www.elsevier.com/locate/cabpCognitive and Behavioral Practice 13 (2006) 42–52

Getting Fathers Involved in Child-Related Therapy

Vicky Phares, Sherecce Fields, and Idia Binitie, University of South Florida

1077n 2Publ

Fathers are involved in treatment for child and family problems to a far lesser extent than are mothers. This article reviews the level offathers’ inclusion in therapy, delineates possible barriers to fathers’ participation in child-related treatment, and discusses factorsassociated with fathers’ involvement in therapy. Empirically and clinically informed strategies to engage fathers in treatment are offeredto help therapists increase fathers’ participation in the therapeutic process. Finally, future directions for clinically informed research inthis area are discussed.

IN CONTRAST to mothers, fathers are much less ofteninvolved in research related to children’s and adoles-

cents’ emotional/behavioral problems (Phares, Lopez,Fields, Kamboukos, & Duhig, 2005; Zimmerman, Salem,& Notaro, 2000). Thus, it is not surprising to learn thatfathers are less often involved in the treatment of suchproblems than are mothers. Although the same issue isevident in health care (Phares et al., 2005) andeducational (Greif & Greif, 2004) settings, the currentarticle focuses on child-related therapy for emotional/behavioral problems. This article provides an overview offathers’ involvement in treatment. Possible barriers toincluding fathers in treatment are reviewed, followed by adiscussion of paternal characteristics and therapistcharacteristics that are associated with the inclusion offathers in treatment. Empirically and clinically informedstrategies are provided to help therapists engage fathersinto child-related treatment. Finally, future directions forresearch are provided.

Connections Between Fathers’ and Children’sFunctioning

In order to understand the context of father involve-ment in child-oriented therapy, it is important to firstexplore the connections between father and childfunctioning. In both normative (Lamb, 2004; Videon,2005) and abnormal development (Connell & Goodman,2002), fathers have significant influences on childfunctioning. In the realm of abnormal development,there is consistent evidence that parental psychopathology

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is related to child and adolescent psychopathology(Connell & Goodman, 2002). A review by Phares andCompas (1992) found an association between paternalcharacteristics and child psychopathology, especially forexternalizing disorders. Comparable connections be-tween parent-child maladjustment were found for bothfathers and mothers. These findings are consistent withthe conclusions in a review by Connell and Goodman(2002), which demonstrated that the presence ofpsychopathology in mothers and fathers was equallyrelated to externalizing problems in children. Althoughthey found that children’s and adolescents’ internalizingproblems were significantly more related to mothers’than fathers’ psychopathology, the differences betweenmaternal and paternal effects were small. A recent meta-analysis found that paternal depression was associatedwith both internalizing and externalizing problems inchildren and adolescents (Kane & Garber, 2004).

Not only is parental psychopathology related to childfunctioning, but other parental characteristics appear tobe related to the development of difficulties in childrenand adolescents. Fergusson and Horwood (1999) foundthat self-reported punitive parenting styles were a likelypredictor of later affiliation with delinquent peers.Heaven, Newbury, and Mak (2004) found this pattern tobe particularly true for fathers. They found that as fathers’levels of physical parenting increased, boys’ delinquentbehaviors increased. Interestingly, the opposite effect wasfound for girls—as the level of physical parentingincreased, delinquent behavior decreased. Although theauthors did not consider levels of internalizing problemsin association with fathers’ physical parenting in girls, theydid find that fathers’ low levels of warmth were associatedwith depression in their children (especially girls).Heaven et al. (2004) also found significant inverse

43Getting Fathers Involved

associations between fathers’ levels of conscientiousnessand child delinquent behavior.

In addition to playing a role in the abnormaldevelopment of their children, fathers’ behaviors canalso serve as protective factors for normal development.Children have been shown to tolerate life stress better ifthey come from families where they have a positiverelationship with their father (Lamb, 1986). The greateramount of time spent together and the higher quality ofthis time, the better the overall adjustment of the child.In situations of divorce, children who have regularcontact with their father show better adjustment thanthose who do not, assuming there are low levels ofinterparental conflict (Amato & Gilbreth, 1999; Carr,1995).

There is also strong empirical support that childrencan act differently with their mothers and their fathers.For example, in an observational study, Dumas andGibson (1990) found that conduct-disordered childrenwere more compliant and less aversive with theirmothers than their fathers. This pattern of findingswas particularly evident when mothers showed highlevels of depression. Conversely, when mothers showedlower levels of depression, conduct-disordered childrenshowed less compliance and more aversive interactionswith their mother in contrast to their fathers. Thus, thefamily context (with attention to both maternal andpaternal functioning) is important to address whenconsidering children’s emotional/behavioral problems.

Overall, fathers influence their children in bothnegative and positive ways. With the connectionsbetween father-child psychopathology as well as therole of fathers’ positive behavior as a potential protectivefactor for children, it is reasonable to expect that fathersmight also influence the therapeutic process whenchildren experience problem behaviors. The inclusionof fathers in child-related therapy is addressed next.

Fathers’ Involvement in Child-Related Therapy

From a theoretical perspective, different therapeuticorientations take different perspectives on the inclusionof parents in treatment, regardless of whether theparent is a mother or a father. The type of treatment inwhich the therapist engages usually influences thetherapist’s decision to involve parents in treatment,with cognitive-behavioral therapies often focusing onlyon the child, behavioral therapies often focusing on theparent (for example, with behavioral parent training),and family therapies often focusing on all members ofthe family (Sexton, Alexander, & Mease, 2004).

The type of referral problem may also influencewhether parents are integrated into treatment. Forexample, evidence-based treatments of externalizingdisorders such as oppositional-defiant disorder (Brestan

& Eyberg, 1998) and conduct disorder (Chamberlain &Smith, 2003; Webster-Stratton & Reid, 2003) are muchmore likely to include parents as a central part of thetreatment, whereas treatments of internalizing disorderssuch as depression (Weisz, Southam-Gerow, Gordis, &Connor-Smith, 2003) and anxiety disorders (Kendall,Aschenbrand, & Hudson, 2003) are more likely to workwith the child directly and only include parents as aperipheral part of treatment.

There are, however, examples of evidence-basedtreatments for internalizing disorders that includeparents as a central component of the treatment(Barrett & Shortt, 2003; Curry & Reinecke, 2003).Interestingly, some of this work has uncovered factorsthat appear to moderate the effectiveness of parentalinvolvement in treatment. For example, in a studycomparing the effectiveness of child-focused cognitivebehavioral treatment (CBT) for anxiety with a com-bined treatment of CBTand family anxiety managementtraining (FAM), Barrett, Dadds, and Rapee (1996)found that child age and gender moderated theeffectiveness of the parental involvement component.Children aged 7 to 10 years old showed better outcomesat posttreatment and follow-up when they received bothCBT and FAM rather than CBT alone, whereasadolescents aged 11 to 14 years old showed nodifferences in outcomes based on whether they receivedjust CBT or both CBT and FAM. Girls also showed betteroutcomes at posttreatment and follow-up with thecombined CBT and FAM treatment whereas boysshowed equivalent outcomes regardless of whetherthey received just CBT or both CBT and FAM. Thisstudy suggests that it may be important to try to includeparents in treatment of anxiety with younger childrenand with girls (Barrett et al., 1996).

