Parenting With Love and Limits®

Mental Health In-home Parent Skill-Based Supported

Parenting with Love and Limits® (PLL) is a family-focused intervention for teenagers (ages 10-18) with severe emotional and behavioral problems (e.g., conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder). The program is designed to help families re-establish adult authority through setting consistent limits and reclaiming loving relationships. PLL consists of both multifamily group therapy sessions and individual family therapy coaching sessions.

 

Multifamily group sessions are led by two facilitators, including one PLL Coach and one co-facilitator. Group session topics include reasons for teenager misbehavior, button-pushing, behavior contracts, positive feedback, and approaches for restoring nurturing relationships. Each group session is conducted in two parts. During the first half of each session, all parents and teenagers meet in one group to learn skills related to addressing behavioral problems. The second half of each session is split into one group of parents and one group of teenagers. During these breakout groups, the group facilitator validates concerns and leads solution-focused discussions.

 

Families also attend individual family therapy coaching sessions with PLL Coaches. These sessions are intended to complement the group sessions and follow four phases of treatment. The first phase sets the terms of the therapy. The second and third phases focus on developing a behavioral contract and role-playing skills learned in group sessions. The fourth and final phase focuses on evaluating and maintaining progress and preventing relapse. After initial work to stabilize the family system, PLL Coaches also address trauma in the family system, as needed.


Parenting with Love and Limits is rated as a supported practice because at least one study carried out in a usual care or practice setting achieved a rating of moderate or high on design and execution and demonstrated a sustained favorable effect of at least 6 months beyond the end of treatment on at least one target outcome.


Date Research Evidence Last Reviewed: Oct 2021


Sources

The program or service description, target population, and program or service delivery and implementation information was informed by the following sources: the program or service manual, the program or service developer’s website, the California Evidence Based Clearinghouse for Child Welfare, the National Institute of Justice’s CrimeSolutions clearinghouse, and the studies reviewed.


This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.

Target Population

PLL targets families with teenagers (ages 10 to 18) who have severe emotional and behavioral problems (e.g., conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder). Teenagers frequently have co-occurring issues (e.g., depression, substance use, chronic truancy, destruction of property, domestic violence, suicidal ideation) and/or involvement with the juvenile justice, mental and behavioral health, and child welfare systems.

Dosage

PLL is typically delivered over the course of 4 to 6 months. Families participate in six 2-hour weekly multifamily group sessions led by one PLL Coach and one co-facilitator. Up to six families meet all together for the first hour of each session. Parents and teenagers split into breakout groups for the second hour of each session. In addition to group sessions, families participate in 4 to 20 individual family therapy sessions led by a PLL Coach. The number of individual sessions is based on problem severity and need. Families typically participate in about four to eight individual sessions lasting 1 to 2 hours each.

Location/Delivery Setting
Recommended Locations/Delivery Settings

PLL is typically delivered in residential care settings, outpatient clinics, community-based organizations, and participants’ homes.

Location/Delivery Settings Observed in the Research

  • Correctional Facility
  • Community-based aftercare

Education, Certifications and Training

Multifamily group sessions are led by two facilitators consisting of one PLL Coach and one co-facilitator. The individual family sessions are led by a PLL Coach. PLL Coaches must have at least a master’s degree in a counseling related field. Co-facilitators must have at least a bachelor’s degree.

PLL Coaches must complete 5 days of training prior to implementing PLL. After training, the developer provides ongoing clinical supervision to facilitate implementation fidelity. This support includes 2-hour semi-monthly case consultation, video-taped session analysis, and a real-time data dashboard.

Program or Service Documentation
Book/Manual/Available documentation used for review

The PLL Group Manual is implemented in conjunction with the PLL Coaching Manuals.

Sells, S. P., & Souder, E. (2016). Group manual: Multi-family group psychotherapy (3rd ed.). Parenting with Love and Limits.

Sells, S. P., & Souder, E.  (2020). PLL family therapy coaching manual #1: PLL Family Systems Stabilization (PLL-FSS). (3.1 ed.) Parenting with Love and Limits.

Sells, S. P., & Souder, E. (2020). PLL family therapy coaching manual #2: PLL Family Systems Trauma (PLL-FST). (3.1 ed.). Parenting with Love and Limits.

Available languages

The materials for PLL are available in English, Spanish, and Dutch.

