Date of Award

Summer 2015

Document Type


Degree Name

Doctor of Philosophy (PhD)


Counselor Education and Counseling Psychology

First Advisor

Fox, Robert A.

Second Advisor

Edwards, Lisa M.

Third Advisor

Lopez, Francesca A.


This study used a randomized control design with treatment and wait-list conditions to evaluate the efficacy of a culturally-adapted version of the Early Pathways program (Fox & Gresl, 2014), an in-home, parent-child therapy program with 137 at-risk Latino children under the age of six referred for severe behavior and emotional problems, such as aggression, oppositional behavior, self-injury and property destruction. Early Pathways directly engaged the parent-child dyad, emphasizing parent-directed training and child-engagement activities, such as psycho-education, child-led play, and cognitive-behavioral strategies. Cultural modifications included establishing community partnerships to identify Latino family needs, translation of materials, offering bilingual services, acculturation assessment, and cultural competence training. Multivariate analyses of covariance (MANCOVA) revealed significant differences between the immediate and delayed treatment groups on all post-test measures with the pre-test scores as covariates. After the delayed group completed treatment, repeated measures, multivariate analyses of variance (MANOVA) showed significant improvement for both groups on all measures with maintenance at four- to six-week follow-up. Outcomes included reduced child behavior problems, increased child pro-social behaviors, improved caregiver discipline, enhanced caregiver nurturing, improved parent-child relationships, and a decrease in clinical diagnoses following treatment. This study offers guidance for developing culturally-adapted early intervention services for young Latino children in poverty referred for severe behavior problems.