Parent attributional style and early termination from child and parent therapy

Behavior problems are prevalent in young children and represent a threat to a child's typical development. These early behavior problems are even more common in children from low-income, urban settings. If left untreated, such challenging behaviors may become ingrained and lead to later more severe behaviors including aggression, violence, and anti-social behaviors. Research has demonstrated that participation in child and parent therapy (CPT) programs significantly reduces problematic child behaviors while increasing positive behaviors in both the child and the parent. However, CPT programs report rates of early termination as high as 70%. Research to reduce these early termination rates have historically focused on barriers to treatment including logistical conflicts, race, culture, socioeconomic status, child age, and symptom severity. However, several years of implementing intervention enhancements specifically designed to address these barriers have yielded only moderate and inconsistent results and early termination rates in CPT programs have remained essentially unchanged. More recent research has focused on a new category of barriers to treatment, parent cognitive variables. One such cognitive variable is parental attributions – the spontaneous explanations that parents make to explain the reason for their child's behaviors. This study examined whether attributional style can predict treatment compliance in a CPT program specifically targeting low-income, urban, minority parents of children with behavior problems. For the study, 425 parents of children with behavior problems completed the Parent Cognition Scale – Adapted (PCS-A) to assess their parent-referent and child-referent attributions at pretest and posttest. Results indicated that parents of children with behavior problems tended to have a more negative attributional style at pretest, but that these attributions underwent a positive shift after receiving CPT treatment. Results also indicated that caregivers who viewed themselves as more of the cause of their child's behavior problems at pretest were significantly more likely to successfully complete the CPT program. Alternatively, caregivers who viewed their child as more responsible for their own behavior problems at pretest were significantly more likely to prematurely terminate from the CPT program. Limitations of the study, suggestions for future research, and implications for CPT programs serving similar populations were discussed.