Limitations of the existing research on PMT include a lack of knowledge on mechanisms of change[5] and the absence of studies of long-term outcomes.
[4] PMT may be more difficult to implement when parents are unable to participate fully due to psychopathology, limited cognitive capacity, high partner conflict, or inability to attend weekly sessions.
[4] In the context of developing countries in particular, family socio-economic disadvantage is a significant predictor of abusive parenting that impacts adolescent's psychological, behavioural and physical health outcomes.
In most PMT, parents are taught to define and record observations of their child's behavior, both positive and negative; this may involve the use of a progress chart.
This monitoring procedure provides useful information for the parents and therapist to set specific goals for treatment, and to measure the child's progress over time.
[5]: 216 In addition, parents learn to select simple behaviors as an initial focus and reward each of the small steps that their child achieves towards reaching a larger goal (this concept is called "successive approximations").
[5]: 216 [9]: 162 PMT also teaches parents to appropriately set limits using structured techniques in response to their child's negative behavior.
The different ways in which parents are taught to respond to positive versus negative behavior in children is sometimes referred to as differential reinforcement.
[10]: 128 Parents also learn to remove their child's privileges, such as television or play time, in a systematic way in response to unwanted behavior.
Across all of these strategies, the therapist emphasizes that consequences should be administered calmly, immediately, and consistently, and balanced with encouragement for positive behaviors.
[5]: 216 [10]: 151 Another common element of many PMT programs is preparing parents to manage problem behaviors in situations that are typically difficult for the child, such as being in a public place.
[2] The per family cost of group parent training programs to bring an average child into a non-clinical range of behavioral disruption was estimated in 2013 to be US$2,500, which according to the authors of a Cochrane review was "modest when compared with the long-term health, social, educational and legal costs associated with childhood conduct problems".
[6] A meta-analysis of evidence-based ADHD treatment in children further supports this, as researchers found wide variability in how PMT was carried out across previous studies.
[1] Early studies of this approach showed that the treatment was effective in the short-term in improving parenting skills and reducing children's disruptive behaviors.
[24] Patterson and colleagues theorized that adverse environmental contexts lead to disruptions in parent practices, which then contribute to negative child outcomes.