Emotion Regulation and Attrition in Parent-Child Interaction Therapy

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.