Larissa N. Niec

Time-out from positive reinforcement (TOPR) is an effective limit-setting strategy for decreasing disruptive behaviors in young children. However, most publicly available information on TOPR (e.g., social media and other internet outlets) is inaccurate, leading to misperceptions and ineffective implementation by caregivers. We evaluated a brief (2-minute) behavioral, psychoeducational video on the evidence-based use of TOPR to determine whether a low-dose, universal intervention would change caregivers’ attitudes, increase knowledge, and improve correct use of TOPR. The primary caregivers of 1,472 children 2 to 8 years old were randomly assigned to watch a video on TOPR (intervention) or a video on the stages of child play (control). Caregivers completed self-report measures assessing their knowledge of and attitudes toward TOPR, use of TOPR, and severity of their child’s behavior problems at baseline, immediate follow-up, and 1-month follow-up. Acceptability of the intervention was assessed at immediate and 1-month follow-up. Caregivers who watched a 2-minute video on TOPR showed significant improvements in their understanding of TOPR ( F (1, 703) = 6.56, p = .011, Cohen’s d = .20) and the correct use of time-out ( F (1, 703) = 4.36, p = .037, Cohen’s d = .16), but their attitudes toward time-out did not significantly change. Implications for the development and dissemination of universal, low-dose psychoeducation on TOPR are discussed.

In vivo therapeutic coaching of parent-child interactions is the primary mechanism of change in behavioral parent training programs such as parent-child interaction therapy (PCIT), yet relatively little research has examined the coaching process. The primary aim of this study was to explore the bidirectional interaction between therapist-parent dyads to better understand how therapists influence parent behavior and vice versa. Observational data from two research projects were analyzed separately and together using lag sequential analysis (LSA). Results demonstrate that therapist responsive coaching (e.g., praising parent behavior) led parents to use more child-centered skills. Responsive coaching techniques led to immediate increases in parents’ use of the targeted positive parenting skill (10%–25% re-use). Responsive strategies followed targeted parent verbalizations more often than directive strategies, suggesting that therapists reinforce positive parenting skills as soon as parents use them. When directive coaching techniques were used, there was a 18% to 32% chance that parents followed through with a child-centered skill as coached. This study is the first to explore the influence of in vivo coaching on parent skill acquisition on a micro-level and has implications for the therapist training.

During the COVID-19 pandemic, children’s physical health and access to mental health resources have been two critical concerns. Parent-Child Interaction Therapy-Health (PCIT-Health) is a treatment model aimed at helping parents manage children’s general behavior and their behavior in obesogenic contexts (screen time and mealtime). Due to social distancing guidelines, PCIT-Health was adapted for remote delivery through video conferencing. In this article, we describe the experience of implementing virtual PCIT-Health with a family. The family’s progress through treatment is described, along with the challenges associated with remote service delivery and how those challenges were addressed. Progress through treatment was measured with questionnaires administered to caregivers and with observational measures of parent-child interactions. The results from these measures indicate that caregivers experienced a reduction in stress and improvements in their child’s behavior after PCIT-Health completion. They also reported engaging in healthier management of their child’s screen time and mealtime behaviors. As coded from observational assessments, parents increased their use of positive parenting practices. Telehealth-delivered PCIT-Health is a promising treatment modality for increasing parenting skills and improving child behavior.

Although live coaching using behavioral principles is a powerful mechanism of change in behavioral parent training (BPT), little research has examined the coaching process. We used a cross-sectional sample of coaches with different levels of training in the evidence-based behavioral parent training model parent-child interaction therapy (PCIT) to begin to understand how training impacts coaching techniques. Forty-six coaches including PCIT lay helpers, therapists, within-agency and global/regional trainers, provided a sample of coaching in response to a standardized parent-child interaction. Level of training was significantly and positively associated with coaching verbalizations ( r(44) = .80, p < .001). Training level was also associated with effective coaching strategies such that as training increased, coaches used more strategies related to positive treatment outcomes for families. Results suggest that coaches with less training may benefit from additional education around certain types of responsive coaching strategies. Findings raise important questions about how “adequate” and “optimal” coaching might be defined.

The Psychosocial Strengths Inventory for Children and Adolescents (PSICA) was created to address the need for a valid and practical measure of children’s psychosocial strengths that is feasible for use in psychological assessment and treatment. We evaluated the PSICA’s reliability and validity in a sample of 49 families. Parents completed measures of child psychosocial competence and behavior problems. The PSICA demonstrated good internal consistency, test-retest reliability, and negative associations with child behavior problems. The PSICA is a promising measure for the assessment of child competence and outcomes of parenting interventions.

Background Home visiting programs are effective in improving maternal-child health, and higher therapeutic alliance is associated with improved program retention and outcomes. Black, single, low-income mothers have a higher risk for poorer health outcomes in pregnancy and postpartum and for early termination of therapeutic services. Objective To examine associations between clinician and client alliance and social, economic, and racial demographics. Methods Mothers (N = 71) who were pregnant or had an infant (age < 24 m) receiving Infant Mental Health (IMH) services through community health service agencies and their clinicians (N = 50) completed the Scale to Assess Therapeutic Relationships (clinicians: STAR-C, clients: STAR-P) at 3-, 6-, 9-, and 12 months, and provided demographic information. Results Survival analysis showed those with higher alliance ratings, both client and clinician ratings, at the 3-month time-point were more likely to remain in treatment longer (for clients est = -1.67, p = .0017; for clinician est = -.75, p = .031). Controlling for clinician experience and frequency of reflective supervision, Black clinicians had higher alliance ratings than white clinicians, (b = 3.1 (1.6), p = .049). Neither clinician-client racial match nor client marital status predicted alliance. Black clinicians’ ratings of alliance did not vary by client race, but white clinicians reported weaker alliance with their Black, relative to white, clients (β = .40, p = .045). Conclusions Weaker alliance reported by white clinicians with Black clients, coupled with a lack of client-race related differences for Black clinicians, suggests white clinician racial bias may be important to consider in regards to program retention and health disparities.

Parent–Child Interaction Therapy with Toddlers (PCIT‐T) is a new attachment‐based parenting intervention designed to meet the needs of children aged 12–24 months presenting with challenging behaviors. This study examined outcomes of the first phase of PCIT‐T, Child Directed Interaction–Toddler (CDI‐T), 4‐months post treatment. Participants were 56 toddlers (Child Mage = 19.13 months) referred to receive CDI‐T over an 8‐week period at an Australian community‐based child behavior treatment clinic for treatment of difficult toddler behaviors. Participants completed questionnaires and observational measures at baseline (Time 1), post‐treatment (Time 2), and 4‐month follow‐up (Time 3). At both Time 2 and Time 3, there were statistically significant increases in observed positive parenting skills and emotional availability and decreases in negative parenting behaviors and child noncompliance. There were also significant improvements in parent‐reported child externalizing and internalizing behaviors, parental stress, and maternal depression. There was a pattern of a shift away from attachment insecurity and attachment disorganization. Results suggest that the CDI‐T phase of PCIT‐T is a promising intervention for toddlers presenting with behavioral issues. Future studies should be conducted to assess efficacy in other settings, using larger samples and utilizing randomized controlled designs.