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. Author manuscript; available in PMC: 2023 Sep 1.
Published in final edited form as: Clin Pract Pediatr Psychol. 2022 Sep;10(3):295–306. doi: 10.1037/cpp0000451

Emotion Regulation, Coercive Parenting, and Child Adjustment: A Serial Mediation Clinical Trial

Robyn E Metcalfe 1,2, Maggie L Osa 1,2, Jeremy A Jones 3,4, David S DeGarmo 1,2
PMCID: PMC9909837  NIHMSID: NIHMS1835285  PMID: 36777258

Abstract

Objective:

Prior intent to treat (ITT) evaluation of the Fathering Through Change (FTC) online interactive behavioral parent training program demonstrated a causal link from the FTC intervention to reductions in pre-post changes in fathers’ coercive parenting, and in turn, reductions in pre-post changes in child behavioral problems (a moderate indirect effect size d = .30). The present study expands on this work by investigating mediational mechanisms.

Methods:

The present study employed a sample of 426 recently divorced or separated fathers who were each randomly assigned to either the FTC program or to the waitlist control. We tested a set of ITT serial mediation hypotheses positing effects of the FTC on fathers’ reductions in coercive parenting would be mediated through reductions in emotion regulation problems. To be included in this intervention, fathers had been separated or divorced within the past two years and also had children between the ages of four and twelve.

Results:

The intervention obtained a significant total and set of unique pathways linking the FTC intervention to improved child adjustment. This supports a causal experimental link to reduced child behavior problems (d = .39). Emotion regulation did not fully mediate the intervention effect on parenting.

Conclusions:

Emotion regulation added both direct and indirect experimental explained variance over and above parenting alone. Clinical implications are discussed for the application of online training through pediatric settings.

Keywords: child behavior, parent training, fathers, emotion regulation, prevention

Behavioral health problems such as depressive disorders, anxiety disorders, conduct disorder (CD), oppositional defiant disorder (ODD), and attention-deficit/hyperactivity disorder (ADHD), are among the leading reasons that children and families are referred to pediatric healthcare settings (Ghandour et al., 2019; Weber et al., 2019). Children’s behavioral health problems introduce notable economic strain for families, communities, and healthcare systems (Beecham, 2014). A potential cost-effective approach to mitigate this burden is use of evidence-based behavioral parent training (BPT) programs (Furlong et al., 2013, Weber et al., 2019). One primary goal of BPT is to reduce harsh punitive parenting and promote nurturing, prosocial parenting practices, which, in turn, improves child behavior (Reid et al., 2002). Of particular importance is the remediation of coercive cycles and harsh discipline. Harsh parenting includes verbal and physical aggression, such as name-calling and hitting children (Erath et al., 2010), as well as irritable, erratic, and excessive discipline (Patterson, 2005). Decades of evidence shows that harsh parenting is robustly associated with a myriad of children’s behavioral health problems (e.g., Gershoff, 2002; MacKenzie et al., 2015).

Parent emotion regulation is considered a key precursor and putative mechanism for treating harsh coercive parenting. Empirical data provides support for emotional socialization and parental emotion regulation as potential mediators that explain how caregivers specifically influence their children’s socioemotional and behavioral development and how it contributes to or protects against harsh parenting (Han et al., 2015; Leidy, Schofield, & Parke, 2012). However, very little attention has been paid to evidence-based evaluations of parent training components that focus on emotion regulation; and even less in programs tailored to fathers (Snyder et al., 2013; Zhang et al., 2018). In this report, we extend a prior web-based preventive intervention model of harsh parenting for fathers (DeGarmo & Jones, 2019) by incorporating and testing fathers’ emotion regulation as a targeted explanatory mechanism of BPT that included specific components on emotion regulation and mindfulness independent of sessions on core parenting skills.

The Need for and Role of Fathers Emotion Regulation

Despite widespread research on ways that adaptive emotion regulation strategies are critical to effective parenting (Rutherford et al., 2015; Morelen et al., 2014; Tan & Smith, 2019; Shih et al., 2018), the predictive value of parental emotion regulation skills has been underexplored in fathers. Parents not only model emotional expression but also provide an example of how to respond to emotional expression. For instance, fathers may help children learn about emotional expression and regulation, as fathers often display both a wide range of affect and greater emotional intensity and unpredictability in play compared with mothers (Parke & Brott, 1999). This could provide opportunities for children to learn skills such as interpreting emotional signals. Practicing of positive and neutral strategies for interacting with children, such as engaging in child-directed play, can help parents learn to regulate their emotions by providing parents with the skills to manage child behavior and to deescalate aggressive or frustrating responses, particularly during highly emotional situations.

