Evaluating the Reach, Usage, Human Support Needs, and Clinical Outcomes of Digital Parent Training for Child Oppositional Defiant Disorder Before and During Wartime - Longitudinal Study

Sep 29, 2026

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Digital parent training programs (DPTs) are presented as a scalable option for treating childhood oppositional defiant disorder (ODD), yet evidence is limited on their ability to reach untreated families and maintain effectiveness during major crises such as war. A fully remote, human-supported guided DPT was evaluated across two Israeli cohorts, before and during wartime, examining reach, usage, support needs, and outcomes with parent questionnaires, platform metrics, and clinician ratings.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Introduction

Background and need for accessible child mental health care

Rationale for digital parent training and human support

War-related context and research gap

Abstract

Background

Objective

Methods

Results

Conclusions

JMIR PEDIATRICS AND PARENTING Baumel et al Original Paper Evaluating the Reach, Usage, Human Support Needs, and Clinical Outcomes of Digital Parent Training for Child Oppositional Defiant Disorder Before and During Wartime: Longitudinal Study | Amit Baumel, PhD; Or Brandes, MA; Chen R Saar, PhD | | --- | | Department of Community Mental Health, University of Haifa, Haifa, Israel
Corresponding Author:
Amit Baumel, PhD
Department of Community Mental Health University of Haifa
Abba Khoushy Ave 199
Haifa, 3498838 Israel
Phone: 972 48288496
Fax: 972 48288723
Email: [abaumel@univ.haifa.ac.il](abaumel@univ.haifa.ac.il)
Abstract | | Background: Digital parent training programs (DPTs) have emerged as a scalable solution for treating childhood oppositional defiant disorder (ODD), offering remote access and reduced barriers to care. However, there is limited data on their potential to reach untreated populations and their effectiveness during times of crisis, such as war.
Objective: This study aimed to evaluate the reach, usage patterns, human support needs, and clinical outcomes ofa fully remote guided DPT for child ODD, comparing 2 cohorts treated before and during wartime in Israel.
Methods: Parents of children with ODD were enrolled in a human-supported DPT, with 25 families recruited before and 30 during wartime. Data included self-reported questionnaires (measured before-, postintervention, and 3 months after the end of the intervention), platform usage metrics, and clinician assessments.
Results: Most families (62%, 34/55) had not previously received any intervention for their child’s behavior problems. Significant self-reported improvements in child behavior (Cohen d≥0.79) and parenting practices (0.39≤Cohen d≤0.87) were found post intervention. On average, families engaged with the program for 138.6 minutes across 31.4 unique logins, supported by 38.8 minutes of human interaction, primarily via messaging. During wartime, parents completed onboarding significantly faster (15.70 days vs 31.36 days) and were more likely to complete the critical “overcoming disobedience” phase (27/30, 90% vs 17/25, 68%) . However, while self-reported changes were similar, clinician-rated recovery from ODD was marginally lower during wartime (13/30, 43% vs 17/25, 68%) .
Conclusions: DPTs present an acceptable avenue for care that could reach parents who have not sought treatment through traditional channels. However, this study’s results suggest that their clinical effectiveness may be lower under extreme stress conditions such as wartime, underscoring the need for future studies in this area.
(JMIR Pediatr Parent 2025;8:e80420) doi: 10.2196/80420 | KEYWORDS parent training; crisis; behavior problems; usage; oppositional defiant disorder; wartime; digital health Introduction Oppositional defiant disorder (ODD) is among the most prevalent types of mental disorders affecting young children, and it is crucial to treat it at an early onset [1] . However, the provision of child mental health services is limited [2]. In Israel, the wait times for publicly administered face-to-face mental health interventions are very long, with an ongoing gap between supply and demand that is not easily closed [3] . To address barriers related to service delivery in the treatment of behavior problems, digital parent training programs (DPTs) aimed at treating childhood disruptive behaviors have emerged over the last decade [4-6] . These interventions have demonstrated efficacy in meta-analyses [7-9], with trials reporting at least [https://pediatrics.jmir.org/2025/1/e80420](https://pediatrics.jmir.org/2025/1/e80420) XSL• FO RenderX JMIR Pediatr Parent 2025 | vol. 8 | e80420 | p. 1 (page number not for citation purposes) JMIR PEDIATRICS AND PARENTING Baumel et al moderate effect size improvements in child behaviors for guided DPTs (Cohen d>0.50) [7,9, 10] . Although DPTs appear to offer a feasible way t

FAQs

What outcomes were evaluated for the digital parent training program?

The study evaluated program reach, usage patterns, human support needs, and clinical outcomes for children with ODD, using parent questionnaires, platform usage metrics, and clinician assessments.

How did wartime conditions affect program onboarding and completion?

During wartime, parents completed onboarding significantly faster and were more likely to complete the critical “overcoming disobedience” phase than those treated before wartime.

Did clinical effectiveness remain the same during wartime?

Although self-reported changes were similar, clinician-rated recovery from ODD was marginally lower during wartime, suggesting reduced clinical effectiveness under extreme stress.

Sep 29, 2026

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