;
• Handout for fostering secure attachment; and
• Playing with the child monitoring form.
Homework
• Monitoring child behavior;
• Monitoring child-directed play; and
• Coaching child emotional and social skills.
Session activities
1. Discussing homework;
2. Setting the agenda for the session;
3. Teaching the guidelines for efficient communication with your children and
fostering secure attachment;
4. Teaching the guidelines on playing with the children;
5. Teaching the guidelines to coach the children in emotion-regulation and social
skills;
6. Summarizing the session and ask for feedback; and
7. Establishing homework.
Exercises
• Role-playing effective communication and play;
• Demonstrating and peer practice play with the child, emotional and social skills
coaching; and
• Demonstrating and practice (e.g., tickets with child statement) for coaching
emotion-regulation skills in children.

Session 6: Setting Boundaries

Objectives
• Understand and implement the characteristics of the kind and firm parenting
model;
• Understand how to establish family rules and implement this knowledge;
• Understand how to provide a rational model for the child: modeling positive
behaviors; and

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28 3 The Rational Positive Parenting Program

• Understand and implement strategies for managing unwanted behaviors: setting

consequences, grandma’s rule, and developing behavioral contract.
Materials
• Child behaviors and consequences monitoring forms;
• Family rules and consequences form;
• Handout of types of consequences, grandma’s rule, and behavioral contract; and
• Video vignettes.
Homework
• Establishing family rules and consequences;
• Communicating family rules in a family meeting; and
• Monitoring child behaviors and consequences.
Session activities
1. Discussing homework;
2. Setting the agenda;
3. Discussing how to propose family rules;
4. Acting in a way to serve as a rational model for the child: modeling positive
behaviors;
5. Managing unwanted behaviors:
• Active ignoring bad behavior,
• Implementing grandma’s rule, and
• Developing behavioral contract;
6. Summarizing the session and asking for feedback; and
7. Establishing homework.
Exercises
• Peer discussion of family rules and role-play communicating the family rules;
• Brainstorm possibilities for modeling positive behaviors; and
• Role-play active grandma’s rule and behavioral contract.

Session 7: Fostering Positive Behaviors

Objectives
• Understand and implement the refinement of family rules;
• Understand and implement the principles of a token economy reward system;
and
• Understand and implement the principles of self-reward and increasing chil-
dren’s self-motivation for appropriate behavior.

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The Protocol of the Rational Positive Parenting Program 29

Materials
• Child behaviors and consequences monitoring forms;
• Token economy form; and
• Handout effective token economy guidelines.
Homework
• Monitoring child behaviors, rewarding identified alternative behaviors, and
applying consequences for unwanted behaviors according to family rules and
• Establish a token economy system with the child.
Session activities
1. Discussing homework;
2. Setting the agenda;
3. Refining family rules and implementing them;
4. Establishing a token economy reward system;
5. Coaching self-motivation and self-rewarding strategies;
6. Summarizing the session and asking the parents for feedback; and
7. Establishing homework.
Exercises
• Peer discussion of token economy system details;
• Role-play for establishing the token economy system with the child; and
• Role-play self-motivation and self-rewarding statements.

Session 8: Time-Out

Objectives
• Understand and implement time-out as a method for positive discipline and
• Understand and avoid the errors in the use of time-out.
Materials
• Child behaviors and consequences monitoring forms;
• Time-out guidelines handout; and
• Video vignettes.
Homework
• Monitoring child behaviors and consequences and
• Monitoring time-out.
Session activities
1. Discussing homework;
2. Setting the agenda for the session;
3. Implementing time-out;

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30 3 The Rational Positive Parenting Program

4. Summarizing the session and asking the parents for feedback; and
5. Establishing homework.
Exercises
• Time-out demonstration and
• Time-out role-play.