Fathers’ parenting predicts child noncompliance (DeGarmo, 2010), inattentiveness (Keown, 2012), cognitive development (Cabrera et al., 2007), and mental health outcomes (Majdandžić et al., 2018). Prior research has found that coercive fathering explains a larger proportion of the variance in children’s behavioral concerns than coercive mothering (DeGarmo et al., 2016). Likewise, fathers’ levels of supportive parenting are more protective against the development of externalizing behaviors (e.g., child delinquency) compared with mothers’ levels of supportive parenting (Hoeve et al., 2009). Quality fathering behaviors contribute to the healthy mental and physical development of their children, regardless of whether fathers are living with their children and independent of the influence of mothers (Flouri, 2005). Indeed, quality fathering predicts both improved academic outcomes and improved behavioral health, such as lower levels of internalizing and externalizing behaviors, at all stages of child development (Leidy et al., 2012). Thus, fathers must be adequately reflected in clinical research to inclusively and comprehensively describe parents and parenting behaviors.

Equity, Access, and Fathering

Although federal fatherhood initiatives are increasing research efforts with fathers, father-focused parenting interventions are scarce, particularly in contexts with rigorous program or research evaluation. Further, participation of fathers in interventions is often low (Panter-Brick et al., 2014). This problem persists despite evidence that participation of fathers in BPT has greater benefits for two-parent families compared with interventions that focus exclusively on mothers (Cowan et al., 2010; Sicouri et al., 2018). Few clinical interventions have been adapted to meet the specific needs of fathers (DeGarmo et al., 2016) and existing programs often focus on overall involvement or on reduction of interparental conflict rather than on skill-building specific parenting behaviors (Cowan et al., 2010). Further, BPT research including fathers is often plagued with high dropout rates, limiting statistical power and generalizability to fathers (e.g., Lunkenheimer et al., 2017). For example, Fletcher and colleagues (2011) completed a meta-analysis of the Triple P Parenting program and found that broadly, only 20% of fathers participated in these interventions. Additionally, only half of the included studies even reported on factors that predicted father participation.

Web-Based Models

A web-based delivery modality may improve fathers’ participation in parenting interventions. Research demonstrates that the top four practical barriers for fathers engaging in parenting interventions are costs of service, conflicts with work commitments, general participation time, and the location of services (Sicouri et al., 2018). Online programs circumvent many of these significant barriers by increasing convenience, allowing for flexible schedules, and reducing service costs (Tiano & McNeil, 2005). Versatility regarding when and where the program will be completed may result in increased engagement and decreased attrition rates among fathers. Moreover, many single fathers report high levels of social anxiety and depression (Wade et al., 2011), and web-based programs provide support without the pressure of physical attendance and face-to-face interaction (Frank et al., 2015). Fathers are also unlikely to seek parenting support if doing so may be viewed as an indicator of weakness or incompetence (Fabiano, 2007). An online delivery through a secure platform could enhance confidentiality and anonymity and therefore reduce the potential for shame and stigma. Consistent with this perspective, a consumer preference survey among fathers revealed that a web-based delivery of parenting support programs was preferred to 11 other possible intervention modalities (Frank et al., 2015).

In pediatric care settings, web-based delivery offers the opportunity to provide parenting interventions in an accessible format. Previous research has highlighted notable disparities in parenting support between affluent non-Hispanic White parents and parents from rural areas, marginalized ethnic and racial groups, and lower-income backgrounds (Corralejo & Domenech Rodríguez, 2018). One reason for these disparities may be the systemic dearth of health care and professional parenting support in these populations (Flores et al., 2005). Indeed, residential segregation and the limited availability of primary care is considered a leading social determinant of health in youth (Williams & Collins, 2001). The flexibility of online delivery can provide direct support to fathers in marginalized and/or rural communities with minimal logistical and financial stress. For instance, single fathers are not required to navigate the cost of employment absenteeism in exchange for participation.

