One-in-five parents describe feeling overwhelmed by their children’s behavior (Lawrence et al, 2015; Mash & Johnston, 1990). Empirical evidence suggests that children’s problem behaviors arise due to an array of sociodemographic factors related to the child, parent, parent‒child relationship, and environment, with higher incidence for families with multiple risk factors and where children and parents are locked into escalating coercive cycles (Campbell, 2006; Patterson, 1982). The gold standard treatment for struggling families over the past 50 years has been behavioral parent training (BPT: Kaminski & Claussen, 2017). Leading BPT programs such as Triple P and Incredible Years have been supported by hundreds of randomized controlled trials (RCTs) and disseminated to over 25 countries and languages (Sanders et al., 2014; Webster-Stratton & Reid, 2018). BPT is founded on learning theory and helps parents reinforce their child’s desirable behaviors through play, praise, and rewards and discourage undesirable behaviors through clear limits, planned ignoring and consistent consequences (Kaminski & Claussen, 2017).
However, BPT engagement and outcomes rely on parents’ capacity to effectively deliver behavioral strategies, which is influenced by their own attributions and emotional state (Mah & Johnston, 2008; Whittingham et al., 2009). This has led program developers and researchers to explore interventions beyond BPT. Mindful parenting is one such intervention that has attracted substantial empirical interest over the past few decades (Ahemaitijiang et al., 2021; Bögels & Restifo, 2013).
Mindful parenting emerged following the publication of Myla and Jon Kabat-Zinn’s (1997) seminal text “Everyday Blessings” and encourages parents to respond to their child with intentional, nonjudgmental, and present-moment awareness. Several proposed theories have emphasized slightly different mechanisms (e.g., Duncan et al., 2009; Bögels et al., 2014; Shapiro et al., 2006). More recently, Kabat-Zinn & Kabat-Zinn (2021, p.268) reflected on 25 years of development within this field and restated four elements in their working definition for mindful parenting:
“(1) greater awareness of a child’s unique nature, feelings, and needs; (2) greater ability to be present and listen with full attention; (3) recognizing and accepting things as they are in each moment, whether pleasant or unpleasant; (4) recognizing one’s own reactive impulses and learning to respond more appropriately and imaginatively, with greater clarity and kindness.”
Some mindful parenting programs deliver mindfulness practices that are then applied to parenting (e.g., Bogels & Restifo, 2013), while others have integrated mindfulness with behavioral components (e.g., Coatsworth et al., 2015; Donovan et al, 2023a; Lengua et al., 2021). Research on these latter mindfulness-enhanced BPTs (MeBPTs) has progressed from small-sample prepost studies toward well-constructed RCTs, thus far with mixed empirical support (Ahemaitijiang et al., 2021; Burgdorf et al., 2019; Donovan et al., 2022b). Nonetheless, many researchers have argued that integrating mindfulness within existing BPT programs is a natural evolution for parenting interventions (Emerson et al., 2021; Lengua et al., 2021; Maliken & Katz, 2013; Singh et al., 2021). Conversely, a separate body of research has found that adding modules to BPT programs to address parent attributions did not improve outcomes in child behavior or parent attributions (Leijten et al., 2018; Sanders et al., 2000, Sanders et al., 2004). Indeed, a recent cluster meta-analysis of parenting programs showed improved child and parent outcomes for behavioral compared with multicomponent programs (Leijten et al., 2022). These authors argue that additional modules may unhelpfully clutter and water down active BPT components. However, mindfulness was not included in any of the multicomponent programs reviewed, and adding modules on parent attributions differs in both content and process from integrating mindfulness with behavioral strategies. Existing research has therefore not yet adequately examined whether the integration of mindfulness can deliver additional benefit for BPT. That said, the concern about blended multicomponent programs overcrowding and watering-down key active components needs to be kept in mind.
The Confident Carers Cooperative Kids program (CCCK: Donovan et al., 2023a) is a manualized 8-week group intervention for parents of children with disruptive behaviors that integrates mindfulness and behavioral components to improve parent engagement and outcomes. For example, CCCK introduces a bushfire metaphor that acknowledges how child behavior problems (the fire) can wreak destruction in family life and is influenced in any given situation by child and parent biological factors (fuel), family stress factors (heat), and family attention factors (oxygen). Parents are invited to step back and notice this bigger picture (“defuse”: Hayes et al., 2012) and to recognize how they can inadvertently fuel the fire by providing attention to undesirable child behaviors through arguing, lecturing, negotiating, etc. Parents are also helped to notice that they have minimal influence over fuel and heat factors (“it’s not your fault, it’s not your child’s fault”: Gilbert, 2010), although they do have influence over the flow of oxygen (“choose where and when you direct your attention”). Consistent with evidence-informed shared conceptualizations, the bushfire metaphor helps parents to understand how the problem has arisen, has been maintained, and identifies pathways toward resolution (Kuyken et al., 2009). Within CCCK, these pathways are languaged in terms of “reducing the heat”, “growing the green in family life” and “following your parenting values” and delivered through strategies such as play, praise, clear instructions, family agreements, and planned-ignoring. Parents are thereby provided with an overarching mental image to guide their use of common behavioral strategies. An investigation into CCCK based on a 10-year sample (N = 338) has demonstrated large pre- to postintervention improvements across child behavior, parenting approach, parent wellbeing, and mindful parenting (Donovan et al., 2022a). A further study exploring predictors found that CCCK outcomes and attendance were similarly positive across 16 sociodemographic variables and that parents with more severe difficulties at baseline showed larger improvements (Donovan et al., 2023b). In terms of mechanisms of change, improvements in mindful parenting, and not parenting approach, predicted greater parent-rated child behavior improvements, contradicting a similar earlier study (Emerson et al., 2021). These promising findings for CCCK may be explained by the benefits of 15 years of implementation, integration, and revision, drawing on codesign principles (Michelson et al., 2013; Burkett, 2012). Alternately, the large effect size changes may be associated with prepost naturalistic research designs, and CCCK outcomes may diminish once subject to the next step of more stringent controlled trials. However, prior to embarking on a resource-intensive RCT, parents’ experiences of blended MeBPT programs need to be explored using a qualitative approach.
Several qualitative studies have reported on parents’ experiences of BPT programs (for a review, see Butler et al., 2020) and, more recently, mindful parenting programs (e.g., Haydicky et al., 2017; Ma & Sui, 2016; Mazumdar et al., 2023). We were unable to identify any peer-reviewed qualitative research investigating MeBPT. A search of the gray literature located two recent unpublished mixed method studies; however, neither protocol represented an integrated MeBPT (Dahl, 2021; Huynh, 2020).
The current study aimed to contribute to the literature by gaining an in-depth understanding of parents’ experiences of change after attending an integrated MeBPT program. Themes generated from semistructured interviews exploring change at 6 months postintervention were triangulated with a larger dataset of postintervention qualitative written feedback from parents and relevant theory. We were interested in discovering which intervention components parents reported as most and least meaningful and valuable in parenting their children, and, to what extent parents described behavioral or mindfulness concepts within their change narratives. More specific to CCCK, the study also sought to determine whether integrated MeBPT was described as meaningful and helpful by parents prior to future RCT investigation. The main research question was as follows: How do parents describe change following attendance at a mindfulness-enhanced behavioral parenting group program?