Session 9: Problem-Solving and Coping Skills

Objectives
• Understand and implement problem-solving skills;
• Understand and implement activities with the child to coach the child in
problem-solving skills;
• Manage specific child and parent problems; and
• Understand and implement the principles of progress monitoring and coping
strategies.
Materials
• Child behaviors and consequences monitoring forms and
• Problem-solving steps handout.
Homework
• Monitoring child behaviors, rewards, and consequences and
• Teaching the child problem-solving skills.
Session activities
1. Discussing homework;
2. Setting the agenda;
3. Teaching and rehearsing problem-solving training;
4. Coaching child problem-solving abilities;
5. Managing specific child and parent problems;
6. Teaching and implementing progress monitoring and coping strategies;
7. Summarizing the session and asking the parents for feedback; and
8. Establishing homework.
Exercises
• Problem-solving specific difficult situations in group and
• Coaching self-instructions for problem-solving skills.

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The Protocol of the Rational Positive Parenting Program 31

Session 10: Rational Positive Parenting

Objectives
• Summarizing the parenting strategies learned and the status of their
implementation;
• Monitoring status of child behaviors;
• Developing a coping plan with difficult situations; and
• Final assessment.
Materials
• Monitoring forms;
• Questionnaires; and
• Video vignettes.
Session activities
1. Discussing homework;
2. Setting the agenda;
3. Discussing the parenting strategies learned;
4. Monitoring status of child behaviors;
5. Developing coping plans for difficult situations;
6. Summarizing the principles of the program and asking parents for feedback; and
7. Participating in final assessment.
Exercises
• Developing own coping strategies with difficult situations

The Short Version of the Rational Positive Parenting

Program (s-rPPP)

Session 1: Rational parenting: unconditional acceptance;

Session 2: Joint activities and rewards;
Session 3: Family rules and managing misbehavior; and
Session 4: Problem solving and coping plans.
The following section will detail each session of the s-rPPP, with its objectives,
activities, and materials. The sessions include readings from the SOS Help for
Parents and SOS Help for Emotions (Clark 1996) self-help books, the SOS Help for
Parents video vignettes and handouts (http://sosprograms.com/), the stories for
children and cartoons of RETMAN (http://retman.ro/; see Fig. 3.1), and “psycho-
logical pills” with their mobile version PsyPills (see Fig. 3.2).

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32 3 The Rational Positive Parenting Program

Session 1: Rational Parenting. Unconditional Acceptance

Objectives
• Initial assessment and introduction into the program;
• Recognizing own and child emotions and stress cues;
• Understanding the ABC model and building rational thinking; and
• Coaching child emotional and social skills.
Materials
• Questionnaires
• Child behavior monitoring forms;
• ABC monitoring forms;
• Rational therapeutic stories RETMAN; and
• Psychological pills.
Homework
• Monitoring child behaviors (home and at school);
• Monitoring dysfunctional emotions based on the ABC form;
• Developing parent “psychological pills”; and
• Emotions form for child.
Session activities
1. Setting the agenda;
2. Introducing the rPPP;
3. Conducting the initial assessment;
4. Teaching the distinction between types of stress—adaptive and maladaptive
reactions;
5. Teaching the ABC model of parent’s reactions;
6. Developing rational thinking coping strategies—parental “psychological pills”;
7. Coaching emotion-regulation skills in children;
8. Summarizing the session and asking the parents for feedback; and
9. Establishing homework.
Exercises
• Developing own personalized “psychological pills” and
• Role-play for coaching emotion-regulation skills.

Session 2: Joint Activities and Rewards

Objectives
• Building positivity in parent–child relationship;
• Using effective commands and prompts;
• Using effective rewards and praise for positive behaviors; and
• Using ignoring for specific unwanted behaviors.

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The Protocol of the Rational Positive Parenting Program 33

Materials
• Relationship bank account: unconditional accepting statements;
• Relationship bank account: joint activities and play;
• Steps for efficient commands and instructions handout;
• Monitoring form for child positive behaviors and rewards; and
• Video vignettes.
Homework
• Creating and expressing own unconditional accepting and validating statements;
• Planning and monitoring joint activities and play; and
• Monitoring child behaviors, rewards, and ignoring.
Session activities
1. Discussing homework;
2. Setting the agenda;
3. Teaching the relationship bank account;
4. Teaching the steps for effective commands and prompts;
5. Teaching and rehearsing rewards and praising;
6. Using active ignoring;
7. Summarizing the session and asking the parents for feedback; and
8. Establishing homework.
Exercises
• Formulating own statements for child unconditional acceptance and validation;
• Planning for joint activities and play;
• Demonstration and role-play for efficient instructions, praising, and ignoring;
• Establishing a rewards menu; and
• Role-playing for active ignoring.

