Reconceptualizing attrition in Parent–Child Interaction Therapy: “dropouts” demonstrate impressive improvements

Figures & data

Table 1 Effect size comparisons across treatment modalities

Treatment	Study	Sample	Pre-	Post-	Effect size
			X̄ (SD), t-score
PCIT	Present study, Lieneman et al	N=914, children aged 24–84 months, caregiver report, Oregon, child behavior problems	ECBI Intensity	ECBI Intensity
			Terminated early after ≥4 sessions x̄=150.4 (36.3), t=65	Terminated early after ≥ 4 sessions x̄ =123.3 (41.1), t=58	d=0.70 g=0.70
			Graduated x̄=139 (31.3), t=62	Graduated x̄=88.8 (29.4), t=48	d=1.65 g=1.65
			Combined x̄=147.5 (35.5), t=64	Combined x̄=114.5 (41.3), t=55	d=0.86 g=0.86
The Incredible Years	Menting et al^Citation57	N=4,745, children aged 3–9 years, parent report, meta-analysis, worldwide, child behavior problems	t=43.9–73.5	n.r.	d=0.50
Child-Parent Psycho-therapy (CPP)	Lieberman et al^Citation58	N=27, children aged 3–5 years, parent report, US, children witness marital violence, 1 year of treatment, 6 month follow-up	CBCL x̄=60.8 (10.6)	CBCL x̄=51.0 (9.9)	d=0.95 g=0.95
Positive Parenting Program (Triple P; all levels)	Nowak and Heinrichs^Citation59	N=11,797, children aged 0–15 years, meta-analysis, worldwide, child behavior problems	n.r.	n.r.	d=0.35–0.57
Child-Centered Play Therapy in schools	Ray et al^Citation60	N=1,106, children pre-K–7th grade, meta-analysis, worldwide, total problem behaviors			d=0.34
CBT	Arnberg and Öst^Citation61	N=523, children aged 8–12 years, meta-analysis, worldwide, depressive symptoms	n.a.	n.a.	d=0.66
Stimulant Medication	Mészáros et al^Citation62	N=1,991, adults, meta-analysis, worldwide, ADHD	n.a.	n.a.	d=0.67

Abbreviations: CBCL, Child Behavior Checklist; n.a., not applicable; n.r., not reported; PCIT, Parent–Child Interaction Therapy.

Figure 1 Mean ECBI Intensity Scale scores for families who graduated versus families who terminated PCIT early, but after at least four sessions.

Abbreviations: ECBI, Eyberg Child Behavior Inventory; PCIT, Parent–Child Interaction Therapy.

Figure 2 Mean ECBI Problem Scale scores for families who graduated versus families who terminated PCIT early but after at least four sessions.

Abbreviations: ECBI, Eyberg Child Behavior Inventory; PCIT, Parent–Child Interaction Therapy.

Table 2 Correlations and descriptive statistics for key study variables (N=914)

	X̄ (SD)	Child gender	Child age	Number of sessions	Grad. status	ECBI I change	ECBI P change
Child gender	—	1	−0.07	0.02	−0.01	−0.04	0.01
Child age (months)	58.66 (14.75)		1	−0.05	−0.09**	0.02	0.01
Number of sessions	13.30 (9.00)			1	0.47**	0.21**	0.21**
Grad. status	—				1	0.29**	0.26**
ECBI I change	32.97 (35.26)					1	0.57**
ECBI P change	6.52 (9.46)						1

Note: **p<0.001.

Abbreviations: ECBI I change, Change in Eyberg Child Behavior Inventory Intensity Scale score from first to last session; ECBI P change, Change in Eyberg Child Behavior Inventory Problem Scale score from first to last session; Grad. status: 0, terminated early; 1, graduated from PCIT.

Figure 3 Decrease in raw ECBI Intensity Scale score from first to last PCIT visit.

Abbreviations: ECBI, Eyberg Child Behavior Inventory; PCIT, Parent–Child Interaction Therapy.

Menting ATA, Orobio de Castro B, Matthys W. Effectiveness of the Incredible Years parent training to modify disruptive and prosocial child behavior: a meta-analytic review. Clin Psychol Rev. 2013;33(8):901–913. doi:10.1016/j.cpr.2013.07.00623994367

 PubMed Web of Science ®Google Scholar

Lieberman AF, Ghosh, Ippen C,VAN, Horn P. Child-parent psychotherapy: 6-month follow-up of a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2006;45(8):913–918. doi:10.1097/01.chi.0000222784.03735.9216865033

 PubMed Web of Science ®Google Scholar

Nowak C, Heinrichs N. A comprehensive meta-analysis of Triple P-Positive Parenting Program using hierarchical linear modeling: effectiveness and moderating variables. Clin Child Fam Psychol Rev. 2008;11(3):114–144. doi:10.1007/s10567-008-0033-018509758

 PubMed Web of Science ®Google Scholar

Ray DC, Armstrong SA, Balkin RS, Jayne KM. Child centered play therapy in the schools: review and meta-analysis. Psychol Sch. 2015;52(2):107–123. doi:10.1002/pits.21798

 Web of Science ®Google Scholar

Arnberg A, Ost L-G. CBT for children with depressive symptoms: a meta-analysis. Cogn Behav Ther. 2014;43(4):275–288. doi:10.1080/16506073.2014.94731625248459

 PubMed Web of Science ®Google Scholar

Meszaros A, Czobor P, Balint S, Komlosi S, Simon V, Bitter I. Pharmacotherapy of adult attention deficit hyperactivity disorder (ADHD): a meta-analysis. Int J Neuropsychopharmacol. 2009;12(8):1137–1147. doi:10.1017/S146114570999019819580697

 PubMed Web of Science ®Google Scholar