title: An Evaluation of Parent-Child Interaction Therapy With and Without Motivational Enhancement to Reduce Attrition.
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.
authors.affiliation: a School of Applied Psychology and Menzies Health Institute of Queensland , Griffith University.
authors.forename: Haley J
authors.initials: HJ
authors.lastname: Webb
authors.affiliation: b Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine , Bond University.
authors.forename: Rae
authors.initials: R
authors.lastname: Thomas
authors.affiliation: a School of Applied Psychology and Menzies Health Institute of Queensland , Griffith University.
authors.forename: Leanne
authors.initials: L
authors.lastname: McGregor
authors.affiliation: a School of Applied Psychology and Menzies Health Institute of Queensland , Griffith University.
authors.forename: Elbina
authors.initials: E
authors.lastname: Avdagic
authors.affiliation: a School of Applied Psychology and Menzies Health Institute of Queensland , Griffith University.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Zimmer-Gembeck
mesh_terms: D000328:Adult; D001315:Australia; D002675:Child, Preschool; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D010287:Parent-Child Relations