Session 3: Family Rules and Managing Misbehavior

Objectives
• Expressing effective commands and prompts;
• The kind and firm parenting model: establishing family rules; and
• Managing unwanted behaviors: consequences, grandma’s rule, and time-out.
Materials
• Child behaviors and consequences monitoring forms;
• Family rules and consequences form;
• Handout types of consequences, grandma’s rule, and time-out; and
• Video vignettes.

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34 3 The Rational Positive Parenting Program

Homework
• Establishing family rules and consequences;
• Communicating family rules in a family meeting; and
• Monitoring child behaviors, commands, and consequences.
Session activities
1. Discussing homework;
2. Setting the agenda;
3. Teaching and rehearsing effective commands and prompts;
4. Discussing and implementing the principles of family rules;
5. Managing unwanted behaviors: active ignoring, grandma’s rule, and time-out;
6. Summarizing the session and asking the parents for feedback; and
7. Establishing homework.
Exercises
• Role-playing effective commands and prompts;
• Peer discussion family rules and role-play communicating family rules; and
• Role-play disciplining strategies.

Session 4: Problem Solving and Coping Plans

Objectives
• Understanding and implementing the principles of problem solving;
• Learning activities to teach the child problem-solving skills: coaching child
problem-solving abilities;
• Understanding how to manage specific child and parent problems;
• Understanding and implementing the principles of progress monitoring and
coping strategies; and
• Final assessment.
Materials
• Child behaviors and consequences monitoring forms;
• Problem-solving steps handout; and
• Questionnaires.
Homework
• Monitoring child behaviors, rewards, and consequences and
• Teaching the child problem-solving skills.
Session activities
1. Discussing homework;
2. Setting the agenda;
3. Problem-solving training;
4. Coaching child problem-solving abilities;

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The Protocol of the Rational Positive Parenting Program 35

5. Managing specific child and parent problems;

6. Progress monitoring and coping strategies;
7. Summarizing the principles of the program and asking parents for feedback;
8. Participating in final assessment; and
9. Establishing homework.
Exercises
• Problem-solving specific difficult situations in group and
• Coaching self-instructions for problem-solving skills.

The Online Version of the rPPP

Module 1—I want to be a rational positive parent!

Module 2—Rational parenting: managing stress
Module 3—Rational parenting: unconditional parenting

Fig. 3.3 The parent attention

bias retraining task (David
and Podină 2014) based on
the visual search task
paradigm using facial stimuli
of the NIMH-ChEFS database

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36 3 The Rational Positive Parenting Program

Module 4—Positive parenting and rewards

Module 5—Limit setting
Module 6—Managing child behaviors
Module 7—Effective communication and praise
Module 8—Problem solving
The materials of the online rPPP include the following:
• readings from the SOS Help for Parents and SOS Help for Emotions (Clark
1996) self-help books,
• the SOS Help for Parents video vignettes and handouts (http://sosprograms.com/),
• the stories for children and cartoons of RETMAN (http://retman.ro/; see Fig. 3.1)
• “psychological pills” with their mobile version PsyPills (see Fig. 3.2), and
• the parent attention bias retraining implicit task (David and Podină 2014; see
Fig. 3.3), aiming to redirect the attention of parents from angry faces of children
to happy faces of children.
In the following section, we present the forms used by the parent participating
(in the rPPP).

Child Behavior Monitoring Form1

Monitoring form of ____________________________

(child’s name)
For the following behaviors
1. ____________________________________________
2. ____________________________________________

To be specified for each behavior:

(F) Frequency – how many times it was displayed?
(I) Intensity – on a 1-10 scale, where 1=very weak and 10=extremely intense
(D) Duration - in minutes
Week: ____________
Mo Tu Wed Thu Fri Sat Sun
Parent F F F F F F F
Behavior 1________ I I I I I I I
D D D D D D D

Behavior 2________ F F F F F F F
I I I I I I I
D D D D D D D
Teacher (other adult) F F F F F
Behavior 1________ I I I I I
D D D D D
F F F F F
Behavior 2________ I I I I I
D D D D D

