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Emotion Regulation and Attrition in Parent–Child Interaction Therapy

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Abstract

Objectives

As evidence of the importance of emotion regulation (ER) continues to mount, little is known about how families dealing with child behavior problems can better develop this important ability. We explored the relations among a caregiver training program for children with severe problem behavior (Parent–Child Interaction Therapy; PCIT), child ER, caregiver ER, parenting stress, and attrition. This study was part of a larger investigation evaluating the impact of incentives on treatment outcomes.

Methods

Measures of caregiver and child ER, child behavior problems, and parenting stress were completed by caregivers referred for PCIT from a predominantly low-income community sample of 66 caregiver–child dyads. Caregiver–child interactions were coded for caregiver verbalizations during three play situations. ANCOVA, t-test, and correlational analyses were conducted to examine changes in ER across treatment and compare those who completed treatment with those who dropped out of treatment early.

Results

Caregiver ER and child ER lability/negativity improved significantly across both phases of PCIT. Child adaptive ER improved significantly from pre- to post-treatment and during the second phase of treatment for those children in the non-incentives group only. Baseline levels of child and caregiver ER were not significant predictors of attrition.

Conclusions

Findings are discussed with respect to the importance of both caregiver and child ER in the provision of PCIT and other behavioral parent training programs.

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Author Contributions

C.C.L.: co-designed the study, assisted in data collection, performed data analyses, and wrote the manuscript. E.I.G.: managed data collection on site, supervised and trained clinicians, and assisted in revising the manuscript. L.B.Q.: trained study personnel, managed data collection, and assisted in data analysis and manuscript revision. C.B.M.: co-designed the study, mentored data collection, analysis, and writing, and assisted in revising the manuscript. All authors reviewed and edited the final manuscript.

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Authors and Affiliations

  1. West Virginia University, Morgantown, WV, USA

    Corey C. Lieneman & Cheryl B. McNeil

  2. Riverside University Health System—Behavioral Health: Preschool 0–5 Programs, University of California Riverside, School of Medicine, Riverside, CA, USA

    Emma I. Girard

  3. University of Arkansas, Fayetteville, AR, USA

    Lauren B. Quetsch

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  1. Corey C. Lieneman
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  2. Emma I. Girard
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  3. Lauren B. Quetsch
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  4. Cheryl B. McNeil
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Correspondence to Corey C. Lieneman.

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All procedures performed this study involving human participants were in accordance with the ethical standards of the institutions (IRB approval received by West Virginia University; IRB authorization agreement received for Riverside University Health System—Behavioral Health, Policy 203 Approved by the Mental Health Research Committee—Reference: Welfare and Institutions Code Division 5, Section 5608; California Administrative Code, Title 9, Sections 772, 773, 777, 778, 779, and 780; American Psychological Association, Ethical Principles of Psychologists, 1989; 45 CFR 164.501, 164.508,164.512(i)).

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Lieneman, C.C., Girard, E.I., Quetsch, L.B. et al. Emotion Regulation and Attrition in Parent–Child Interaction Therapy. J Child Fam Stud 29, 978–996 (2020). https://doi.org/10.1007/s10826-019-01674-4

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