In addition, a web-based intervention facilitates communication among single fathers, contributing to social support (Wright et al., 2003). This mutual alliance fosters feelings of validation and acceptance, which may enhance intervention efficacy and positive child health outcomes (Nystrom & Ohrling, 2008). A meta-analysis of existing technology-based parenting interventions demonstrated a statistically significant medium effect across numerous parent and child outcomes (Nieuwboer et al., 2013). Finally, a profound feature of web-based delivery is the ease of future scalability and dissemination. Unlike traditional face-to-face interventions, technology-based programs can easily distribute online resources for facilitators and participants. Thus, web-based models offer the ability to provide support, education, and training to large numbers of single fathers with varying needs and obstacles across the United States.

The Fathering Through Change Intervention

Fathering Through Change (FTC) was adapted from prior evidence-based Behavioral Parent Training (BPT) and Parent Management Training–Oregon Model (PMTO) interventions, including Parenting Through Change, an intervention targeted towards single mothers (Forgatch, 1994), to help single fathers develop effective parenting behaviors. Interventions based on the PMTO model comprise the largest category of best-practice parenting interventions. The adaptation process was guided by focus groups and interviews with stakeholders including fathers, judges, court administrators, and consultation with PMTO-certified trainers.

The FTC program consists of ten content modules. The first six weeks present core curriculum content-- “Introduction to the Program”, “Give Effective Directions”, “Teach Through Encouragement”, “Recognize and Regulate Emotions”, “Use Discipline That Works”—as well as a review/troubleshooting module. These modules are presented sequentially and fathers must complete a module to proceed to the following one. The final four weeks introduce “Solve Problems”, “Protect Children from Conflict”, “Active Communication”, and “Strengthen Your Relationship”. The FTC program has shown substantial behavioral health benefits for children (DeGarmo & Jones, 2019).

Unlike many other parent training models, FTC provides direct and explicit instruction in parent emotion regulation. The “Recognize and Regulate Emotions” session provides a mix of psychoeducation, video-based modeling of skills, in-session opportunities to practice skills, and self-evaluation of lesson knowledge. It also assigns and encourages the independent practice of the modeled skills post-session. Core content includes psychoeducation on the behavioral escalation curve and how both children and adults are susceptible to escalation, potentially creating coercive interaction with each party escalating their behavior. This can lead to increased conflict and aggression, which increases the potential for violence (Colvin & Sugai, 2005; Smith et al., 2014). Skill instruction is primarily derived from cognitive behavioral techniques including models of simple breathing exercises and mindfulness practices. Video-based modeling focuses on demonstrating skills to better regulate emotions and prevent escalation. Actors are utilized to portray fathers and their children in real-life contexts where escalation is likely to occur (e.g., transitions) and to demonstrate the negative consequences of escalation when emotions are left unregulated. This is followed by a portrayal of the same scenario but with the father utilizing emotion regulation skills, which prevents escalation and leads to improved outcomes for the father and children. Importantly, the emotion regulation content is systematically revisited in other FTC sessions when applicable. For example, instruction is included on utilizing emotion regulation skills when appropriately disciplining a child or when providing effective directions to increase child compliance.

Study Aims

Based on previous research establishing a significant indirect effect of the FTC intervention on child adjustment through changes in parenting behaviors (DeGarmo & Jones, 2019), the present study extends the prior findings by testing the influence of fathers’ emotion regulation in a set of serial mediation hypotheses. We examine whether changes in harsh parenting are explained by preceding changes in emotion regulation for at-risk fathers. This study is a secondary analysis of the DeGarmo and Jones (2019) dataset.

Hypothesis.

FTC will be associated with changes in father emotion regulation; emotion regulation, in turn, will be associated with change in coercive parenting; with a negative indirect effect from FTC to reductions in coercive parenting. Given the previously established indirect effect from FTC to reduced child adjustment problems through parenting, we will test serial mediation including emotion regulation as an intervening proximal mediator (FTC→Emotion Regulation Problems→Coercive Parenting→Child Adjustment).

Method

Participants

All informed consent procedures and assessment protocols were approved by the institutional review boards of the Oregon Research Institute and the University of Oregon (DHHS assurance number FWA00000336). Fathers received study information from research staff and provided affirmative consent to participate either in person, via phone, or online. All informed consent procedures and assessment protocols were in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments, and with the ethical standards of the American Psychological Association. Additional information about the intervention and study design is available in DeGarmo and Jones (2019).

