1. ACT Enhanced Parenting Intervention to Promote At-Risk Adolescents’ School Engagement Larry Dumka, Ph.D. Sanford School of Social and Family Dynamics ARIZONA STATE UNIVERSITY Association for Contextual Behavioral Science World Conference 12 June 19-22 - Minneapolis, MN

2. Acknowledgements Co-Investigators Nancy Gonzales, Anne Mauricio, our research team staff and RAs U.S. National Institute for Mental Health Families who participated

3. Social Problem School disengagement during transition to middle school Ensuing mental health problems

4. Universal family level intervention 3 components Parent training Adolescent goal setting and coping Family interaction session 9 after-school sessions + 2 home visits RCT focused on low-income Mexican American families

5. Decreased externalizing and internalizing symptoms in middle and high school; decreased mental disorder diagnoses in late adolescence Delayed substance use in middle school; decreased binge drinking in late adolescence; decreased alcohol and substance abuse disorder in emerging adulthood Higher grades in middle school; decreased high school dropout Mediation analyses identified core components *Gonzales, Dumka et al. (2011) Journal of Consulting and Clinical Psychology; Gonzales et al. (2014) Prevention Science; Jensen et al. (2014) Journal of Child Clinical and Adolescent Psychology Results from Randomized Control Trial and Follow-up*

6. Challenge Increase uptake of intervention

7. Redesign to optimize Bridges Reduce resource cost - shorten to 4 sessions with technological augmentation Increase impact - emphasize parent and teen self- regulation (psychological flexibility)

8. BRIDGES Strengthens Competencies during Middle Sch 1. 1.Effective Parenting 2. 2.Youth Coping 3. 3.School Engagement 4. 4.Family Relations Reduces Risky Middle School Outcomes Risk Taking Substance use Deviant peers Early Sex initiation Mental Health Symptoms Externalizing Internalizing School Disengagement Prevents Problems in Late Adolescence & Young Adulthood Alcohol abuse disorder Substance abuse disorder Mental disorders Risky sexual behavior School dropout Theory of Intervention SELF REGULATION To impact interrelated cognitive, emotional, biological interactional systems

9. Question? What are the core parenting skills that are needed to support adolescents’ school engagement and prosocial development?

10. Parenting Component - Skills Targeted 1. CONNECT (positive reinforcement, effective listening) 2. WATCH (monitor teen’s social contexts, school engagement) 3. LIMIT (opportunities for risky and antisocial behavior; structure prosocial behavior) 4. CONTAIN CONFLICT What’s different when children become teens?

11. ACT Enhancements to Bridges Values, Committed Action – Own that this is critical time and they matter – Guided imagining re: desired parenting legacy – Set change goals re: CONNECT, WATCH, LIMIT – Home practice commitments Present Moment, Self as Context – Breath focus Acceptance, Defusion – Avoiding controlling communication – Supporting teen flexibility (problem solving) – Non reactivity to teen negative behavior and provocation

12. Breath Focus Provided rationale Breath focus practice (3-4 min; 1-2 times/session) with reflection on: – Desired legacy with teen – How teen sees you now – Experiences of receiving appreciation – Non acceptance of teen, controlling – Observing self (self-as-context) – When anger is present – On using core skills

13. Questions for you Given what you know about ACT and parenting adolescents, what else would you recommend to ACT enhance a 4 session Bridges program? 1. What rationale would you use to motivate present moment/mindfulness practice? 2. What would you do to optimize committed action?