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The Protocol of the Rational Positive Parenting Program 37

Child Behavior Monitoring Form 2

Monitoring form of ____________________________
(Child’sname)
For the following behaviors
1. ____________________________________________
2. ____________________________________________
To be specified for each behavior:
(F) Frequency – how many times it was displayed?
(I) Intensity – on a 1-10 scale, where 1=very weak and 10=extremely intense
(D) Duration - in minutes
Week: ____________
Mo Tu Wed Thu Fri Sat Sun
Parent F F F F F F F
Behavior 1________ I I I I I I I
D D D D D D D
F F F F F F F
Behavior 2________ I I I I I I I
D D D D D D D
Teacher (other adult) F F F F F
Behavior 1________ I I I I I
D D D D D
F F F F F
Behavior 2________ I I I I I
D D D D D

Alternative behaviors
Alternative behavior 1_________________________Rewards (R) _____________________
Alternative behavior 1_________________________Rewards (R) _____________________
Mo Tu Wed Thu Fri Sat Sun
Parent F F F F F F F
Behavior 1________ R R R R R R R
F F F F F F F
Behavior 2________ R R R R R R R
Teacher (other adult) F F F F F
Behavior 1________ R R R R R
F F F F F
Behavior 2________ R R R R R

Goals for improved

parenting__________________________________________________________________________
_________________________________________________________________________________
_____________________

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38 3 The Rational Positive Parenting Program

ABC Behavior Monitoring Form

Child’s name_____________

The B. Behavior___________________________

How often did this occur? How intense was it? What was its duration?
(1-10)
Mo
Tue
Wed
Thu
Fri
Sat
Sun
Average

The A. Antecedents

When did was the behavior displayed?

Where did it occur?
With whom did it occur?
When it does not occur?
Where it does not occur?
With whom does not it occur?

The C. Consequences

What follows immediately after the behavior?

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The Protocol of the Rational Positive Parenting Program 39

Rewards and active ignoring monitoring form

Week: ____________
Mo Tu Wed Thu Fri Sat Sun

F___ F___ F___ F___ F___ F___ F___

Positive Behavior 1________
R ___ R ___ R ___ R ___ R ___ R ___ R ___
Positive Behavior 2________
F___ F___ F___ F___ F___ F___ F___
R ___ R ___ R ___ R ___ R ___ R ___ R ___

F ___ F___ F___ F___ F___ F___ F___

Negative behavior 1________ I___ I ___ I ___ I ___ I ___ I ___ I ___

Negative behavior 2________ F___ F___ F___ F___ F___ F___ F___
I ___ I ___ I ___ I ___ I ___ I ___ I ___

F=frequency
I=Ignoring
R=rewards

Homework sheet

My home work activities

TO DO

1. _______________________________________________________

2. _______________________________________________________

3. _______________________________________________________

TO READ

_______________________________________________________

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40 3 The Rational Positive Parenting Program

The ABC worksheet

A B C
Activating event Beliefs Consequences
What happened? How did you react? (emotional,
physiological, behavioral)
Howintense? 1-10

E.g., Anger, 7
My child misbehaved. He should obey to my requests. Harsh punishment

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 A B C D E F
Activating event Beliefs Consequences Dispute/restructure Effective thinking Functional
What happened How did you react? Is it realistic? consequences
(emotional, Is itlogic?
physiological, Is it pragmatic?
behavioral)
How intense? 1-10

E.g., He should obey to my Anger, 7 It has no logic. I would like him very Annoyance - 6
My child. requests. Harsh punishment It does much to obey to my Adequate punishment
misbehaved not help me in requests.
determining him to
obey.
The Protocol of the Rational Positive Parenting Program

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The ABCDEF worksheet
41
42 3 The Rational Positive Parenting Program

Emotions worksheet

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The Protocol of the Rational Positive Parenting Program 43

PsyPills for parents Form

(Developed by Gavita, 2013)

