Treatment Outcome Articles
Attrition Studies
Emotion Regulation and Attrition in Parent–Child Interaction Therapy. (abstract)
Lieneman, C. C., Girard, E. I., Quetsch, L. B., & McNeil, C. B. (2020).
The impact of incentives on treatment adherence and attrition: A randomized controlled trial of Parent-Child Interaction Therapy with a primarily Latinx, low-income population. (abstract)
Quetsch, L. B., Girard, E. I., & McNeil, C. B. (2020).
An Evaluation of Parent-Child Interaction Therapy With and Without Motivational Enhancement to Reduce Attrition (abstract)
Webb, H. J., Thomas, R., McGregor, L., Avdagic, E., & Zimmer-Gembeck, M. J. (2017)
An Evaluation of Parent-Child Interaction Therapy With and Without Motivational Enhancement to Reduce Attrition (abstract)Outcomes of Parent-Child Interaction Therapy in an urban community clinic: A comparison of treatment completers and dropouts (abstract)
Danko, C.M., Garbecz, L.L., & Budd, K.S. (2016)
Outcomes of Parent-Child Interaction Therapy in an urban community clinic: A comparison of treatment completers and dropouts (abstract)
Danko, C.M., Garbecz, L.L., & Budd, K.S. (2016)
Parent-Child Interaction Therapy in a Community Setting: Explaining Outcomes, Attrition, and Treatment Setting (abstract)
Lanier, P., Kohl, P. L., Benz, J., Swinger, D., Moussette, P., & Drake, B. (2011)
A motivational intervention can improve retention in PCIT for low-motivation child welfare clients(abstract)
Chaffin M., Valle L. A., Funderburk B., Gurwitch R., Silovsky J., Bard D., McCoy C., Kees M. (2009)
Predicting treatment and follow-up attrition in Parent-Child Interaction Therapy (abstract)
Fernandez, M. A., & Eyberg, S. M. (2009)
Parent-Child Interaction Therapy: An Examination of Cost Effectiveness (abstract)
Goldfine, M. E., Wagner, S. M., Branstetter, S. A., & McNeil, C. B. (2008)
Predicting outcome in Parent-Child Interaction Therapy: Success and attrition (abstract)
Werba, B., Eyberg, S.M., Boggs, S.R., & Algina, J. (2006)
Keeping families in once they’ve come through the door: Attrition in Parent-Child Interaction Therapy (abstract)
Fernandez, M.A., & Eyberg, S.M. (2005)
Longitudinal Studies
An immediate and long-term study of a temperament and Parent-Child Interaction Therapy based community program for preschoolers with behavior problems (abstract)
Pade, H., Taube, D. O., Aalborg, A. E., & Reiser, P. J. (2006)
Outcomes of Parent-Child Interaction Therapy: Mothers' reports of maintenance three to six years after treatment (abstract)
Hood, K. K., & Eyberg, S. M. (2003)
Parent-Child Interaction Therapy with behavior problem children: One and two year maintenance of treatment effects in the family (abstract)
Eyberg, S. M., Funderburk, B. W., Hembree-Kigin, T. L., McNeil, C. B., Querido, J. G., & Hood, K. K. (2001)
General Outcome Studies
Parent-Child Interaction Therapy from the Parents' Perspective. (abstract)
Woodfield, M. J., & Cartwright, C. (2020).
Improving large‐scale implementations by applying research and data analysis: A case study on First 5 LA's implementation of PCIT in Los Angeles County (abstract)
Bahng, G., Taborga, M., Bae, C., & Jimenez, A. (2018).
A mixed-methods study of system-level sustainability of evidence-based practices in 12 large-scale implementation initiatives. (abstract)
Scudder, A. T., Taber-Thomas, S. M., Schaffner, K., Pemberton, J. R., Hunter, L., & Herschell, A. D. (2017).