A total of 426 fathers were recruited through online advertising such as Facebook, Craigslist, and community listservs. To be eligible, fathers must have been divorced or separated within the past 24 months and must have had a target child between the ages of four and twelve. Fathers were randomly assigned via random number generator to either receive the FTC intervention (n = 225) or to a wait-listed control condition (n = 201). Sixty-one percent of participating fathers had joint legal custody, 14% had full legal custody, and 6% had a co-parent with full legal custody. For 19% of participants, custody was still pending. The mean age in years for fathers was 37.24 and the mean age for the target children was 7.88. Eighty-two percent of fathers identified their race as European American, 7.5% as African American, 2% as Asian American, 1% as Native American or Pacific Islander, and 11% multiracial. Additionally, in terms of ethnicity, 11% identified as Hispanic American. For education, 28% of fathers had received a high school diploma, 30% had completed community college or an associate degree, and 24% had completed a bachelor’s degree. The average annual income for this sample was binned in the $40,000 to $49,999 range. The CONSORT flow diagram is shown in Figure 1.

Figure 1.

Figure 1.

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CONSORT flow of the FTC study participants.

Measures

FTC Intervention.

Randomized intent to treat (ITT) contrast was coded 1 (FTC) and 0 (waitlisted control).

Emotion Regulation Skills.

Paternal emotion regulation was measured with four parent-report 3-item subscales of the Difficulty in Emotion Regulation Skills short form (DERS-SF; Victor & Klonsky, 2016): limited regulation strategies (e.g., When I am upset, I believe that wallowing in it is all I can do), Lack of impulse control (e.g., When I am upset, I lose control over my behaviors), lack of emotional awareness (e.g., reversed: When I am upset, I acknowledge my emotions ), and lack of emotional clarity (e.g., I have difficulty making sense out of my feelings). Chronbach’s alphas ranged from .80 to .93 at T1 and .78 to .87 at T3.

Coercive Parenting Construct.

Coercive parenting was a latent variable that was measured by four previously validated parent-report scales. Three scales were from the Parenting Practices Interview (PPI; Webster-Stratton et al., 2001): Harsh Discipline, Positive Parenting, and Inept Discipline. The fourth indicator was the Interpersonal Mindfulness in Parenting scale (IM-P; Duncan et al., 2015). Harsh discipline was an 11-item scale. Three items were rated on a 7-point Likert scale ranging from 1 (not at all) to 7 (extremely likely) (e.g., If your child refused to do what you wanted him/her to do, how likely is it that you would use each of the following discipline techniques: raise your voice [yell] or give your child a spanking, slap, or hit). Chronbach’s alpha was .84 for T1 and .86 for T3. Positive parenting was measured using 15 items that were rated on a 7-point scale (e.g., How often do you do each of the following things when your child behaves well or does a good job: praise or compliment your child; give your child a hug, kiss, pat, handshake or “high five”; give him/her an extra privilege [such as cake, go to the movies, special activity for good behavior]; give points or stars on a chart) rated from 1 (strongly disagree) to 7 (strongly agree). Chronbach’s alpha was .74 for T1 and .81 for T3. Inept discipline was also rated on a 7-point scale and included nine items (e.g., If you ask your child to do something and he/she doesn’t do it, how often do you give up trying to get him/her to do it? ‖how often do you change your mind based on your child’s explanations, excuses or arguments?) Chronbach’s alpha was .67 for T1 and .68 for T3. Mindful parenting was a 10-item scale rated from 1 (never true) to 5 (always true) (e.g., When I’m upset with my child, I notice how I am feeling before I take action, I rush through activities with my child without being really attentive to him/her). Chronbach’s alpha was .71 for T1 and .74 for T3.

Child Adjustment Problems.