• I can accept myself as a parent even when my child does not obey or respect me.
• When my child does not obey, I accept him/her despite this behavior.
• I can accept myself even if sometimes I consider that I am not a good parent;
I will do everything in my power to change my inefficient behaviors.
• When I am not a good parent, I can accept my children as being worthwhile and not
condemnable.
• When my children do not appreciate or respect me, I can accept that it does not influence
my self-worth, their worth in any way and it does not mean that my life is completely bad.
• When I have difficulty parenting, I can accept that it does not influence my self-worth
in any way.
• I very much want to be obeyed bmy child, but I accept that things do not have to
always be how I want.
• I very much want to be a good parent and I am doing everything in my power for this,
but if I do not manage to be a good parent all the time, it does not mean that I am worthless;
it just shows that I had a poor behavior,which can be improved in the future.
• It is preferable to be obeyed by my child, and I am doing efforts for this, but when I do not
manage this, it is very bad but not manage this, it is very bad but not awful, and I can stand it.
• I want very much to be appreciated and respected by my children, and I do my best to get it,
but I accept that just because I want and/or worked hard for this, it does not mean that it
absolutely must happen.
• It is very bad and unpleasant if my children do not appreciate or respect me, but I can stand it,
and try to find solutions, positive alternatives, and/or ways to cope.
• I can stand when my child disobeys me, although it is difficult for me to tolerate it.
• It is unpleasant and unfortunate to be disobeyed by my own child but it is not terrible, and
I can find solutions, positive alternatives, and/or ways to cope.

My personal PsyPill

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44 3 The Rational Positive Parenting Program

Rewards Menu Form

My child’s______________________________

Preferred…

Social rewards
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………

Material rewards
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………

Activity rewards
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………

Playing with the child monitoring form

Fill in activities spent playing with your child, duration, child and own reactions.

Date Activity Duration Child reaction Own reaction

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The Protocol of the Rational Positive Parenting Program 45

Family rules and consequences form

Listed below are the rules of our family together with the members to whom they apply and their consequences.

Family rule This rule applies to… Consequences

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46 3 The Rational Positive Parenting Program

Points Chart Form

Date _______________

Targeted behavior(s) Points earned

Weekly earned points Total

Mo Tue Wed Thu Fri Sat Sun

Week1
Week 2
Week 3
Week 4

Reward menu

Reward Points needed

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The Protocol of the Rational Positive Parenting Program 47

Bank account of parent-child positive relationship

INVOLVE
MENT
CARE

AFFECTION
ENCOURAG PLAY
EMENT

SUPPORT

EMPATHY
ACCEPTANCE
&
VALIDATION

PRAISE

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48 3 The Rational Positive Parenting Program

Bank account of unconditional accepting and validating statements

(child and partner)

I can see
your point.

I disagree with
your behavior but
I love you

………………………..
I understand how
difficult it is for
you but I will help
you.

…….

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Appendices

The Main Measures Developed for the rPPP

Parent Anger Scale

Instructions: At one time or another, most parents feel angry. For each of the
following items, circle the response that best describes you.

1 2 3 4 5 6
Less than once About once a About once Several days Every Several
a month month a week a week day times a day

(1) Even though I hold it in and do not show it, I get angry with my 1 2 3 4 5 6
child
(2) I get angry and break or throw away some of my child’s things 1 2 3 4 5 6
(3) I get angry and cannot stop thinking about the way my child behaved 1 2 3 4 5 6
(4) I get angry and have a problem controlling my behavior toward my 1 2 3 4 5 6
child
(5) I get angry with my child 1 2 3 4 5 6
(6) I get angry with my child and feel like throwing things, slamming 1 2 3 4 5 6
doors, or banging the table
(7) I get angry with my child and I feel like spanking or hitting my child 1 2 3 4 5 6
(8) I get angry with my child and I spank, slap, or hit my child 1 2 3 4 5 6
(9) I get angry with my child and throw things, slam doors, or bang the 1 2 3 4 5 6
table
(10) I get so angry with my child that I cannot control my behavior 1 2 3 4 5 6
(11) I get so angry with my child that I do not do things that I know my 1 2 3 4 5 6
child wants me to do
(12) I get so angry with my child that I feel my blood boil 1 2 3 4 5 6
(13) I get so angry with my child that I feel my muscles get tight 1 2 3 4 5 6
(continued)

© The Author(s) 2016 49

O.A. David and R. DiGiuseppe, The Rational Positive Parenting Program,
Best Practices in Cognitive-Behavioral Psychotherapy,
DOI 10.1007/978-3-319-22339-1

