Children with externalized behavior disorders : opportunities for the support systems of primary care and congregations.


Children with externalized behaviors and their parents face significant challenges. Parents find themselves stressed and uncertain how to navigate the parenting demands of children with difficult behaviors. Two significant social support networks in the U.S. have the capacity to mollify the potential stress and negative outcomes that challenging childhood behaviors can have for the child, their family and their various social networks. These networks include the primary care medical system and congregations. Primary care clinics that have behaviorally integrated are poised to increase the access parents have to evidenced-based information and intervention for themselves and their children with disruptive behaviors and their families. Further, families with a child with difficult behaviors who are part of a congregation, they can also find significant support in this setting as well. The qualitative study, quantitative study and concept paper in this dissertation provide guidance for increasing access and effectiveness to treating and supporting children with challenging behaviors. An interpretative phenomenological approach was used to explore parents’ perceptions of their child’s disruptive behaviors and what they hope for from their primary care provider. The quantitative study focuses on exploring the outcomes of the primary care adaptation of an intervention model for children with difficult behaviors and their parents. The third article, chapter four, is a concept paper which focuses on congregations as an important system of care for children and their families while applying a liberation theology ethic. The chapter provides guidance for future research for a community-wide comprehensive approach to supporting families and children who have externalized behaviors. The final chapter provides a summary with implications for future research. This chapter includes recommendations for evaluation of practice and additional research.



Primary care. Integrated behavioral health. Pediatrics. externalized behaviors.