Child adjustment was also measured as a latent variable. It was based on three parent-reported indicators. Two indicators were drawn from the Eyberg Child Behavior Inventory (Burns & Patterson, 2010). These indicators included the problem intensity scale, a 36-item measure that assessed the frequency of child behaviors on a 7-point scale ranging from 1 (never) to 7 (always) (e.g., How often does this occur with your child?‖ Does not obey house rules, Hits parents, Has temper tantrums, Steals, Lies, Fights). Chronbach’s alpha was .91 for T1 and .96 for T3. The problem behavior scale was a summative score of these same 36 items, dichotomized as a yes (1) or no (0). The Kuder–Richardson (KR-20) alpha reliability for these binary items was .92 at T1 and .93 at T3. Finally, the third indicator was the Strengths and Difficulties Questionnaire (Ford et al., 2009) prosocial behavior scale, in which five items were rated from 0 (not true) to 2 (certainly true) and summed (e.g., Considerate of other people’s feelings, Shares readily with other children, Kind to younger children). Alpha was .74 for T1 and.81 for T3.

Control Variables.

Target children were coded boy (1) or girl (0). Additionally, custody status was coded as full-custody father (1) or no-custody or shared-custody (0) for parsimony. For a sensitivity analysis, baseline contact in the number of days per month was substituted for custody status.

Analytic Strategy

The primary effectiveness hypothesis was formulated as a test of sequential indirect effects or serial mediation (Hayes, 2018). Mediation requires a direct intervention effect on a proximal outcome (e.g., change in parenting) and, in turn, for the mediator to predict change in a distal outcome (e.g., child adjustment). More modern approaches focus on statistical significance of the indirect effect (Hayes & Rockwood, 2017), while historical approaches focused on whether the direct effect was rendered non-significant in the presence of a mediator. The analysis will test the full sequence and subsets of serial mediation from FTC to change in child adjustment problems, FTC → Emotion Regulation Problems → Coercive Parenting → Child Adjustment. To test hypothesis 1, we specified ITT analyses using structural equation path models (SEM) in Mplus 8.5. SEM is a technique based in latent variable regression that uses both factor analyses (the measurement model) and path analyses (the prediction model). Change was specified as autoregressive change, predicting post-intervention T3 data while controlling for T1 data (a pre–post analysis of covariance approach). Next, we specified across-time error covariances for pre–post indicators (Byrne, 2011). We evaluated model fit using the fit indices recommended by Byrne (2011): a chi-square minimization p value of > .05; a comparative fit index (CFI) of ≥ .95; a chi-square ratio (χ2/df) of ≤ 2.0; and a root mean square error of approximation (RMSEA) of < .08. We also used bias-corrected bootstrapped standard errors and confidence intervals for testing indirect effects (Preacher & Hayes, 2008).

SEM models were estimated using full information maximum likelihood (FIML), a model-specific missing data strategy that uses all available information from the observed data. FIML provides more reliable standard errors than mean-imputation, list-wise, or pair-wise models. All latent variable indicators were required to have 60% of items present before computing a scale score. A missing-values analysis using Little’s test for missing completely at random (MCAR) tested missing data patterns in the full model covariance matrix including T1 and T3 indicators. Data were found to be missing completely at random, meeting assumptions for FIML estimation (Little’s MCAR χ2[83] = 78.16, p = .63). In total, 55% of the cases had complete data and 45% were partially missing. Across all possible data point values, 22% of the data were missing. Within variables, the percent of missingness ranged from 0 to 45%.

Results

Results of the ITT analyses are shown in the form of standardized estimates for the SEM model (Figure 2). The serial mediation hypothesis was partially supported. There were three specific pathways linking FTC to reductions in child behavior problems: (1) A two mediator path (FTC → paternal emotion regulation → parenting → child adjustment), (2) FTC through paternal emotion regulation only (FTC → paternal emotion regulation → child adjustment), and (3) FTC-to-child adjustment through parenting only (FTC → parenting → child adjustment). The model supported each unique pathway. Starting with Path 1, FTC predicted reductions in the fathers’ emotion regulation problems (β = −.12, p < .05). Increases in emotion regulation problems were in turn associated with increases in coercive parenting (β = .26, p < .01) and increases in coercive parenting predicted increases in child behavior problems (β = .52, p < .001). For Path 2, changes in paternal emotion regulation had a direct independent effect on increases in child behavior problems (β = .29, p < .001). Similarly, the intervention reduced child behavior problems independently through reductions in coercive parenting (β = −.27, p < .01). The models did not support full mediation given the remaining direct effects of the intervention on coercive parenting independent of emotion regulation as a mediator. Likewise, emotion regulation had an independent effect on child adjustment problems independent of coercive parenting as a mediator.