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50 Appendices

(continued)
(14) I get so angry with my child that I grab or push my child 1 2 3 4 5 6
(15) I get so angry with my child that I just want to make the tension go 1 2 3 4 5 6
away
(16) I get so angry with my child that I say mean things, use bad 1 2 3 4 5 6
language, curse, or insult my child
(17) I get so angry with my child that I scream or yell at my child 1 2 3 4 5 6
(18) I lose control of my anger with my child 1 2 3 4 5 6
(19) I resent the time and energy I put into parenting 1 2 3 4 5 6
(20) I think my anger with my child is justified because of the way my 1 2 3 4 5 6
child behaves
(21) I think that I have a harder job being a parent than other people 1 2 3 4 5 6
(22) I think that my child deserves to be punished for misbehaving 1 2 3 4 5 6
(23) I use my anger to get my child to behave 1 2 3 4 5 6
(24) When I feel angry with my child, I boil inside, do not show it, and 1 2 3 4 5 6
keep things inside of me
(25) When I get angry with my child, I feel like saying mean things to 1 2 3 4 5 6
my child
(26) When I get angry with my child, I feel like screaming or yelling at 1 2 3 4 5 6
my child
(27) When I get angry with my child, I tell relatives and friends so they 1 2 3 4 5 6
will know how bad my child has behaved
(28) I lose my temper with my child about:
1. almost nothing
2. only one thing
3. two or three things
4. several things
5. many things
6. almost everything
(29) When I get angry with my child, I stay angry for:
1. only a few minutes
2. less than 1 hour
3. about 1–2 hours
4. several hours
5. about 1–2 days
6. several days
(30) On average how angry do you get at your child?
1. Not at all angry
2. Somewhat angry
3. Mildly angry
4. Moderately angry
5. Very angry
6. Extremely angry

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Appendices 51

Thank you for your cooperation

Raymond DiGiuseppe, Tamara Del Vecchio, and Oana Gavita developed the Parent
Anger Scale.
Do not use without permission.

Parent Rational and Irrational Beliefs Scale (P-RIBS)

Name: Today’s Date: / /

Age:___ Sex: Male or Female (circle one) Date of Birth: / /

General instructions: This scale has two parts. Please follow the specific
instructions as follows.

Part 1

Instructions: Please think about a situation when your child(ren) disobey, or dis-
respect you. Try to recall the thoughts that you have had in such situations. When
faced with adverse situations, some parents tend to think that situation absolutely
must be the way they want (in terms of absolute must). In the same situation, other
people think in preferential terms and accept the situation, even if they want very
much that those situations do not happen. In light of these possibilities, please
estimate how much the statements below represent the thoughts that you have in
such situations.

Strongly Disagree Neutral Agree Strongly

disagree agree
1. My child absolutely must 1 2 3 4 5
respect and obey me
2. If my child disobeys me, it does 1 2 3 4 5
not mean that I am a worthless
person
3. I think it is awful to be 1 2 3 4 5
disobeyed by my own child
4. If my child disobey me, it 1 2 3 4 5
means that I am worthless
5. It is unbearable to be disobeyed 1 2 3 4 5
by my own child
6. I am always optimistic about 1 2 3 4 5
my future
7. I can stand when my child 1 2 3 4 5
disobeys me, although it is
difficult for me to tolerate it
(continued)

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52 Appendices

(continued)
Strongly Disagree Neutral Agree Strongly
disagree agree
8. It is important for me to keep 1 2 3 4 5
busy
9. I really do not want my child to 1 2 3 4 5
disobey me, but I realize and
accept that things do not have to
always be the way I want them to
be
10. It is unpleasant and 1 2 3 4 5
unfortunate to be disobeyed by
my own child, but it is not terrible
11. When my child disobeys me, I 1 2 3 4 5
think that they are bad, worthless,
or condemnable
12. When my child disobeys me, I 1 2 3 4 5
accept them as being worthwhile
despite her/his poor behavior

Part 2

Instructions: Please think about a situation when your child(ren) disobey, or dis-
respect you. Try to recall the thoughts that you have had in such situations. When
faced with adverse situations, some parents tend to think that situation absolutely
must be the way they want (in terms of absolute must). In the same situation, other
people think in preferential terms and accept the situation, even if they want very
much that those situations do not happen. In light of these possibilities, please
estimate how much the statements below represent the thoughts that you have in
such situations.