There is also evidence that parental psychologicalsymptoms can moderate the effectiveness of treatment.For example, Sonuga-Barke, Daley, and Thompson(2002) found that children of mothers with high levelsof attention-deficit/hyperactivity disorder (ADHD)symptoms did not improve significantly after themothers received parent training, whereas childrenof mothers with low or moderate levels of ADHDshowed significant reductions in ADHD behavior dueto treatment. Relatedly, involving parents with psy-chological problems into treatment appears to impactthe effectiveness of treatment. Cobham, Dadds, andSpence (1998) found that children with an anxiousparent fared better in CBT that included a parentanxiety management component in contrast to chil-dren who just received CBT alone. Children withparents who showed low levels of anxiety fared equallyas well whether they received CBT alone or CBT com-bined with a parent anxiety management component.

44 Phares et al.

Interestingly, although the parent anxiety managementsessions were open to both mothers and fathers, in themajority of cases only the mother showed up for thesessions (Cobham et al., 1998). Overall, these studiessuggest that considering parents’ psychological symptomsmay be relevant to whether or not parents should beinvited to participate in treatment.

The setting of the treatment may influence therapists’ability to engage parents in treatment as well. Forexample, therapy based in a school setting may befocused more on the child rather than parents andother family members because of the demands of theschool setting and the difficulty in getting parents totherapy sessions at the school during working hours(Logan & King, 2001). Thus, even before considering thedifferential involvement of fathers versus mothers intreatment, these caveats about parental involvement intreatment must be acknowledged.

There may also be situations where therapists deter-mine that involvement of parents, and more specificallyfathers, is contraindicated. Scott and Crooks (2004)argued that, because maltreating fathers are oftenprone to overly controlling behaviors, engagement ofmaltreating fathers into parent training therapy shouldnot be the initial focus of an intervention. There are otherintervention strategies that should be tried with maltreat-ing fathers and their families (Scott & Crooks, 2004), butif a therapist was in a position to initially focus on parenttraining skills, then engaging the father in treatmentwould be contraindicated. Other characteristics, such asdomestic violence, are associated with child maladjust-ment (McCloskey & Lichter, 2003), but would likely becontraindications to including the father in child-relatedtherapy. Overall, there are many factors that maycontribute to low levels of fathers’ involvement in therapy,including theoretical orientations, the type of referralproblem, as well as characteristics of the child, parent, andtreatment setting.

When considering the differential involvement offathers versus mothers in treatment, two different avenuescan be explored—research and actual clinical practice.From the research perspective, fathers are involved inoutcome studies that explore the effectiveness of child-related treatment much less frequently than are mothers.Because the research in this area is so limited, reviews ofstudies from the past three decades are necessary toascertain the patterns of findings on this topic.

In their classic review of research on behavioral parenttraining, Budd and O’Brien (1982) found that fatherswere included in 39% of the studies of behavioral parenttraining whereas mothers were included in 100% of thestudies. When a closer analysis of these studies wascompleted, Budd and O’Brien found that only 97 of the747 families in these studies (13%) included fathers in the

treatment. More recently, researchers have exploredfathers’ roles in treatment effectiveness (e.g., Bagner &Eyberg, 2003) but the majority of outcome studiesinvolving parents continue to focus on mothers (McBride& Lutz, 2004; Tiano & McNeil, 2005). Quite often,researchers plan to include fathers in treatment and inlong-term outcome studies, but the sample sizes of fathersare too small to provide analyses with enough statisticalpower (e.g., Cobham et al., 1998).

Regarding the involvement of fathers in treatment,surveys of clinicians suggest that the same pattern oflimited inclusion of fathers holds true in actual practice. Itis unclear whether the lower rates of fathers’ participationin treatment are due to therapists not asking fathers toparticipate or whether fathers decline or refuse toparticipate in treatment (or some combination of bothof these reasons). Regardless of the reason, it is clear thatfathers participate in child-related treatment to a lesserextent than do mothers. For example, Lazar, Sagi, andFraser (1991) found that clinicians reported includingfathers in child-oriented treatment 6% of the time incontrast to the inclusion of mothers 38% of the time.These clinicians were based in school systems and childprotective agencies. In a study of children receivingtreatment for ADHD, Singh (2003) found that only 32%of fathers were included in the diagnostic and treatmentprocess. In a survey of clinicians in community-basedoutpatient settings, Duhig, Phares, and Birkeland (2002)found that clinicians included fathers in 30% of theirsessions whereas mothers were included in 59% of thesessions. This pattern of lower inclusion of fathers incomparison with mothers was evident in families headedby single mothers (21% versus 56%), in dual-parentfamilies (40% versus 62%), in families with children 12and under (30% versus 66%), and in families withadolescents aged 13 to 18 years old (31% versus 51%).Thus, although there were lower rates of inclusion offathers when they did not reside in the household, theoverall pattern of lower paternal participation in treat-ment was notable across all family constellations and alldevelopmental levels. Overall, fathers are included inchild-related therapy to a lesser extent than are mothers.

When fathers are included in therapy, outcome studiesdo not suggest an overwhelming improvement for theefficacy of treatment at termination, but there appear tobe some improvements at long-term follow-up (Bagner &Eyberg, 2003; Phares, 1996). There has been limitedresearch on this topic, and nearly all of the research hasbeen completed within the realm of behavioral parenttraining with small sample sizes. Even with these caveats,there is little evidence that including fathers in addition tomothers has an impact on therapeutic outcome forchildren’s emotional/behavioral problems immediatelyafter treatment (Phares, 1996). A number of studies have

45Getting Fathers Involved

found that children’s emotional/behavioral problemsdecrease at the end of treatment regardless of whethermothers and/or fathers are involved in treatment(Bagner & Eyberg, 2003; Firestone, Kelly, & Fike, 1980;Martin, 1977; Webster-Stratton, 1985). Results at follow-up, however, are a bit more promising. In a review offather involvement in behavioral parent training, Coplinand Houts (1991) found that the inclusion of fathers intreatment was associated with increased treatmenteffectiveness at long-term follow-up. Webster-Stratton(1985) found that after 1 year, children who had fathersinvolved in treatment showed an increased level ofmaintenance than those who did not have a fatherinvolved in the behavioral parent training. Similarly,Bagner and Eyberg (2003) found that mothers reportedgreater maintenance of treatment gains when the fatherwas involved in treatment compared with mothers’reports when the father was not involved in treatment.Notably, when fathers were absent from parent-childinteraction therapy, mothers reported a loss in treat-ment gains after 4 months (Bagner & Eyberg, 2003).Thus, there is some limited evidence that fathers’involvement in behavioral parent training can increasethe likelihood that treatment gains at termination will bemaintained at long-term follow-up.