Other supporting materials

Model Overview

Provider Dashboard Preview

Working with PLL

Contact Information for Developers

Website: https://gopll.com/

Phone: (800) 735-9525

Email: info@gopll.com

Results of Search and Review Number of Studies Identified and Reviewed for Parenting With Love and Limits®
Identified in Search 9
Eligible for Review 4
Rated High 0
Rated Moderate 1
Rated Low 3
Reviewed Only for Risk of Harm 0
Outcome Effect Size Effect Size more info
and Implied Percentile Effect Implied Percentile Effect more info
N of Studies (Findings) N of Participants Summary of Findings
Child well-being: Delinquent behavior 0.38
14
1 (5) 306 Favorable: 4
No Effect: 1
Unfavorable: 0

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group.

Outcome Effect Size Effect Size more info
and Implied Percentile Effect Implied Percentile Effect more info
N of Studies (Findings) N of Participants Summary of Findings Months after treatment
when outcome measured
Months after treatment when outcome measured more info
Child well-being: Delinquent behavior 0.38
14
1 (5) 306 Favorable: 4
No Effect: 1
Unfavorable: 0
-
Early, 2013
Rearrest Rate 0.31 *
12
- 306 - 12
Felony Arrest Rate 0.25
10
- 306 - 12
Readjudication Rate 0.48 *
18
- 306 - 12
Felony Adjudication Rate 0.47 *
18
- 306 - 12
Recommitment Rate 0.37 *
14
- 306 - 12

*p <.05

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications.

Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.

Full citations for the studies shown in the table are available in the "Studies Reviewed" section.

Sometimes study results are reported in more than one document, or a single document reports results from multiple studies. Studies are identified below by their Prevention Services Clearinghouse study identification numbers.

Studies Rated Moderate

Study 11831

Early, K. W., Chapman, S. F., & Hand, G. A. (2013). Family-focused juvenile reentry services: A quasi-experimental design evaluation of recidivism outcomes. OJJDP Journal of Juvenile Justice, 2(2), 1-22. https://www.ojp.gov/pdffiles/251063.pdf


Studies Rated Low

Study 11826

Ryon, S. B., Early, K. W., & Kosloski, A. E. (2017). Community-based and family-focused alternatives to incarceration: A quasi-experimental evaluation of interventions for delinquent youth. Journal of Criminal Justice, 51(2017), 59-66. https://doi.org/10.1016/j.jcrimjus.2017.06.002

This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.
Study 11825

Karam, E. A., Sterrett, E. M., & Kiaer, L. (2017). The integration of family and group therapy as an alternative to juvenile incarceration: A quasi-experimental evaluation using Parenting with Love and Limits. Family Process, 56(2), 331-347. https://doi.org/10.1111/famp.12187

This study received a low rating because none of the target outcomes met measurement standards.
Study 11827

Sterrett-Hong, E. M., Karam, E., & Kiaer, L. (2017). Statewide implementation of Parenting with Love and Limits among youth with co-existing internalizing and externalizing functional impairments reduces return to service rates and treatment costs. Administration and Policy in Mental Health and Mental Health Services Research, 44(5), 792-809. https://doi.org/10.1007/s10488-016-0788-4

This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.


Studies Not Eligible for Review

Study 11828

Smith, T. E., Sells, S. P., Rodman, J., & Reynolds, L. R. (2006). Reducing adolescent substance abuse and delinquency: Pilot research of a family-oriented psychoeducation curriculum. Journal of Child and Adolescent Substance Abuse, 15(4), 105-115. https://doi.org/10.1300/J029v15n04_06

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 11829

Baruch, G., Vrouva, I., & Wells, C. (2011). Outcome findings from a parent training programme for young people with conduct problems. Child & Adolescent Mental Health, 16(1), 47-54. https://doi.org/10.1111/j.1475-3588.2010.00574.x

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 11830

Sells, S. P., Early, K. W., & Smith, T. E. (2011). Reducing adolescent oppositional and conduct disorders: An experimental design using the Parenting with Love and Limits model. Professional Issues in Criminal Justice, 6(3&4), 9-30.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11832

Winokur, K. (2010). Parenting with Love and Limits (PLL) research evaluation: Idaho DHW 2009−10 outcomes. Justice Research Center.

This study is ineligible for review because it does not use an eligible publication source (Study Eligibility Criterion 4.1.2).

Study 11833

Winkour, K. (2010). Parenting with Love and Limits (PLL) Champaign County, IL mental health board research evaluation: 2009–10 outcomes. Justice Research Center.

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).