Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Public Health

First Advisor

Daniel J. Whitaker, PhD

Second Advisor

Shannon Self-Brown, PhD

Third Advisor

John R. Lutzker, PhD


Parenting focused interventions to address child maltreatment are a widely used tool for caregivers, and many have shown promising results for reducing child maltreatment risk and recidivism. Parenting focused intervention utilization and changes in parenting behaviors are two important variables that are needed for positive outcomes for caregivers and children. Without service utilization and engagement, caregivers cannot benefit from parenting focused interventions. Likewise, barriers to skill uptake while enrolled in parenting focused intervention, further impede the achievement of reductions in child maltreatment risk and recidivism.

Caregiver depression, substance use, and trauma exposure are established risk factors for the perpetration of child maltreatment. Caregivers with these mental health risk factors are often referred to parenting services and mental health services at the same time. It is not well understood how caregiver mental health risk impacts utilization and effectiveness of parenting interventions, or how simultaneous involvement may affect parenting behaviors.

The manuscripts included in this dissertation focus on how caregiver mental health risk factors (i.e., depression, substance use, and trauma exposure) impacts use of and benefit from parenting focused interventions. The overarching goal of this dissertation was to examine various facets of this relationship, across three levels of child maltreatment risk. To this end, the goals of each individual manuscript were: (1) to understand how caregiver mental health factors influence service utilization and changes in child abuse potential in a prevention sample of first time mothers enrolled in an early intervention home visiting program; (2) to examine how caregiver mental health impacts parenting focused intervention use and parenting behavior change in a nationally representative CPS-involved sample; and (3) to assess how receipt of mental health services impacts child maltreatment parenting program completion and parenting behavior change among a high risk sample of caregivers enrolled in an evidence based behavioral parenting program. When taken as a whole, the findings from each study suggest that when intervening directly with caregivers to address child maltreatment from a prevention or intervention standpoint, it is important to consider caregiver mental health, as it can influence both utilization and changes in parenting behaviors.