Results of these studies, however, must be consideredpreliminary given the nature of the research designs andthe sample sizes. For example, no large-scale clinicaltrials have been conducted with random assignment offamilies to treatment with or without the father. Randomassignment to treatment conditions was not provided ineither the Webster-Stratton (1985) or Bagner andEyberg (2003) studies. In the Webster-Stratton (1985)study, families were placed in the treatment group basedon whether or not the father lived in the home (i.e.,families with a father in the home were placed in thefather-involved treatment condition and families with-out a father in the home were placed in the father-absent treatment condition). The Bagner and Eyberg(2003) study allowed for a more complex researchdesign, but random assignment was still not completed.Specifically, the father-involved and father-absent treat-ment conditions were the same as in the Webster-Stratton (1985) study, but there was a third group inwhich the father lived in the home but did notparticipate in treatment. The lack of random assignmentlimits the strength of these findings, which is a fact thatall of the researchers acknowledged (Bagner & Eyberg,2003; Webster-Stratton, 1985). These studies are furtherlimited by their sample sizes. The Webster-Stratton studyincluded 18 father-involved and 12 father-absent fami-lies and the Bagner and Eyberg study included 56 father-involved, 16 father-uninvolved, and 35 father-absentfamilies. Thus, these findings should be considered

preliminary. Results from these studies need to bereplicated with larger sample sizes in which randomassignment can be used to test the directionality ofresults related to fathers’ involvement in treatment.

Although the data are not overwhelming, there issome limited evidence that the inclusion of fathers intherapy is associated with better long-term treatmentgains for children. Thus, the mechanisms that lead tobetter long-term outcomes when fathers are involved intreatment are worth considering.

It may be that the inclusion of fathers in treatmentallows the therapist to work on coparenting issues, suchas increasing consistency of discipline and decreasinginterparental conflict. Horton (1984) found that theinclusion of fathers in parent training could increase theconsistency of application of skills acquired by thechildren in the home as well as allow children to beexposed to the skills in a greater number of settings overa longer period of time. Inclusion of fathers allows for afocus on partner support training in addition to parenttraining, which can result in decreased interparentalconflict and increased parental problem solving (Dadds,Sanders, Behrens, & James, 1987).

Relatedly, parents’ beliefs about the cause of theirchild’s problems and their parenting self-efficacy appearto be related to long-term treatment outcomes (Hoza etal., 2000). Specifically, fathers’ attributions of noncom-pliance (i.e., whether the behavior was within the child’scontrol or not) and their parenting efficacy weresignificant predictors of treatment outcome after 14months. Spoth, Redmond, Haggerty, and Ward (1995)similarly found that parenting efficacy was a predictor ofacquisition of parenting skills. This pattern was foundfor fathers as well as mothers.

Overall, there is some, albeit limited, evidence thatthe inclusion of fathers in child-related treatment isassociated with longer term treatment gains as well asimprovements in family members’ functioning. Thequestion remains, however, as to why fathers are notincluded in treatment more often.

Possible Barriers to Father’s Involvement inTherapy

There are several factors that could account forfathers not being engaged in their child’s treatment.Characteristics of the father, the therapist, or thetreatment modality and setting could all influence thelevel of paternal involvement in therapy.

First of all, fathers may not have a great deal ofinvolvement in their child’s life in general. Fathersspend significantly less time with their children than domothers (Hofferth, Stueve, Pleck, Bianchi, & Sayer,2002), which is thought to be due to the societal andcultural expectations and gender roles of mothers and

46 Phares et al.

fathers (Silverstein, 2002). The more hours fathers workoutside of the home, the fewer hours fathers spend withtheir children (Hofferth, 2003). Given that fathers do notspend large amounts of time with their children, it is notsurprising to find that fathers may not use their limitedtime with their children to attend therapy sessions.

A father’s history with his own father seems to play arole in paternal involvement in therapy. In a study offathers’ involvement or lack of involvement in therapy,Walters, Tasker, and Bichard (2001) found that fathers’history of relationships was a determinant of their therapyattendance. Fathers who grew up in an environmentwhere their own father had little involvement in raisingthe children were less likely to feel that they had a role inmaking treatment decisions and thus were less likely toattend therapy sessions (Walters et al., 2001).

Fathers’ views of the nature of the problem may alsoinfluence whether or not they feel therapy is warrantedand may influence their level of participation intreatment. For example, fathers often believe that theirchild’s problems are due to lack of motivation or lack ofwill power (Singh, 2003). They may feel that it is just amatter of the child “bucking up” and that therapy is awaste of time.

Fathers’ own functioning as well as the functioning inthe family seem to relate to fathers’ willingness forchildren to be involved in treatment. In a study thatcompared mothers’ and fathers’ willingness to involvetheir children in psychological treatment, Fals-Stewart,Fincham, and Kelley (2004) found that substance-abusingfathers were significantly less likely than substance-abusing mothers to allow their custodial children toparticipate in treatment.

Additionally, they found that fathers were less likely toallow their children to be involved in treatment if theywere legally mandated to attend treatment (as opposed toseeking out the treatment voluntarily or being referred bya social service agency), if they reported higher ratherthan lower problems within their family and socialnetworks, if they had fewer days of abstinence fromsubstances, and if they reported higher levels of psycho-logical distress. Fathers’ own functioning and that of thefamily may relate to fathers’ willingness for their own aswell as their children’s participation in treatment.

Whether they have children or not, men are less likelythan women to seek help from psychological professionals(Addis & Mahalik, 2003; Cusack, Deane, Wilson, &Ciarrochi, 2004). This pattern is consistent across age,nationality, race/ethnicity, and parental status (Addis &Mahalik, 2003; Duhig et al., 2002; Moller-Leimkuhler,2002). Potentially due to the masculine gender rolesocialization process, men may not ascribe to the notionthat talking about their problems will be beneficial (Addis& Mahalik, 2003). Men typically have a coping style that

values actively working to solve problems rather than justtalking about the problems (Bekker, Hogue, & Liddle,2001; Enzlin, Mathieu, & Demyttenaere, 2002). Thus, itappears that men are less likely to seek treatment thanwomen, whether or not they have children.

In order to understand this issue from the perspectiveof men who have children, Walters et al. (2001) surveyedfathers to investigate their attendance at family-relatedappointments. They found that fathers were oftenreluctant to take part in therapy because of time pressuresrelated to work, awkward feelings, concerns about havingtheir masculinity attacked, feeling that the clinics werecontrolled by women, reticence about acknowledgingtheir problems, and concerns that their children wereemotionally closer to their mothers. Overall, there are anumber of personal and social barriers that may preventfathers from taking part in child-oriented therapy.