Effectiveness of Parent-Child Interaction Therapy (PCIT) in the treatment of young children's behavior problems. A randomized controlled study (abstract)
Bjorseth, A., & Wichstrom, L. (2016)
Building an evidence-base for the training of evidence-based treatments in community settings: Use of an expert-informed approach (abstract)
Scudder, A., & Herschell, A. D. (2015)
Filling potholes on the implementation highway: Evaluating the implementation of Parent-Child Interaction Therapy in Los Angeles county (abstract)
Timmer, S. G., Urquiza, A. J., Boys, D. K., Forte, L. A., Quick-Abdullah, D., Chan, S., & Gould, W. (2015)
Predictors and correlates of homework completion and treatment outcomes in Parent-Child Interaction Therapy (abstract)
Danko, C. M., Brown, T., Van Schoick, L., & Budd, K. S. (2015)
State-wide dissemination and implementation of Parent–Child Interaction Therapy (PCIT): Application of theory (abstract)
Beveridge, R. M., Fowles, T. R., Masse, J. J., McGoron, L., Smith, M. A., Parrish, B. P., Circo, G., & Widdoes, N. (2015)
Effectiveness of community dissemination of Parent-Child Interaction Therapy (abstract)
Pearl, E., Thieken, L., Olafson, E., Boat, B., Connelly, L., Barnes, J. & Putnam, F. (2012)
Utilizing benchmarking to study the effectiveness of Parent-Child Interaction Therapy implemented in a community setting (abstract)
Self-Brown, S., Valente, J. R., Wild, R. C., Whitaker, D. J., Galanter, R., Dorsey, S. & Stanley, J. (2012)
Introduction: Innovative approaches to Parent-Child Interaction Therapy (abstract)
Storch, E. A., & Floyd, E. M. (2005)
Outcomes of Parent-Child Interaction Therapy: A comparison of treatment completers and study dropouts one to three years later (abstract)
Boggs, S. R., Eyberg, S. M., Edwards, D. L., Rayfield, A., Jacobs, J., Bagner, D., & Hood, K. K. (2004)
Parent-Child Interaction Therapy: New directions in research (abstract)
Herschell, A. D., Calzada, E. J., Eyberg, S. M., & McNeil, C. B. (2002)
Changes in hyperactivity and temperament in behaviourally disturbed preschoolers after Parent-Child Interaction Therapy (PCIT) (abstract)
Nixon, R. D. V. (2001)
Importance of early intervention for disruptive behavior problems: Comparison of treatment and waitlist-control groups (abstract)
McNeil, C. B., Capage, L. C., Bahl, A., & Blanc, H. (1999)
Efficacy of Parent-Child Interaction Therapy: Interim report of a randomized trial with short-term maintenance (abstract)
Schuhmann, E. M., Foote, R. C., Eyberg, S. M., Boggs, S. R., & Algina, J. (1998)
Parent-Child Interaction Therapy: A guide for clinicians (abstract)
Foote, R. C., Schuhmann, E. M., Jones, M. L., & Eyberg, S. M. (1998)
Parent-Child Interaction Therapy: A psychosocial model for the treatment of young children with conduct problem behavior and their families (abstract)
Eyberg, S.M., Boggs, S., & Algina, J. (1995)
Parent-Child Interaction Therapy with behavior problem children: Relative effectiveness of two stages and overall treatment outcome (abstract)
Eisenstadt, T. H., Eyberg, S., McNeil, C. B., Newcomb, K., & Funderburk, B. (1993)
Assessing therapy outcome with preschool children: Progress and problems (abstract)
Eyberg, S. (1992)
Parent-Child Interaction Therapy with behavior problem children: Generalization of treatment effects to the school setting (abstract)
Funderburk, B., Newcomb, K., McNeil, C. B., Eyberg, S., & Eisenstadt, T. H. (1991)
Parent-Child Interaction Therapy: Integration of traditional and behavioral concerns (abstract)
Eyberg, S. (1988)
Parent-Child Interaction Training: Effects on family functioning (abstract)
Eyberg, S.M., & Robinson, E.A. (1982)
Treatment Comparison Studies
Does Parent Training Format Affect Treatment Engagement? A Randomized Study of Families at Social Risk (abstract)
Gross, D., Belcher, H. M. E., Budhathoki, C., Ofonedu, M. E., & Uveges, M. K. (2018).
