The Total Transformation Program® – Does It Work?

[The impetus for this post was a recent comment on this blog]

Total Transformation Infomercial

What is the Total Transformation Program®?

According to their website, “The Total Transformation is a child behavior modification program for child behavior problems like oppositional defiance disorder and child anger issues.”¹ It “offers practical, real world solutions for the most challenging problems parents face such as defiance, disrespect, lying and cursing, acting out in school, unmotivated behavior and more.” As the video above notes, it will even help in dealing with A.D.D./A.D.H.D.

If you are unfamiliar with their advertising,
I recommend watching the video before reading further.

Does the Total Transformation Program® Actually Work?

In Search of Reviews:  A Google search on the term “total transformation program” turned up the following on the first page:

• Positive Review – http://www.amamasrant.com/a_mamas_rant/2008/09/my-review-of-th.html “…the program makes a lot of sense, and seems practical and down to earth…”
• Positive Review – http://www.focusas.com/TT.html “Total Transformation gives PARENTS the tools to help solve real-life behavior problems in children and teens.“
• Semi-Positive Review – http://holymama.typepad.com/holymama/2006/12/total_transform.html “Total Transformation wasn’t going to ‘work’ for us, and for this one child. I still believe in it wholly, though.”  (It didn’t work for the reviewer’s child because of very severe problems.)
• Positive Review with a dose of realism -http://answers.yahoo.com/question/index?qid=20080805112142AAFGPIz “There’s no miracle cure, it takes a lot of work on the parents part. But I will tell you that the program will definately give you the tools you need to make changes.”²

However, there are some negative reviews on Amazon.

“We were not at all satisfied with this product. When we tried to return it, we too, received the run around. We were told it takes longer than 30 days to see results (but the refund policy is only for 30 days – imagine that). We tried this program consistently for well over 4 months. It was an absolute failure….” Really Really Disappointed – Don’t Waste Your Money, November 17, 2009

“I tried this with my daughter. It did not work. I passed it along to a friend. It did not work. She sold it and kept the proceeds. We are no longer friends. How’s that for a total transformation?” Total Junk, September 15, 2008

“I do not even want to give this product one star but amazon makes you pick at least one. My husband and I decided to try this out with our son. After trying it for two months, it was not effective AT ALL. Very time consuming without any positive results. My husband and I felt like fools for even ordering the thing. First of all, the terms of the trial period are horrendously inconspicuous, which may lead you to keep the product longer than intended. Let me tell you, if it is kept longer than the 30 days, you WILL NOT GET A REFUND!!!” HORRIBLE, May 29, 2009

In Search of Scientific Data: The following Google searches turned up nothing of value, that is, no reference to a scientific study that examined this program.³

Google Searches Performed

• “scientific” site: www.thetotaltransformation.com
• “data” site: www.thetotaltransformation.com
• “study” site: www.thetotaltransformation.com
• “studies” site: www.thetotaltransformation.com

There are, however, many testimonials on the website that attest to the program’s effectiveness. But the accumulation of testimonials does not constitute scientific data. It may be the impetus for a scientific study but it is not, in and of itself, “science.”  Furthermore, there is something very curious about the testimonials. They seem to all refer to the first 30 days of program implementation. Where are the testimonials of those who have used the program for longer than 30 days? Those testimonials are sorely missing.

Does It or Doesn’t It Work?

Logically speaking, it is safe to say that it should work. In fact it should work for at least 30 days in most cases. After all, imposing a structure where such structure may not exist or may have been implemented in an inconsistent manner, is quite likely to have a beneficial effect. In a very thoughtful and well-reasoned review (See: Sound Parenting Techniques, May 19, 2008), the reviewer – a retired special education teacher – writes:

The program contains much practical content on ways for the parents to change THEMSELVES, which will impact their children’s reactions OVER TIME. It is NOT a “quick fix” in all regards–there IS NO such thing–but parents should start to see very positive results relatively soon IF they stick with it. As the saying goes, “It may get worse before it gets better” if children sense that things are changing–again, once children learn the PARENTS are consistent in acting differently, they will respond and act differently too.⁴

A Product Endorsement?

I am puzzled by a review of the Total Transformation® Program written by Dr. Quinn of the National Center for Girls and Women with ADHD. (A summarization of the review appears on the Total Transformation® website and, it seems, the full review appears on Amapedia, Amazon’s answer to Wikipedia.) If one reads it very carefully it reads as an “endorsement by similarity.” Here is what I mean by “endorsement by similarity.”