In addition to fathers’ own barriers to therapeuticinvolvement, therapists’ attitudes may also influence theinclusion of fathers in treatment. Some therapists mayfeel that it is a waste of time to ask fathers to be involvedin therapy because the fathers will decline the invitation(Hecker, 1991). This concern has been confirmed instudies of fathers’ participation in therapy when they areasked to participate. For example, Duhig et al. (2002)found that, based on clinicians’ reports, fathers agreedto be involved in child-related treatment significantly lessthan mothers (62.6% of the time versus 91.3%,respectively).

One possible factor in the lack of attention to fathers intreatment may be a result of therapy research thatinadvertently focuses on the centrality of mothers in thewell being of the family (Holden, 1990). Therapists mayhave specific socially influenced notions of fathers’ rolesin the family, and therefore may accept that the fathercannot be engaged in therapy (Mason & Mason, 1990).Clinicians may tend to view fathers as “uncooperative anddifficult to reach” (Wolins, 1983) and appear to excusethem from attending therapy due to conflicts with work orbecause they are not the child’s primary caretaker(Walters et al., 2001). In addition, clinicians may bereluctant to include fathers because of their owndiscomfort in dealing with interparental conflict in thetherapy sessions (Vetere, 2004). These beliefs could leadsome clinicians to seek only mothers for involvement intherapy.

In a classic study, Broverman, Broverman, Clarkson,and Rosenkrantz (1970) found that clinicians’ views ofmen and women in therapy were consistent with societalgender role stereotypes. More recently, the gender rolefor women in our society is still to have an interest inchildren and be involved in their care, whereas this role isless salient for men (Prentice & Carranza, 2002). Ifclinicians have more traditional gender role beliefs (i.e.,

47Getting Fathers Involved

a framework of gender-related associations moreconsistent with societal expectations; Bem, 1981),they might be more likely to overlook fathers becausethey might not feel that child-related therapy isconsistent with men’s roles and they may be morelikely to defer to the mother as the primary source ofinformation. This, in turn, could lead to fathersbelieving that they are not as important to thetherapeutic process as mothers (Sachs, 1986).

Overall, there are a great many potential barriers thatappear to keep fathers away from being involved inchild-related therapy. On the positive side, however,there are a number of characteristics that are associatedwith the inclusion of fathers in therapy.

Factors Associated with Fathers’ Involvementin Therapy

There are a number of factors associated with theinclusion of fathers in therapy. These factors tend to berelated to either the therapist or the father. Most of theresearch studies on therapist characteristics have beenbased on surveys of clinicians regarding their ownpractices. In a survey of social workers and psycholo-gists, Lazar et al. (1991) found that fathers were morelikely to be included in therapy if the therapist wasmale. Interestingly, in a review of dissertation researchprojects, Silverstein and Phares (1996) found that malegraduate students were more likely than femalegraduate students to include fathers in their disserta-tion research. It is unclear how the gender of thetherapist (or researcher, for that matter) is related topaternal inclusion. For example, male therapists maybe more dedicated to including fathers in treatmentand thus may be more inclined to invite them intotreatment, or it may be that fathers respond morepositively to male therapists’ invitations to participatein therapy in contrast to invitations by female therapists(Lazar et al., 1991).

Other therapist characteristics that were related toinclusion of fathers were also related to inclusion ofmothers in therapy. Specifically, in contrast to clinicianswho do not include parents in treatment, therapistswho include both mothers and fathers in therapy weremore likely to have completed more family-relatedcourses in graduate school, to have a family systemsorientation, and to work in a setting that allows flexiblehours for therapy appointments (Duhig et al., 2002;Lazar et al., 1991). Interestingly, working in indepen-dent practice in contrast to a university-based clinic ora community mental health center was found to beassociated with including fathers in treatment (Duhiget al., 2002). It may be that clinicians in independentpractice tend to have more control over the therapeu-tic process, which allows them more leeway to invite

whoever they wish to therapy sessions and to schedulehours for therapy that are more convenient for fathers(as well as mothers).

There are also factors associated with fathers that arerelated to their involvement in the therapeutic process.Walters et al. (2001) found that fathers who shared theparental load with their wife and who reported greatermarital satisfaction were more likely to attend child andfamily therapy sessions than fathers who shared less ofthe parental role and who reported lower levels ofmarital satisfaction, respectively. A number of character-istics of fathers’ relationships with their own father wereassociated with a greater likelihood to attend therapy,including a higher quality relationship between thefather and his own father throughout the lifespan(including childhood, adolescence, and adulthood)and a perception that his father was a good parent.Fathers who had experienced a stable childhood andadolescence (e.g., parental marital stability, living withthe family as opposed to living in a boarding school, andgeographical stability) were more likely to attendtherapy sessions for their child. Interestingly, therewere no differences in paternal therapy attendancebased on child age, family constellation, living in or outof the home, employment status, mothers’ employmentstatus, or socioeconomic status (Walters et al., 2001).

Overall, there are numerous factors related to theinvolvement of fathers in therapy. It is thereforeworthwhile for clinicians to take these factors intoaccount when considering involving fathers in therapy.It is also important that fathers are not viewed as“marginal family members” (Lazar et al., 1991) and thatthey not be overlooked in their possible beneficial rolein the therapeutic process.

In thinking about the complexity of factors that relateto the inclusion of fathers into child-related therapy,clinicians may want to consider the use of decision-making strategies for whether or not to try to engage thefather into treatment. As can be seen in Table 1, a seriesof questions might help clinicians consider whether itwould be wise to spend time trying to engage the fatherinto treatment. In some ways, clinicians must considerthe cost-benefit ratio of what can be gained by trying toengage fathers into treatment versus the time, energy,and complexity of trying to engage fathers intotreatment. Questions regarding referral problems,family constellation, feasibility of including the fatherin treatment, possible contraindications of fathers’involvement, use of joint or separate sessions, and bothparents’ willingness to have the father participate maybe helpful in deciding whether or not to ask fathers toparticipate in treatment. There is some evidence, at leastwith childhood anxiety disorders, that including parentsin treatment for younger children, girls, and children

Table 1Decision-making strategies for considering the involvement of fathers in child-related treatment

Question Considerations

What is the referral problem? Effective treatments for externalizing disorders tend to includeparents (and thus fathers) more frequently than for internalizingdisorders

Is the father or a father-figure involvedin the child’s life?

If yes–consider asking him to participate in treatment. Itmay be necessary to determine which father/father-figurehas the most relevance for inclusion in treatment if thechild has more than one father/father-figure in his/her life.

From a logistics standpoint, is it feasible forthe father to attend treatment sessions?