Figure 2.

Figure 2.

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Structural equation model testing hypothesized serial mediation pathways from FTC parent training intervention to change in child adjustment. Paths are standardized estimates. Model fit: χ2 (236) = 568.08, p = .00; CFI = .90; RMSEA = .07; χ2/df = 2.48. FTC sum of indirect effects on change in child adjustment problems, d = .32, a moderate effect, bias-corrected bootstrapped 95% CI [−.63, −.10].

The test of three unique and total indirect effects are shown in Table 1 in the form of Y standardized scores which represent Cohen’s d effect size for a dichotomous contrast. The total hypothesized indirect intervention impact on child adjustment problems was supported. The sequential mediation for Path 1 through paternal emotion regulation and parenting was p < .11 (indirect effect = −.03). The unique pathways through paternal emotion regulation (Path 2 = −.07, p < .07) and through parenting (Path 3 = −.07, p < .01) were marginally significant, with bootstrapped confidence intervals not containing zero. Finally, the combined overall indirect impact of the intervention through the independent pathways was a moderately strong effect size (Total indirect effect = −.39, p <.001). Overall, the model had marginal but acceptable fit to the data. Although the chi-square minimization coefficient p value was less than .05, the root mean square error of approximation was less than .08, the chi-square ratio was close to 2, and the comparative fit index was high [χ2 (236) = 568.08, p = .00; CFI = .90; RMSEA = .07; χ2/df = 2.48]. A sensitivity analysis using paternal baseline contact days per month instead of custody status yielded substantively identical results.

Table 1.

Y standardized FTC indirect effects and confidence intervals for serial mediation pathways

Indirect Effect Estimand 95th % C.I.1
FTC indirect pathways to change in child adjustment problems
(1) FTC → ΔEmotion Regulation → ΔCoercive Parenting → ΔChild Problems   −.03 [−.14, .00]
(2) FTC → ΔEmotion Regulation → ΔChild Problems   −.07† [−.23,−.01]
(3) FTC → ΔCoercive Parenting → ΔChild Problems   −.28** [−.55,−.09]
(4) Total Indirect Effects FTC to ΔChild Problems (1) + (2) + (3)   −.39*** [−.68,−.16]
FTC indirect pathway to change in coercive parenting
(5) FTC → ΔEmotion Regulation → ΔCoercive Parenting   −.06† [−.18,−.00]
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Note:

1

Bias corrected bootstrapped confidence intervals with 1000 draws.

Δ = change;

***

p < .001,

**

p < .01,

*

p < .05;

†

p <.07

Discussion

This paper examined the FTC program (versus a waitlist control) to examine the total overall impact of the intervention on reductions in child behavior problems using tests of serial mediation. We looked at whether child behavioral health would be mediated through father emotion regulation concerns and father coercive parenting using structural equation modeling. Results partially supported the hypotheses, with a significant total indirect impact of unique pathways linking the FTC intervention to child behavioral health through parenting regulation and parenting behaviors. Paternal emotion regulation did not fully mediate the intervention effect on parenting; therefore, it did not fully account for the FTC active ingredients promoting better parenting skills. However, the findings showed that adding paternal emotion regulation to the theoretical preventive intervention process obtained added unique direct and indirect explained variance over and above the prior ITT evaluation focusing on parenting practices alone. For coercive harsh parenting, emotional awareness and regulatory skills may be particularly salient for fathers relative to mothers (DeGarmo et al., 2016).

Counter to expectations, fathers’ difficulties in emotion regulation were not fully mediated through fathers’ coercive parenting and maintained a direct effect in predicting increases in children’s problem behaviors. This suggests that children were partly influenced by the indirect effect of fathers’ emotion regulation strategies through parenting behaviors and were also directly impacted from modeling emotion socialization of fathers. Other post-hoc interpretations could be the need for a better measure of emotion socialization; a potential exogenous factor such as environmental stressors that affect both fathers and their children; or a passive or active gene-environment correlation (rGE). Passive effects are genetic information passed on or inherited by children such as risk for antisocial traits, while active effects represent gene by environment interactions (G×E). The study of fathers’ genetic effects has been historically limited in comparison to empirical work published on mothers (Flouri, 2010). However, evidence from representative studies support both passive and active effects for fathers’ parenting on child behavior (Jaffee et al., 2004; Lifford et al., 2009).

