(PS10-B29) Family Outcomes in Parent-child Interaction Therapy: Concordance as a Proxy for Coparenting

Background: Evidence-based parenting interventions which have long targeted common child concerns (e.g., attention, behavior), have consistently shown low rates of father engagement (Panter-Brick et al., 2014). This is unfortunate given the increasing body of literature which highlights the unique positive contributions fathers make to children and families when they engage in positive parenting (Fabiano & Caserta, 2018). Among the commonly cited barriers to father engagement (e.g., limited clinic hours, lack of father-specific marketing), disagreement between caregiver ratings of child behavior problem levels has been understudied. It is possible that these parenting programs may have impacts on coparenting in ways that are measurable using comparisons between ratings. The current study applies existing theory on multiple informant ratings (De los Reyes & Kazdin, 2005) to secondary data analysis of a clinical sample of families who have completed Parent-Child Interaction Therapy (PCIT) with engagement from both mothers and fathers. Analyses will describe changes in levels of caregiver concordance (i.e., agreement and difference scores) to answer: 1) Do mother and fathers agree on levels of child behavior problems at intake? and 2) Does mother-father agreement change over the course of treatment?

Method: Treatment occurred in an academic health setting between 2018 and 2021, resulting in 64 families with two caregivers engaged. Measures utilized in analyses include child and parent demographics, parent-reported measures of child behavior problems (i.e., Eyberg Child Behavior Index, ECBI), and concordance which is measured using difference scores (i.e., mother minus father) and q-correlations between parent ratings. Descriptive statistics highlight the level of concordance (i.e., agreement) over the course of treatment while t-tests compare differences from intake to post-treatment.

Preliminary

Results: Of the 64 families in the sample, 15.6% (N=10) designated a father as the primary caregiver. At intake, q-correlation (i.e., agreement) between mothers and fathers ECBI Intensity scores indicated low levels of agreement (r = 0.35) compared to post-treatment, where agreement was moderate (r = 0.54). Changes in concordance were measured over the course of treatment. Specifically, t-tests revealed that mother-father difference scores were significantly closer to zero (i.e., perfect agreement) at post-treatment (M = -1.14, SD = 6.90) than at intake (M = 2.89, SD = 7.66) for ECBI Intensity scores (t = 2.9, p = .003). Mother-father concordance on the ECBI Problem score did not significantly change over the course of treatment.

Significance: Preliminary findings provide the first application of concordance analysis to a clinical sample of PCIT families where both mothers and fathers were engaged in treatment. Differences in ECBI Intensity and Problem concordance suggest that changes in agreement may vary depending on the scale. When used in clinical decision-making and outcome monitoring, concordance analyses may provide a unique way to characterize and capitalize on coparenting benefits of interventions like PCIT.