Cultural adaptation and implementation of evidence-based parent-training: A systematic review and critique of guiding evidence (abstract)
Baumann, A. A., Powell, B. J., Kohl, P. L., Tabak, R. G., Penalba, V., Proctor, E. E., Domenech-Rodriguez, M. M., & Cabassa, L. J. (2015)
Treating child disruptive behavior in high-risk families: A comparative effectiveness trial from a community-based implementation (abstract)
Abrahamse, M. E.; Junger, M., van Wouwe, M. A., Boer, F., & Lindauer, R. J. (2015)
Study protocol for a comparative effectiveness trial of two parent training programs in a fee-for-service mental health clinic: Can we improve mental health services to low-income families? (abstract)
Gross, D. A., Belcher, H. M., Ofonedu, M. E., Breitenstein, S., Frick, K. D., & Chakra, B. (2014)
Parent management training for reducing oppositional and aggressive behavior in preschoolers (abstract)
Pearl, E. S. (2009)
Behavioral outcomes of Parent-Child Interaction Therapy and Triple P-Positive Parenting Program: A review and meta-analysis (abstract)
Thomas, R., & Zimmer-Gembeck, M. J. (2007)
Mindfulness and behavioral parent training: Commentary (abstract)
Eyberg, S. M., & Graham-Pole, J. R. (2005)
Attrition Studies Articles
Emotion Regulation and Attrition in Parent–Child Interaction Therapy.
Lieneman, C. C., Girard, E. I., Quetsch, L. B., & McNeil, C. B. (2020). Emotion Regulation and Attrition in Parent–Child Interaction Therapy. Journal of Child & Family Studies, 29(4), 978–996.
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.
Keywords: Disruptive behavior; Emotion regulation; Parent–Child Interaction Therapy; Parenting stress; PCIT.
Article: https://researchrepository.wvu.edu/cgi/viewcontent.cgi?article=7127&context=etd
The impact of incentives on treatment adherence and attrition: A randomized controlled trial of Parent-Child Interaction Therapy with a primarily Latinx, low-income population.
Quetsch, L. B., Girard, E. I., & McNeil, C. B. (2020). The impact of incentives on treatment adherence and attrition: A randomized controlled trial of Parent-Child Interaction Therapy with a primarily Latinx, low-income population. Children & Youth Services Review, 112, N.PAG. https://doi.org/10.1016/j.childyouth.2020.104886
Abstract: • Attrition and homework nonadherence are common issues in parent training programs. • Families eceived either PCIT with or PCIT without incentives for treatment adherence. • Families who received incentives no-showed their therapy appointments less often. • Incentives were largely ineffective for other measures of attendance and adherence. Advancements in the implementation of evidence-based family therapies have yielded successful reductions in child disruptive behavior. Unfortunately, effective interventions such as Parent-Child Interaction Therapy (PCIT) are plagued with high rates of attrition and low rates of homework completion in community clinics. To evaluate the use of low-cost incentives on attendance and homework adherence in PCIT in a community mental health center. Families referred for PCIT (N = 84; 63.1% Latinx) were randomly assigned to receive PCIT as usual or PCIT plus incentives. Families were able to earn incentives for attendance, homework completion, and therapeutic skill mastery. Attrition rates (59.5%) were reflective of other community-based intervention studies, with a significant reduction in no-show rates for families receiving incentives. No significant changes were found between groups on attainment of therapeutic skill mastery or number of sessions prior to termination. Families completed homework at low rates with no differences between groups. Low-cost incentives largely did not impact meaningful outcomes for attendance in parent training, although no-shows were less likely. These findings suggest that adherence is a complex phenomenon requiring multi-faceted solutions.
Keywords: Attrition; Homework; Incentives; Latinx; Parent-Child Interaction Therapy; Treatment barriers.
Article: https://www.sciencedirect.com/science/article/pii/S0190740919312460
An Evaluation of Parent-Child Interaction Therapy With and Without Motivational Enhancement to Reduce Attrition
Webb, H. J., Thomas, R., McGregor, L., Avdagic, E., & Zimmer-Gembeck, M. J. (2017). An Evaluation of Parent–Child Interaction Therapy With and Without Motivational Enhancement to Reduce Attrition. Journal of Clinical Child & Adolescent Psychology, 1-14.
Abstract: Although many interventions for child externalizing behavior report promising outcomes for
families, high attrition prior to program completion remains a problem. Many programs report dropout rates of 50% or higher. In this trial we sought to reduce attrition and improve outcomes by augmenting a well-known evidence-based intervention, Parent–Child Interaction Therapy (PCIT), with a 3-session individual motivational enhancement component. Participants were 192 Australian caregivers (91.7% female; Mage = 34.4 years) and their children (33.3% female; Mage = 4.4 years). Families (51% referred from child welfare or health services for risk of maltreatment) were assigned to PCIT or a supported waitlist, with families assigned to PCIT receiving either standard PCIT (S/PCIT) or motivation-enhanced PCIT (M/PCIT), depending on their time of entry to the study. Waitlist families received phone calls every week for 12 weeks.