Strongly Disagree Neutral Agree Strongly

disagree agree
13. I absolutely must be a good 1 2 3 4 5
parent
14. If I am not a good parent, it 1 2 3 4 5
does not mean that I am a
worthless person
15. I think it is awful to be a bad 1 2 3 4 5
parent
16. If I am not a good parent, it 1 2 3 4 5
means that I am worthless
17. It is unbearable to think of 1 2 3 4 5
myself as a bad parent
(continued)

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Appendices 53

(continued)
Strongly Disagree Neutral Agree Strongly
disagree agree
18. I am always optimistic about 1 2 3 4 5
my future
19. I can stand to be a bad parent 1 2 3 4 5
20. It is important for me to keep 1 2 3 4 5
busy
21. I really do want to be a good 1 2 3 4 5
parent, but I realize and accept
that I may not always be as good
at parenting as I want to be
22. It is unpleasant and 1 2 3 4 5
unfortunate to be a bad parent, but
it is not terrible
23. When my child disobeys me, I 1 2 3 4 5
think that my child is bad,
worthless, or condemnable
24. When my child disobeys me, I 1 2 3 4 5
accept him/her as being
worthwhile

Thank you for your cooperation

Oana Gavita, Daniel David, Tamara Del Vecchio, and Raymond DiGiuseppe
developed the Parent-RIBS.
Do not use without permission.

Parent Anger Triggers Inventory

Instructions: At one time or another, most parents feel angry at things that their
children do. For each of the common childhood behaviors listed below, please
circle the response that best describes how angry you would be if your child acted
this way. Next, indicate how frequently the behavior occurred in the past 2 months.

How angry does this situation make you?

Not at all A little bit Somewhat Quite a bit Extremely
0 1 2 3 4

How frequently did it occur in the past 2 months?

Not at all Sometimes Often
0 1 2

jreyes.psic@gmail.com
54 Appendices

Non-compliance/defiance

How angry? How frequent?

1. Not doing what s/he is told 0 1 2 3 4 0 1 2
2. Doing something when asked not to 0 1 2 3 4 0 1 2
3. Refusing to go to bed or stay in bed at 0 1 2 3 4 0 1 2
night
4. Not answering you when you ask 0 1 2 3 4 0 1 2
him/her a question
5. Refusing to talk to you when s/he 0 1 2 3 4 0 1 2
cannot have his/her own way
6. Getting into something s/he is not 0 1 2 3 4 0 1 2
allowed to
7. Being uncooperative 0 1 2 3 4 0 1 2
8. Running away when being 0 1 2 3 4 0 1 2
disciplined
9. Screaming/yelling when you say “no” 0 1 2 3 4 0 1 2
Physical aggression
10. Hitting adults 0 1 2 3 4 0 1 2
11. Breaking objects on purpose 0 1 2 3 4 0 1 2
12. Pushing adults 0 1 2 3 4 0 1 2
13. Kicking adults 0 1 2 3 4 0 1 2
14. Biting adults 0 1 2 3 4 0 1 2
15. Hurting animals 0 1 2 3 4 0 1 2
16. Hitting other children 0 1 2 3 4 0 1 2
17. Pushing other children 0 1 2 3 4 0 1 2
18. Kicking other children 0 1 2 3 4 0 1 2
19. Biting other children 0 1 2 3 4 0 1 2
20. Playing rough 0 1 2 3 4 0 1 2
21. Fighting with siblings 0 1 2 3 4 0 1 2
Verbal/negative affect
22. Talking mean to other children 0 1 2 3 4 0 1 2
23. Talking mean to adults 0 1 2 3 4 0 1 2
24. Complaining 0 1 2 3 4 0 1 2
25. Screaming/yelling at adults 0 1 2 3 4 0 1 2
26. Screaming/yelling at other children 0 1 2 3 4 0 1 2
27. Demanding 0 1 2 3 4 0 1 2
28. Temper-tantruming 0 1 2 3 4 0 1 2
29. Crying (other than being hurt) 0 1 2 3 4 0 1 2
30. Arguing with adults 0 1 2 3 4 0 1 2
31. Arguing with other children 0 1 2 3 4 0 1 2
32. Whining 0 1 2 3 4 0 1 2
33. Cursing or using bad language 0 1 2 3 4 0 1 2
(continued)