If yes–then consider asking him to participate. If no–thenconsider whether there are alternate strategies to includinghim in therapeutic strategies (e.g., telephonically, via e-mail,homework assignments through the mail) if warranted.

Are there any contraindications to involvingthe father in treatment (such as childmaltreatment or domestic violence)?

If no–then consider asking the father to participate.

Are there any clinical issues that would necessitateseparate rather than joint sessions with the fatherand mother but without the child present (suchas extreme interparental conflict)?

If yes–then consider including the father in treatment butconsider the structure of sessions carefully.

Are both the mother and the father (or father-figure)willing to have the father participate in treatment?

If yes–then consider inviting the father or father-figure toparticipate. If no–consider whether that refusal from eitherthe mother or the father is a clinically meaningful issue thatmay be related to the child’s functioning and consider interveningaccordingly.

48 Phares et al.

whose parents have high levels of anxiety leads to betterchild outcomes (Barrett et al., 1996; Cobham et al., 1998).Because these findings related to parental rather thanpaternal involvement specifically, these factors are notincluded in Table 1. For the factors that are included inTable 1, a caveat is necessary regarding the limitedresearch in this area. Thus, these decision-makingstrategies are only preliminary suggestions that shouldbe combined with clinicians’ own expertise and knowl-edge of effective treatments. In addition, many of thesecharacteristics are fluid and can change over the course oftime (e.g., referral problems are sometimes not theprimary target of treatment once a full assessment iscompleted, intact families do not always remain intactover the course of treatment). Thus, these decision-making strategies may need to be employed more thanonce over the course of treatment.

Strategies to Engage Fathers in Treatment

In the cases where clinicians determine that paternalinvolvement in child-related therapy is warranted, it mightbe helpful to consider specific strategies on how to engagefathers into treatment. For the most part, these strategieshave been suggested based on clinical practice and arealso consistent with findings from the empirical research

literature. In order to increase the likelihood of engagingfathers into treatment, the following recommendationsare made.

Increase Family-Related Training in Graduate Programs

Training in family systems and family processes isassociated with increased involvement of both fathers andmothers in child-oriented treatment, so there should bean emphasis on increasing family-related training ingraduate training programs (Duhig et al., 2002; Lazar etal., 1991). This recommendation for training can easily befollowed in programs oriented toward behavioral andcognitive-behavioral therapy because there is preliminaryevidence that paternal involvement in behavioral andcognitive-behavioral therapies can be associated withgreater long-term outcomes (Bagner & Eyberg, 2003;Chronis, Chacko, Fabiano, Wymbs, & Pelham, 2004).

Invite the Father to Participate in Therapy

It sounds simple, but too often clinicians are on thephone with the referring parent (i.e., the mother) andsetting up the appointment based on the referringparent’s schedule (i.e., the mother), without any atten-tion to engaging the father in the treatment process.Hecker (1991) argued that the therapist should talk

49Getting Fathers Involved

directly to the father and should make it clear that allfamily members are required to attend therapy. Thissuggestion can be followed whether or not the father isin the home or out of the home (assuming that thefather still has some involvement in the child’s life).There may be a need to meet with the father andmotherseparately from the child if the level of interparentalconflict is so high that it should not be dealt with in frontof the child, but therapists should at least try to engagefathers directly into treatment, regardless of the familyconstellation.

Intervene When Fathers are Reluctant to Participate

Therapists can intervene with fathers directly whenthey are hesitant about attending therapy for child andfamily problems. Depending on the referral problemsand the family situations, therapists may want tonormalize the reluctance and work cooperatively withthe father to address his reluctance (Hecker, 1991).Conversely, the therapist may want to challenge thefather’s excuses (such as being “too busy”) in relation tohis commitment to his children’s well-being (Hecker,1991; Walters et al., 2001). Many therapists have found ithelpful to highlight the importance of the father in thefamily as well as in the treatment process and to give arationale for the father’s inclusion in treatment(Szapocznik, Perez-Vidal, Brickman, & Foote, 1988).

Create a Father-Friendly Therapy Environment

Offering flexible appointment schedules, such asappointments in the evenings and on weekends, mayincrease fathers’ willingness to engage in therapy(Carr, 1998). Although the same is true for motherswho are employed, it seems particularly difficult to getfathers to attend therapy sessions that occur duringnormal business hours. Therapists should also beconscious of how their office and waiting roommight be perceived by fathers. For example, arethere magazines in the waiting room that mightinterest men as well as women? Are the furniture,artwork, and other decorations gender-neutral or arethey more geared toward women and children?Attention to these types of environmental nuancesmay help engage and maintain reluctant fathers intreatment.

Offer Sessions for the Father Alone and with the

Parents Alone

Given that fathers often are reluctant to participate intherapy with their child, it might be helpful to offeradditional sessions where the father can discuss personalconcerns that may have relevance to the child’s orfamily’s well-being. In fact, offering additional sessionswhere parents can discuss their own concerns (such as

job stress and personal distress) has been associated withlower treatment dropout rates (Carr, 1998; Walters et al.,2001). If the parental distress necessitates individualtreatment, then it may be helpful for the therapist torefer the father or mother for individual therapy inaddition to continuing to provide child-related therapy.

Be Conscious of Family Diversity

Children referred for mental health services are evenless likely to have two-parent families than are nonclin-ical children (Phares & Lum, 1997). Thus, it is importantfor therapists to be conscious of the many differentfamily constellations in which children might live. Thisreminder is not only meant in relation to single-parentfamilies (where there might be nonresidential fathers,or father-figures who are not biologically related to thechild, or a grandfather and grandmother who areactually raising the child), but it is important fortherapists to consider that some of their child clientsmight be from families with gay parents (where theremight be two mothers who coparent or two fathers whocoparent or any number of other constellations;Silverstein, 2002). In addition, when working withchildren from single-parent households in economicallyimpoverished areas, it is important not to assume thatfathers are absent from their children’s lives (Coley,2001; Danziger & Radin, 1990).

Consider Father Involvement on a Continuum

Throughout this article, father involvement has beentreated somewhat like a dichotomous variable—eitherfathers are involved in treatment or they are not. Inpractice, however, fathers’ involvement can come inmany forms, only one of which is their actual attendanceand engagement into therapy sessions. If fathers are notwilling or able to attend therapy sessions directly,therapists might consider involving them in other ways.For example, during the initial assessment phase,therapists could request fathers to complete assessmentmaterials (which could be sent through the mail ratherthan being completed in person, if needed). For over 20years, Achenbach (1985) has shown the advantages ofincluding multiple informants of children’s emotional/behavioral functioning, and these advantages continueto be relevant currently (Achenbach & Rescorla, 2001).In addition to including fathers during the assessmentphase, therapists might consider inviting fathers tocertain critical sessions rather than expecting them toattend every session. This process is consistent with manycognitive-behavioral treatments where most of the workis done with the older child or adolescent directly butsome sessions are reserved for parental involvement(Curry & Reinecke, 2003). Similarly, therapists might tryto prepare handouts or homework assignments that

50 Phares et al.

could be shared with fathers who can not attend alltherapy sessions.

