Semester

Summer

Date of Graduation

2026

Document Type

Dissertation

Degree Type

PhD

College

Eberly College of Arts and Sciences

Department

Psychology

Abstract

The toddler age (12-36 months) is characterized by a toddler’s increasing desire for autonomy, which can result in caregiver-child conflict and toddler externalizing problems (Kohlhoff & Morgan, 2014). Clinical levels of disruptive behavior in toddlerhood can be predictive of a host of negative outcomes, including problems with academic achievement and delinquency (Copeland et al., 2007; Milledge et al., 2019). High levels of toddler behavior problems also are associated with poor caregiver-child relationships and poor toddler emotion regulation skills (Beijers et al., 2013; Umemura et al., 2022). Thus, interventions targeting toddler behavior problems need to focus on strengthening the caregiver-child relationship and developing toddler regulation skills (Ravindran et al., 2019). Parent-Child Interaction Therapy-Toddler (PCIT-T) specifically focuses on both domains (Girard et al., 2018); however, there is limited evidence on the use of PCIT-T in community-based clinics in the United States (US) and internationally. This study aimed to examine the feasibility of PCIT-T in Japan and the US. Therapists in ten prefectures in Japan and Oregon, United States received a year-long training in PCIT-T and logged information about each session they delivered and toddler outcomes. The study had five objectives: (1) to describe the families that sought behavioral services for their toddler in these community clinics; (2) to describe outcomes of therapist training in PCIT-T; (3) to examine the process of PCIT-T when delivered in community clinics; (4) to evaluate attrition in PCIT-T; and (5) to explore the effectiveness of PCIT-T. Overall, PCIT-T was evaluated as an effective intervention in improving toddler behaviors and parenting skills. There was high attrition in this study, with pre-treatment toddler behavior and caregiver reflections being predictive of attrition. Therapists receiving PCIT-T training were able to complete 1-2 cases during their training year and rated themselves as following the model closely. Overall, this study supports training therapists in PCIT-T and supports PCIT-T as an effective model for toddlers.

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