Helping the Noncompliant Child: An Updated Assessment of Program Costs and Cost-Effectiveness

Area of Science:

• Child Psychology
• Behavioral Science
• Health Economics

Background:

• Childhood behavior disorders (BD) are linked to significant long-term negative outcomes, including delinquency and adult mental health issues.
• Evidence-based behavioral parent training (BPT) programs are effective for early-onset BDs, but comprehensive cost analyses remain limited.
• Low-income families often face barriers to accessing effective behavioral interventions for their children.

Purpose of the Study:

• To provide updated cost and cost-effectiveness estimates for the Helping the Noncompliant Child (HNC) mastery-based BPT program.
• To evaluate the economic viability of delivering HNC to low-income families.
• To compare the costs of HNC with other BPT programs.

Main Methods:

• Cost analysis of research-specific activities and program delivery from a payer perspective.
• Calculation of costs associated with therapist time and non-labor resources (supplies, toys).
• Determination of cost per unit improvement in the Eyberg Child Behavior Inventory (ECBI) intensity score.

Main Results:

• Research-specific activities cost $1,152 per family.
• HNC program delivery costs averaged $293 per family, with therapist time accounting for $275 and non-labor resources for $18.
• The cost to improve the ECBI intensity score by one point was $6, and by one standard deviation was $171.

Conclusions:

• The Helping the Noncompliant Child (HNC) program demonstrates favorable cost-effectiveness compared to similar BPT programs.
• The findings support the economic feasibility of delivering HNC to low-income populations.
• Further cost analyses of BPT programs are crucial for informing clinical practice and policy.