The Impact of PCIT-Based Child Compliance Training on Children’s Self-Regulation

Parent-Child Interaction Therapy (PCIT) is an evidence-based parenting intervention composed of two distinct phases – Child-Directed Interaction (CDI) and Parent-Directed Interaction (PDI). PCIT has been found to promote positive outcomes for parents and children. However, little process-oriented research has been conducted on PCIT to date, with a majority of process-based research focusing on CDI. Thus, the present study sought to: 1) Characterize PDI-specific patterns of parenting skills; and 2) Examine whether parents’ use of PDI-phase skills is related to their children’s post-treatment self-regulation.Participants included 3–7-year-old children and their primary caregivers (n = 50) with prior child welfare system involvement. Families were drawn from a larger randomized clinical trial of PCIT and included dyads who completed one or more PDI sessions. First, patterns of PDI-specific parenting processes, including positive and negative parenting, effective commands, navigation of command sequences, and time-outs were plotted across PDI. Next, linear regression analyses were utilized to determine whether parents’ use of PDI skills predicted their children’s post-treatment self-regulation. Finally, exploratory latent growth curve models were utilized to examine patterns of change in the number of and duration in time-outs experienced by children over the course of PDI, and to explore whether these patterns of change predicted children’s post-treatment self-regulation. Results indicated parents’ use of positive and negative parenting remained relatively stable during PDI. Parents also initiated a consistent number of effective commands and successful command sequences across PDI. Notably, younger parents delivered more effective commands and navigated a higher proportion of command sequences successfully. The number of and duration in time-outs declined over the course of PDI, with significant linear declines in duration in time-outs observed during the first four PDI sessions. Parents’ PDI skills were not found to positively predict children’s post-treatment self-regulation. However, one finding emerged that ran counter to study hypotheses - children who experienced more time-outs and spent more time in time-outs demonstrated lower post-treatment HTKS behavioral regulation. While the present study offers important insight into PDI-specific parenting processes, further research is needed to fully understand patterns of these processes across treatment and assess how they might support children’s post-treatment outcomes