We can acknowledge that the automobile is a useful means of transportation. We can acknowledge that Toyota and General Motors build automobiles. We can acknowledge that their automobiles have a logical structure (the dashboard and instrumentation layout is what is to be expected; the doors allow movement into and out of the vehicle, etc.). At no point did I say anything about the quality of the automobiles.⁵ All I said was that automobiles have particular characteristics and the automobiles made by these manufacturers have those characteristics. Therefore it is likely, but not necessarily the case, that you will be satisfied with their automobiles. Dr. Quinn’s review seems to employ this same logic.

She notes that there is a real “need [for] a structured program” that can be used with children and teenagers with behavioral issues. She then states that the Total Transformation Program® provides a structured program. After explaining why medication alone is not sufficient for dealing with ADHD behavioral issues and, in light of the time constraints on doctors and parents, she notes that a “training program like the TTP program seems ideal” since it can be done at home and does not require visits to a clinic or other setting. Further, Dr. Quinn points out that

TTP is an accountability based treatment program that empowers parents to deal with their child’s inappropriate responses. It offers them a means to decode and understand their child’s behavior. It places parents in the training and coaching role and offers them a concrete plan that they can actualize in the home.

A bit further in the review she examines “the scientific evidence for the effectiveness of such  programs.” She notes that Parent Training (PT) and Collaborative Problem Solving (CPS) are proven methods of dealing with, and correcting, behavioral issues. Now, here’s the “endorsement”:

In my opinion, the TTP incorporates both aspects of these psychosocial treatments and does it in a way that educates and supports parents as they learn to understand and deal with their child’s behaviors. The materials are also reinforcing and available for parents to review as necessary, as opposed to a session that may provide few written materials and concrete examples for the parent.

The implication is that TTP must be an effective program since it uses the same “psychosocial treatments” that have been proven to work.⁶ It would seem we could also conclude that Toyota and General Motors build quality automobiles since they both incorporate doors (scientifically proven to allow ingress and egress), instrumentation panels, and so on. But, sarcasm aside, we know that we cannot make ANY statements about the quality of the automobiles based on similarity of characteristics. This would seem to be the same problem with this endorsement of TTP. Features “X” and “Y” appear in TTP therefore, it would seem that TTP will be an effective program. TTP provides a structure and a set of methods that, in other contexts, have been shown to work. But have these methods been implemented correctly? Have there been any studies that reviewed these particular implementations and, when necessary, made adjustments based on the data? We are never told if such studies had been done.⁷ We do, however, have testimonials (but, seemingly, based only on 30 days implementation) and sales statistics.

At the bottom of the review, Dr. Quinn notes:

Over 85,000 units of the TTP have been sold to date with about 1000 currently being sold per week. A 10-15% return rate reported which indicates overall satisfaction.

TTP may well be effective and there may be many parents who are satisfied with the program. Nonetheless, sales statistics cannot be used as evidence of the program’s effectiveness or the satisfaction level of those who use the program. It can, however, be used as evidence of the effectiveness of a marketing program.

1. I should point out that you will not find this description of the program anywhere on their website. This description is buried in the “Description” metatag for the home page. I found it by doing this search – “behavior modification” site: www.thetotaltransformation.com – on Google. It is telling that the phrase behavior modification does not appear anywhere else on the site, at least based on my Google searches. There is still a slight negative connotation associated with that phrase because of its association with Skinnerism. See this article on behavior modification. You may also want to look at this. Though it examines behavior modification within the context of Special Ed, still, you may find it to be of interest. WebMD also has an interesting article on behavior modification. ↩
2. You will find also find links to two reviews of the program. This one offers a realistic yet optimistic review, while this one reads like a 30-second informercial. ↩
3. The search was limited to the Total Transformation® website. If such studies existed, I am sure it would be on their website.↩
4. I highly recommend reading this review. It offers a lot of practical advice.↩
5. As I write this, Toyota has enacted a massive recall of millions of vehicles and has halted production on eight of its models.↩
6. This reminds me of a story told to me by someone who writes intentionally misleading advertisements. At no point is there anything misleading within the advertisement itself. HOWEVER, the reader is allowed to draw conclusions based on similarities that would imply that a particular product is effective. Here’s the example: An advertisement has a quote from a Harvard study that shows that Vitamin X is effective in dealing with Problem Y. The advertisement then lists the ingredients in the magic elixir and, surprise, Vitamin X is in there. You are then left to draw your own conclusions, namely that the product has Vitamin X and, therefore, could be used to deal with Problem Y. But you will NEVER see this stated within the advertisement itself. ↩
7. Though not directly analogous, nonetheless, the Success For All program offers an interesting contrast. It provides a structured learning environment – which has been implemented in many schools – and has been subject to extensive studies. Most importantly, the program is modified on an ongoing basis as a result of the findings of the various studies. The point here is that it is possible to have a program that really works and, when the data reveals problems, to modify the program accordingly.↩