Parents in M/PCIT reported more readiness to change their behavior from preassessment to after the motivation sessions. Also, parents who reported high, rather than low, motivation at preassessment did have a lower attrition rate, and there was some evidence that enhancing motivation was protective of premature attrition to the extent that caregivers achieved a high degree of change in motivation. Yet comparison of attrition rates and survival analyses revealed no difference between M/PCIT and S/PCIT in retention rate. Finally, there were greater reductions in externalizing and internalizing child behavior problems and parental stress among families in S/PCIT and M/PCIT compared with waitlist, and there was generally no significant difference between the two treatment conditions.
Keywords: PCIT; attrition studies; international & cultural research; motivational enhancement; externalizing behaviors; internalizing behaviors; MPCIT
Article: https://www.tandfonline.com/doi/full/10.1080/15374416.2016.1247357
Outcomes of Parent–Child Interaction Therapy in an urban community clinic: A comparison of treatment completers and dropouts
Danko, C.M., Garbecz, L.L., & Budd, K.S. (2016). Outcomes of Parent–Child Interaction Therapy in an urban community clinic: A comparison of treatment completers and dropouts. Children and Youth Service Review, 60, 42-51https://doi.org/10.1016/j.childyouth.2015.11.007
Abstract: This study examined outcomes of Parent–Child Interaction Therapy (PCIT) for 52 clinically referred children with oppositional behavior and their parents treated in an urban, community mental health clinic serving demographically (i.e., income level, ethnicity) diverse families. Standardized observations of parent–child interactions and parent reported measures of child behavior were collected at pre- and post-treatment. We addressed two primary research questions: (1) What are pre-treatment predictors of treatment completion? (2) What are treatment outcomes both for families who successfully completed PCIT and for treatment dropouts? Multiple logistic regression results showed a significantly greater likelihood of treatment completion related to higher parent education, male child gender, and two parent households. Among families who completed treatment, pre–post data demonstrated significant parent change in observed skill use and improvement in parent reported disruptive behaviors with medium to large effect sizes. Findings also documented early treatment benefits for families who completed the first phase of PCIT but dropped out in the final phase prior to meeting full graduation criteria. We discuss the findings and implications for community-based applications of PCIT in the context of community mental health's mission to provide effective treatment and maximize community access to services.
Keywords: Behavior problemsParent–child relationsCommunity mental healthTreatment outcomePreschool children
Article: https://www.sciencedirect.com/science/article/abs/pii/S0190740915300967?via%3Dihub
Parent-Child Interaction Therapy in a Community Setting: Explaining Outcomes, Attrition, and Treatment Setting
Lanier, P., Kohl, P. L., Benz, J., Swinger, D., Moussette, P., & Drake, B. (2011). Parent–child interaction therapy in a community setting: Examining outcomes, attrition, and treatment setting. Research On Social Work Practice, 21(6), 689-698.https://doi.org/10.1177/1049731511406551
Abstract: The purpose of this study was to evaluate Parent-Child Interaction Therapy (PCIT) deployed in a community setting comparing in-home with the standard office-based intervention. Child behavior, parent stress, parent functioning, and attrition were examined. Using a quasi-experimental design, standardized measures at three time points were collected from parent-child dyads (n=120) with thirty-seven families completing treatment. Growth modeling analyses indicate significant improvements in child and parent outcomes in both treatment settings with more rapid improvements in parent outcomes within office-based treatment. Attrition was predicted by income and parent functioning. PCIT delivered in the community can produce measurable improvements. In-home PCIT is a feasible option but future research should consider benefits and costs. Treatment completion remains a challenge.
Keywords: PCIT; attrition studies; child welfare; children; community intervention; evidence-based practice; intervention; quantitative; home-based interventions
Article: https://journals.sagepub.com/doi/10.1177/1049731511406551
A motivational intervention can improve retention in PCIT for low-motivation child welfare clients
Chaffin M, Valle LA, Funderburk B, Gurwitch R, Silovsky J, Bard D, McCoy C, Kees M. (2009). A motivational intervention can improve retention in PCIT for low-motivation child welfare clients. Child Maltreat, 14(4):356-68.https://doi.org/10.1177/1077559509332263
Abstract: A motivational orientation intervention designed to improve parenting program retention was field tested versus standard orientation across two parenting programs, Parent-Child Interaction Therapy (PCIT) and a standard didactic parent training group. Both interventions were implemented within a frontline child welfare parenting center by center staff. Participants had an average of six prior child welfare referrals, primarily for neglect. A double-randomized design was used to test main and interaction effects. The motivational intervention improved retention only when combined with PCIT (cumulative survival = 85% vs. around 61% for the three other design cells). Benefits were robust across demographic characteristics and participation barriers but were concentrated among participants whose initial level of motivation was low to moderate. There were negative effects for participants with relatively high initial motivation. The findings suggest that using a motivational intervention combined with PCIT can improve retention when used selectively with relatively low to moderately motivated child welfare clients.