This study highlights the lack of inclusion of fathers in parenting intervention contexts as a public health concern, with impacts on child behavioral health. A limited number of father-centric evidence-based programs exist. With fathers historically increasing parenting time with children, brief but effective parent training programs can help prevent or ameliorate behavioral concerns for children at risk for socioemotional and behavioral adjustment problems (e.g., children experiencing family structure transitions, or socially disadvantaged backgrounds). For separating families, the majority of court-mandated parenting programs focus on two-parent coparenting models following divorce, which are mainly successful in the presence of cooperative post-divorce coparenting. The present study indicates that fathers can independently contribute to children’s wellbeing in a direct fashion (see DeGarmo, 2010). The pediatric setting could be more effective than court settings in disseminating safe evidence-based programming.

Due to increased negative mental health symptoms observed in children amid the recent Coronavirus 2019 (COVID-19) global pandemic (Crescentini et al., 2020), declines in parent, child, and family wellbeing warrants an increase in accessible support and intervention to promote long-term behavioral health outcomes (Feinberg et al., 2021). The FTC model has the potential to particularly benefit families in pediatric settings. Screening for parental substance use, intimate partner violence, and physical abuse are common practices in pediatric healthcare (Borowsky & Ireland, 2002; Lane et al., 2007). To our knowledge, screening for maladaptive parenting strategies (e.g., coercive parenting) is not a standard procedure. Our findings corroborate a growing body of literature linking coercive parenting to childhood behavioral problems (Dishion et al., 2004). Indeed, interventions that target the coercive cycle have the potential to improve the health and wellbeing of the child, as well as of the parent (Dishion et al., 2016). Thus, screening for coercive parenting in pediatric settings, and subsequent intervention, may be a promising avenue for indicated prevention of childhood maladjustment problems. As previously noted, it is important to recognize that single fathers may be reluctant to partake in parenting screenings or interventions if they perceive participation as an indicator of weakness or deficiency (Fabiano, 2007). By emphasizing child welfare and a positive father-child relationship, the FTC web-based model offers single fathers the opportunity to access convenient evidence-based parenting support with lasting beneficial impacts on child physical and mental health (DeGarmo & Jones, 2019).

While this study has substantial strengths in its randomized controlled design and focus on one underserved group (single fathers), the sample is disproportionately white and increasing efforts should be made to improve access for a more diverse range of fathers. Additionally, because the FTC intervention includes emotion regulation skills as a part of the model, it is not possible to isolate the specific impacts of the emotion regulation module. Finally, causality and directionality of these associations should be interpreted with caution. Longitudinal studies would provide greater evidence of mediation. Future research might include a components test of the emotion regulation model, an oversampling of racially diverse fathers, and use of behavioral coding instead of exclusively self-report measures to reduce concerns related to social desirability bias.

Unfortunately, implementing father-specific interventions in pediatric or other community non-research settings is challenging and rarely occurs. The health care context traditionally views fathers as second-class parents, starting from the prenatal period, and continues to support a structure of exclusion compared with the involvement of mothers throughout their child’s development. This disservice may have a deleterious effect on all parties involved, including the father, child, and mother. Further, this bias is potentially internalized by fathers and may contribute to the frequency of disengaged fathers. There is potential to rectify this historical precedent by actively engaging fathers to be involved at an equal level in their child’s lives in health care and behavioral health contexts.

Implications for Impact Statement.

Fathers are underrepresented in the literature on parenting. This study focused on an online parenting program for divorced fathers of children ages 4 to 12. It found support for a cascade from receiving the parenting program to reduction in fathers’ emotion regulation problems to reduction in coercive parenting, and finally to lowered child adjustment concerns. In addition to providing more knowledge about how parenting programs affect fathers and their children, this study emphasizes the importance of including fathers in parenting interventions.

Acknowledgments

Research supported by grant R43 HD075499 funded by the National Institute of Child Health and Human Development, and in part, by grant P50 DA048756 funded by the National Institute on Drug Abuse.

Footnotes

All informed consent procedures and assessment protocols were in accordance with the ethical standards of the American Psychological Association.

Authors declare the research was conducted in absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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