If fathers are not available or willing to attend sessionsor to be engaged in any manner, therapists may want toconsider using mothers to report on fathers’ behaviors aswell as to share information about the therapeutic processwith the father. Mothers tend to report on fathers’behavior in ways that are associated with fathers’ reports,but the absolute levels of reported behaviors often differsignificantly. For example, mothers report fewer antisocialbehaviors in fathers than fathers report about themselves(Caspi et al., 2001) and noncustodial mothers report lessfather-child contact than do fathers (Manning & Smock,1999; Seltzer & Brandreth, 1994). Thus, therapists willneed to consider mothers’ reports of fathers’ behavior asan indicator of the mother’s perspective rather than thefather’s own perspective.

In terms of sharing information from therapy sessionswith fathers, mothers are known to serve as a communi-cation link between their children and the children’sfather. In a study of parents’ knowledge of adolescents’activities, Waizenhofer, Buchanan, and Jackson-Newsom(2004) found that fathers gained a significant amount oftheir knowledge about their adolescents’ activities frommothers rather than from adolescents’ directly. In termsof the therapeutic process, Reisinger (1982) found thatmothers provided an informational link between fatherswho did not attend therapy and the therapist. Thus,therapists can consider using mothers as a way to bothreceive and convey information about fathers.

Keep Learning

Given that active involvement in continuing educationexperiences related to fathers and families is associatedwith an increased likelihood of including fathers intherapy (Duhig et al., 2002; Lazar et al., 1991), it isimportant for therapists to continue their educationthroughout their career. With that in mind, there are anumber of books (Fagan & Hawkins, 2001; Phares, 1999),chapters (McBride & Lutz, 2004), and articles (Carr, 1998;Hecker, 1991) that are geared toward helping clinicianslearn how to work with fathers in treatment. In addition,clinicians are encouraged to read more about the familyas a system (Cox & Paley, 2003; Parke, 2004) and aboutcultural diversity within family systems (Boyd-Franklin,2003; Fine & Lee, 2001; McGoldrick, 2002) in order toimprove their engagement of fathers into therapy.

Future Directions

Although the body of empirical and clinical knowl-edge is growing in this area, far more research isneeded to help clarify the importance of includingfathers into child-related treatment. Large-scale, clinical

trials including a research design that utilizes randomassignment are needed. Ideally, an evidence-basedtreatment that routinely uses mothers (such as parenttraining or parent-child interaction treatment; Bagner &Eyberg, 2003) could be used for treatment of a specificdisorder such as oppositional-defiant disorder andfamilies could be randomly assigned to receive treat-ment for mothers-only, fathers-only, or mothers andfathers combined. Given previous findings in this area,treatment outcomes would need to be addressed attermination as well as at long-term follow-up. Perhapsresults from these types of studies will clarify the role offathers’ involvement in the effectiveness of child-relatedtreatment.

Summary

The research literature on the short- and long-termeffects of including fathers in therapy is equivocal, butthere is some preliminary evidence to suggest thattherapists can improve the maintenance of treatmentgains and show better long-term child outcomes whenfathers are included in treatment (Bagner & Eyberg,2003; Webster-Stratton, 1985). Although more research isneeded to clarify the mechanisms and roles of fathers inthe therapeutic process, it is incumbent on all therapiststo consider the role of fathers in their clients’ problems aswell as the therapeutic resolutions to those problems.

References

Achenbach, T. M. (1985). Assessment and taxonomy of child and adolescentpsychopathology. Newbury Park, CA: Sage.

Achenbach, T. M., & Rescorla, L. A. (2001).Manual for the ASEBA school-age forms and profiles. Burlington, VT: University of Vermont,Research Center for Children, Youth, and Families.

Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and thecontexts of help seeking. American Psychologist, 58, 5−14.

Amato, P. R., & Gilbreth, J. G. (1999). Nonresident fathers andchildren’s well-being: A meta-analysis. Journal of Marriage and theFamily, 61, 557−573.

Bagner, D. M., & Eyberg, S. M. (2003). Father involvement in parenttraining: When does it matter? Journal of Clinical Child andAdolescent Psychology, 32, 599−605.

Barrett, P. M., Dadds, M. R., & Rapee, R. M. (1996). Family treatment ofchildhood anxiety: A controlled trial. Journal of Consulting andClinical Psychology, 64, 333−342.

Barrett, P. M., & Shortt, A. L. (2003). Parental involvement in thetreatment of anxious children. In A. E. Kazdin, & J. R. Weisz(Eds.), Evidence-based psychotherapies for children and adolescents (pp.101−119). New York: The Guilford Press.

Bekker, D., Hogue, A., & Liddle, H. A. (2001). Methods of engagementin family-based preventive intervention. Child and Adolescent SocialWork Journal, 19, 163−179.

Bem, S. L. (1981). Gender schema theory: A cognitive account of sextyping. Psychological Review, 88, 354−364.

Boyd-Franklin, N. (2003). Black families in therapy: Understanding theAfrican American experience (2nd ed.). New York: The Guilford Press.

Brestan, E. V., & Eyberg, S. M. (1998). Effective psychosocial treatmentsof conduct-disordered children and adolescents: 29 years, 82studies, and 5,272 kids. Journal of Clinical Child Psychology, 27,180−189.

Broverman, I. K., Broverman, D. M., Clarkson, F. E., & Rosenkrantz, P.

51Getting Fathers Involved

(1970). Sex-role stereotypes and clinical judgments of mentalhealth. Journal of Consulting and Clinical Psychology, 34, 1−7.

Budd, K. S., & O’Brien, T. P. (1982). Father involvement inbehavioral parent training: An area in need of research. BehaviorTherapist, 5, 85−89.

Carr, A. (1995). The psychology of divorce: A synthesis of theliterature. Journal of Child Centered Practice, 2, 101−113.

Carr, A. (1998). The inclusion of fathers in family therapy: A researchbased perspective. Contemporary Family Therapy, 20, 371−383.

Caspi, A., Taylor, A., Smart, M., Jackson, J., Tagami, S., & Moffitt, T. E.(2001). Can women provide reliable information about theirchildren’s fathers? Cross-informant agreement about men’slifetime antisocial behaviour. Journal of Child Psychology andPsychiatry and Allied Disciplines, 42, 915−920.

Chamberlain, P., & Smith, D. K. (2003). Antisocial behavior inchildren and adolescents: The Oregon multidimensionaltreatment foster care model. In A. E. Kazdin, & J. R. Weisz(Eds.), Evidence-based psychotherapies for children and adolescents(pp. 282−300). New York: The Guilford Press.