jreyes.psic@gmail.com
Appendices 55

(continued)
How angry? How frequent?
Rule violation
34. Breaking a rule that you have 0 1 2 3 4 0 1 2
35. Not making his/her bed 0 1 2 3 4 0 1 2
36. Saying things that are not true 0 1 2 3 4 0 1 2
37. Not doing his/her chores 0 1 2 3 4 0 1 2
38. Doing something without asking 0 1 2 3 4 0 1 2
permission
39. Wandering away from home without 0 1 2 3 4 0 1 2
telling you
40. Taking things that do not belong to 0 1 2 3 4 0 1 2
him/her
41. Not staying in his/her seat while in 0 1 2 3 4 0 1 2
the car
42. Climbing on furniture 0 1 2 3 4 0 1 2
43. Running into the street 0 1 2 3 4 0 1 2
44. Not sharing 0 1 2 3 4 0 1 2
45. Throwing food at the table 0 1 2 3 4 0 1 2
46. Leaving his/her things laying around 0 1 2 3 4 0 1 2
the house
47. Making a mess around the house 0 1 2 3 4 0 1 2
48. Wetting the bed 0 1 2 3 4 0 1 2
49. Spilling food or drink 0 1 2 3 4 0 1 2
50. Taking too long
Social/public situations
51. Making you look bad in public 0 1 2 3 4 0 1 2
52. Getting into something s/he is not 0 1 2 3 4 0 1 2
allowed to at other people’s homes
53. Touching things when in a store 0 1 2 3 4 0 1 2
54. Crying/temper-tantruming in public 0 1 2 3 4 0 1 2
55. Complaining in public 0 1 2 3 4 0 1 2
56. Talking mean to you in front of 0 1 2 3 4 0 1 2
others
57. Not doing what s/he is told in public 0 1 2 3 4 0 1 2
58. Whining in front of others 0 1 2 3 4 0 1 2
59. Cursing or using bad language in 0 1 2 3 4 0 1 2
front of others
Disruptive behaviors
60. Being noisy 0 1 2 3 4 0 1 2
61. Not sitting still 0 1 2 3 4 0 1 2
62. Doing something over and over 0 1 2 3 4 0 1 2
again (ex. singing the same song several
times)
63. Running around the house 0 1 2 3 4 0 1 2
64. Interrupting others 0 1 2 3 4 0 1 2

jreyes.psic@gmail.com
56 Appendices

Thank you for your cooperation

Raymond DiGiuseppe, Oana Gavita, and Tamara Del Vecchio developed the Parent
Anger Triggers Scale.
Do not use without permission.

Child Functional and Dysfunctional Mood Scales

Functional and Dysfunctional Child Mood Scales

(Girls Version; Developed by Gavita)

Instruction: Please circle the number between 0 and 10 which best corresponds to
the way in which you have felt on the previous couple of weeks (this week/today/
now); 0 means that you not felt at all that way and 10 means that you felt very much
that way.

jreyes.psic@gmail.com
Appendices 57

jreyes.psic@gmail.com
58 Appendices

Thank you for your cooperation

Oana David developed the Child Functional and Dysfunctional Mood Scales
including the cartoons and visual elements.
Do not use without permission.

Functional and Dysfunctional Child Mood Scales

(Developed by Gavita; Boys Version)

Instruction: Please circle the number between 0 and 10 which best corresponds to
the way in which you have felt on the previous couple of weeks (this week/today/
now); 0 means that you not felt at all that way and 10 means that you felt very much
that way.

jreyes.psic@gmail.com
Appendices 59

jreyes.psic@gmail.com
60 Appendices

Thank you for your cooperation

Oana David developed the Child Functional and Dysfunctional Mood Scales
including the cartoons and visual elements.
Do not use without permission.

jreyes.psic@gmail.com
References

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DOI 10.1007/978-3-319-22339-1

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