Keywords: Drop-out; Retention; Parenting; PCIT; Child Abuse; Child Neglect.
Article: https://pubmed.ncbi.nlm.nih.gov/19258303/
Predicting Treatment and Follow-Up Attrition in Parent-Child Interaction Therapy
Fernandez, M. A., & Eyberg, S. M. (2009) Predicting treatment and follow-up attrition in parent-child interaction therapy. Journal of Abnormal Child Psychology, 37, 431-441
https://doi.org/10.1007/s10802-008-9281-1
Abstract: Predictors of attrition from individual parent-child interaction therapy were examined for 99 families of preschoolers with disruptive behavior disorders. Seventy-one percent of treatment dropouts were identified by lower SES, more maternal negative talk, and less maternal total praise at pretreatment. Following PCIT, families were randomly assigned to an Assessment-Only or Maintenance Treatment condition. Higher maternal distress predicted 63% of dropouts in the Assessment-Only condition. Lower maternal intellectual functioning predicted 83% of dropouts from Maintenance Treatment. Findings highlight a continuing need for evidence-based retention strategies at various phases of engagement in PCIT.
Keywords: PCIT; attrition studies; low-income; child; disruptive behavior disorders; dropout; evidence-based treatment; follow-up; prediction; treatment
Article: https://link.springer.com/article/10.1007%2Fs10802-008-9281-1
Parent-Child Interaction Therapy: An Examination of Cost Effectiveness
Goldfine, M. E., Wagner, S. M., Branstetter, S. A., & McNeil, C. B. (2008). Parent-child interaction therapy: An examination of cost-effectiveness. Journal of Early and Intensive Behavior Intervention, 5(1), 119-141.
Abstract: An empirically supported treatment for children with disruptive behavior disorders, Parent-Child
Interaction Therapy (PCIT), has received increased interest from policymakers and mental health administrators regarding its cost-effectiveness (i.e., ratio of treatment costs to behavior gains). This paper examines the projected costs and treatment outcomes associated with implementing and completing PCIT and demonstrates favorable cost-effectiveness ratios. For example, startup costs of PCIT, including equipment and training, were estimated at approximately $14,000 and the average cost of providing PCIT from intake to termination was estimated at approximately $1,000 per client. Benefits include clinically significant improvements on multiple measures of disruptive behavior and strong maintenance data, suggesting the PCIT is an effective and financially viable form of treatment for child disruptive behavior disorders.
Keywords: PCIT; attrition studies; cost-effectiveness; disruptive behavior disorders
Article: https://psycnet.apa.org/fulltext/2014-52728-011.html
Predicting Outcome in Parent-Child Interaction Therapy: Success and Attrition
Werba, B., Eyberg, S.M., Boggs, S.R., & Algina, J. (2006). Predicting Outcome in Parent-Child Interaction Therapy: Success and Attrition. Behavior Modification, 30, 618-646. https://doi.org/10.1177/0145445504272977
Abstract: This study explored predictors of treatment response and attrition in Parent-Child Interaction
Therapy (PCIT). Participants were 99 families of 3- to 6-year-old children with disruptive behavior disorders. Multiple logistic regression was used to identify those pretreatment child, family, and accessibility factors that were predictive of success or attrition. For all study participants, waitlist group assignment and maternal age were the significant predictors of outcome. For treatment participants (study participants excluding those who dropped out after the initial evaluation but before treatment began), only maternal ratings of parenting stress and maternal inappropriate behavior during parent-child interactions were significant predictors of treatment outcome. These results suggest that for treatment studies of disruptive preschoolers, the benefits of using a waitlist control group may be outweighed by the disproportionate number of dropouts from this group. Once families begin PCIT, however, parent-related variables become salient in predicting treatment outcome
Keywords: PCIT; attrition studies; treatment outcome; responsiveness; success; attrition; dropout; parent training; preschool; child; family; disruptive behavior