Chronis, A. M., Chacko, A., Fabiano, G. A., Wymbs, B. T., &Pelham, W. E. (2004). Enhancements to the behavioral parenttraining paradigm for families of children with ADHD: Reviewand future directions. Clinical Child and Family PsychologyReview, 7, 1−27.

Cobham, V. E., Dadds, R., & Spence, S. H. (1998). The role ofparental anxiety in the treatment of childhood anxiety. Journal ofConsulting and Clinical Psychology, 66, 893−905.

Coley, R. L. (2001). (In)visible men: Emerging research on low-income, unmarried, and minority fathers. American Psychologist,56, 743−753.

Connell, A. M., & Goodman, S. H. (2002). The association betweenpsychopathology in fathers versus mothers and children’sinternalizing and externalizing behavior problems: A meta-analysis. Psychological Bulletin, 128, 746−773.

Coplin, J. W., & Houts, A. C. (1991). Father involvement in parenttraining for oppositional child behavior: Progress or stagnation?Child and Family Behavior Therapy, 13, 29−51.

Cox, M. J., & Paley, B. (2003). Understanding families as systems.Current Directions in Psychological Science, 12, 193−196.

Curry, J. F., & Reinecke, M. A. (2003). Modular therapy foradolescents with major depression. In M. A. Reinecke, F. M.Dattilio, & A. Freeman (Eds.), Cognitive therapy with children andadolescents (2nd ed., pp. 95–127). New York: The Guilford Press.

Cusack, J., Deane, F. P., Wilson, C. J., & Ciarrochi, J. (2004). Whoinfluence men to go to therapy? Reports from men attendingpsychological services. International Journal for the Advancement ofCounselling, 26, 271−283.

Dadds, M. R., Sanders, M. R., Behrens, B. C., & James, J. E. (1987).Marital discord and child behavior problems: A description offamily interactions during treatment. Journal of Clinical ChildPsychology, 16, 192−203.

Danziger, S. K., & Radin, N. (1990). Absent does not equaluninvolved: Predictors of fathering in teen mother families.Journal of Marriage and the Family, 52, 636−642.

Duhig, A. M., Phares, V., & Birkeland, R. W. (2002). Involvement offathers in therapy: A survey of clinicians. Professional Psychology:Research and Practice, 4, 389−395.

Dumas, J. E., & Gibson, J. A. (1990). Behavioral correlates ofmaternal depressive symptomatology in conduct-disorderedchildren: II. Systemic effects involving fathers and siblings.Journal of Consulting and Clinical Psychology, 58, 877−881.

Enzlin, P., Mathieu, C., & Demyttenaere, K. (2002). Genderdifferences in the psychological adjustment to type 1 diabetesmellitus: An explorative study. Patient Education and Counseling,48, 139−145.

Fagan, J., & Hawkins, A. J. (Eds.). (2001). Clinical and educationalinterventions with fathers. New York: The Haworth Press.

Fals-Stewart, W., Fincham, F. D., & Kelley, M. L. (2004). Substance-abusing parents’ attitudes toward allowing their custodialchildren to participate in treatment: A comparison of mothersversus fathers. Journal of Family Psychology, 18, 666−671.

Fergusson, D. M., & Horwood, L. J. (1999). Prospective childhood

predictors of deviant peer affiliations in adolescence. Journal ofChild Psychology and Psychiatry and Allied Disciplines, 40, 581−592.

Fine, M. J., & Lee, S. W. (Eds.). (2001). Handbook of diversity in parenteducation. San Diego: Academic Press.

Firestone, P., Kelly, M. J., & Fike, S. (1980). Are fathers necessary inparent training groups? Journal of Clinical Child Psychology, 9,44−47.

Greif, J. L., & Greif, G. L. (2004). Including fathers in schoolpsychology literature: A review of four school psychologyjournals. Psychology in the Schools, 41, 575−580.

Heaven, P. C., Newbury, K., & Mak, A. (2004). The impact ofadolescent and parental characteristics on adolescent levels ofdelinquency and depression. Personality and Individual Differ-ences, 36, 173−185.

Hecker, L. L. (1991). Where is Dad?: 21 ways to involve fathers infamily therapy. Journal of Family Psychotherapy, 2, 31−45.

Hofferth, S. L. (2003). Race/ethnic differences in father involvementin two-parent families: Culture, context, or economy? Journal ofFamily Issues, 24, 185−216.

Hofferth, S. L., Stueve, J. L., Pleck, J., Bianchi, S., & Sayer, L. (2002).The demography of fathers: What fathers do. In C. S. Tamis-LeMonda, & N. Cabrera (Eds.), Handbook of father involvement:Multidisciplinary perspectives (pp. 63−90). Mahwah, NJ: LawrenceErlbaum.

Holden, G. W. (1990). Parenthood. In J. Touliatos, & B. Perlmutter(Eds.), Handbook of family measurement techniques. ThousandOaks: Sage Publications.

Horton, L. (1984). The father’s role in behavioral parent training: Areview. Journal of Clinical Child Psychology, 13, 274−279.

Hoza, B., Owens, J. S., Pelham, W. E., Swanson, J. M., Conners, C. K.,Hinshaw, S. P., Arnold, L. E., & Kraemer, H. C. (2000). Parentcognitions as predictors of child treatment response inattention-deficit/hyperactivity disorder. Journal of AbnormalChild Psychology, 28, 569−583.

Kane, P., & Garber, J. (2004). The relations among depression infathers, children’s psychopathology, and father-child conflict: Ameta-analysis. Clinical Psychology Review, 24, 339−360.

Kendall, P. C., Aschenbrand, S. G., & Hudson, J. L. (2003). Child-focused treatment of anxiety. In A. E. Kazdin, & J. R. Weisz(Eds.), Evidence-based psychotherapies for children and adolescents(pp. 81−100). New York: The Guilford Press.

Lamb, M. E. (Ed.). (1986). The father’s role: Applied perspectives. NewYork: Wiley.

Lamb, M. E. (Ed.). (2004). The role of the father in child development (4thed.). New York: Wiley.

Lazar, A., Sagi, A., & Fraser, M. W. (1991). Involving fathers in socialservices. Children and Youth Services Review, 13, 287−300.

Logan, D. E., & King, C. A. (2001). Parental facilitation of adolescentmental health services utilization: A conceptual and empiricalreview. Clinical Psychology: Science and Practice, 8, 319−333.

Manning, W. D., & Smock, P. J. (1999). New families and nonresidentfather-child visitation. Social Forces, 78, 87−116.

Martin, B. (1977). Brief family intervention: Effectiveness and theimportance of including the father. Journal of Consulting andClinical Psychology, 45, 1002−1010.

Mason, B., & Mason, E. (1990). Masculinity and family work. In R. J.Perelberg, & A. Miller (Eds.), Gender and power in families.London: Routledge.

McBride, B. A., & Lutz, M. M. (2004). Intervention: Changing thenature and extent of father involvement. In M. E. Lamb (Ed.),The role of the father in child development (4th ed., pp. 446–475).New York: Wiley.

McCloskey, L. A., & Lichter, E. L. (2003). The contribution of maritalviolence to adolescent aggression across different relationships.Journal of Interpersonal Violence, 18, 390−412.

McGoldrick, M. (Ed.). (2002). Re-visioning family therapy: Race, culture,and gender in clinical practice. New York: The Guilford Press.

Moller-Leimkuhler, A. M. (2002). Barriers to help-seeking by men: Areview of sociocultural and clinical literature with particularreference to depression. Journal of Affective Disorders, 71, 1−9.

Parke, R. D. (2004). Development in the family. Annual Review ofPsychology, 55, 365−399.

52 Phares et al.

Phares, V. (1996). Fathers and developmental psychopathology. New York:Wiley and Sons.

Phares, V. (1999). Poppa psychology: The role of fathers in children’s mentalwell being. Westport, CT: Greenwood.

Phares, V., & Compas, B. (1992). The role of fathers in child andadolescent psychopathology: Make room for daddy. PsychologicalBulletin, 111, 387−412.

Phares, V., Lopez, E., Fields, S., Kamboukos, D., & Duhig, A. M. (2005).Are fathers involved in pediatric psychology research andtreatment? Journal of Pediatric Psychology, 30, 631−643.

Phares, V., & Lum, J. J. (1997). Clinically referred children andadolescents: Fathers, family constellations, and other demograph-ic factors. Journal of Clinical Child Psychology, 26, 216−223.

Prentice, D. A., & Carranza, E. (2002). What women should be,shouldn’t be, are allowed to be, and don’t have to be: Thecontents of prescriptive gender stereotypes. Psychology of WomenQuarterly, 26, 269−281.

Reisinger, J. J. (1982). Unprogrammed learning of differentialattention by fathers of oppositional children. Journal of BehaviorTherapy and Experimental Psychiatry, 13, 203−208.

Sachs, B. (1986). Mastering the resistance of working-class fathers tofamily therapy. Family Therapy, 13, 121−132.

Scott, K. L., & Crooks, C. V. (2004). Effecting change in maltreatingfathers: Critical principles for intervention planning. ClinicalPsychology: Science and Practice, 11, 95−111.

Seltzer, J. A., & Brandreth, Y. (1994). What fathers say aboutinvolvement with children after separation. Journal of Family Issues,15, 49−77.

Sexton, T. L., Alexander, J. F., & Mease, A. L. (2004). Levels of evidencefor the models and mechanisms of therapeutic change in familyand couple therapy. In M. J. Lambert (Ed.), Bergin and Garfield’shandbook of psychotherapy and behavior change (5th ed.). New York:Wiley.

Silverstein, L. B. (2002). Fathers and families. In J. P. McHale, & W. S.Grolnick (Eds.), Retrospect and prospect in the psychological study offamilies (pp. 35−64). Mahwah, NJ: Lawrence Erlbaum.

Silverstein, L. B., & Phares, V. (1996). Expanding the parentingparadigm: An examination of dissertation research 1986–1994.Psychology of Women Quarterly, 20, 39−53.

Singh, I. (2003). Boy will be boys: Fathers’ perspectives on ADHDsymptoms, diagnosis, and drug treatment. Harvard Review ofPsychiatry, 11, 308−316.

Sonuga-Barke, E. J. S., Daley, D., & Thompson, M. (2002). Doesmaternal ADHD reduce the effectiveness of parent training forpreschool children’s ADHD? Journal of the American Academy ofChild and Adolescent Psychiatry, 41, 696−702.

Spoth, R., Redmond, C., Haggerty, K., & Ward, T. (1995). A controlledparenting skills outcome study examining individual differenceand attendance effects. Journal of Marriage and the Family, 57,449−464.

Szapocznik, J., Perez-Vidal, A., Brickman, A. L., & Foote, F. H. (1988).Engaging adolescent drug abusers and their families in treatment:A strategic structural systems approach. Journal of Consulting andClinical Psychology, 56, 552−557.

Tiano, J. D., & McNeil, C. B. (2005). The inclusion of fathers inbehavioral parent training: A critical evaluation. Child and FamilyBehavior Therapy, 27, 1−28.

Vetere, A. (2004). Are we continuing to neglect fathers? Clinical ChildPsychology and Psychiatry, 9, 323−326.

Videon, T. M. (2005). Parent-child relations and children’s psycho-logical well-being: Do dads matter? Journal of Family Issues, 26,55−78.

Waizenhofer, R. N., Buchanan, C. M., & Jackson-Newsom, J. (2004).Mothers’ and fathers’ knowledge of adolescents’ daily activities:Its sources and its links with adolescent adjustment. Journal ofFamily Psychology, 18, 348−360.

Walters, J., Tasker, F., & Bichard, S. (2001). ‘Too busy’? Fathers’attendance for family appointments. Journal of Family Therapy, 23,3−20.

Webster-Stratton, C. (1985). The effects of father involvement inparent training for conduct problem children. Journal of ChildPsychology and Psychiatry, 26, 801−810.

Webster-Stratton, C., & Reid, M. J. (2003). The incredible yearsparents, teachers, and children training series: A multifacetedtreatment approach for young children with conduct problems.In A. E. Kazdin, & J. R. Weisz (Eds.), Evidence-based psychotherapiesfor children and adolescents (pp. 224−240). New York: The GuilfordPress.

Weisz, J. R., Southam-Gerow, M. A., Gordis, E. B., & Connor-Smith, J.(2003). Primary and secondary control enhancement trainingfor youth depression: Applying the deployment-focused modelof treatment development and testing. In A. E. Kazdin, & J. R.Weisz (Eds.), Evidence-based psychotherapies for children andadolescents (pp. 165−183). New York: The Guilford Press.

Wolins, M. (1983). The gender dilemma in social welfare: Who caresfor children? In M. E. Lamb, & A. Sagi (Eds.), Fatherhood and familypolicy (pp. 113−129). Hillsdale, NJ: Lawrence Erlbaum.

Zimmerman, M. A., Salem, D. A., & Notaro, P. C. (2000). Make roomfor Daddy II: The positive effects of fathers’ role in adolescentdevelopment. In R. D. Taylor, & M. C. Wang (Eds.), Resilienceacross contexts (pp. 233−253). Mahwah, NJ: Lawrence Erlbaum.

Address correspondence to Vicky Phares, Ph.D. at the University ofSouth Florida, Department of Psychology, 4202 E. Fowler Avenue,PCD 4118G, Tampa, FL 33620, USA ; e-mail: phares@luna.cas.usf .edu.

Received: May 14, 2004Accepted: June 6, 2005Available online 21 February 2006