Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences



Committee Chair

Amy Herschell

Committee Co-Chair

Jennifer Ludrosky

Committee Member

Jennifer Ludrosky

Committee Member

Cheryl McNeil

Committee Member

Amy Root

Committee Member

Nicholas Turiano


Attrition is a significant problem in child psychotherapy (De Haan, Boon, De Jong, Hoeve, & Vermeiren, 2013) and has serious implications (Barrett et al., 2008). Predictors of attrition include those at the client, therapist, and treatment levels. The current study investigated variables associated with attrition in Parent-Child Interaction Therapy (PCIT), an evidence-based parent training program for families with young children (ages 2.5- to 7-years-old) with disruptive behavior disorders. The sample of 67 caregivers were treated by 25 therapists from 19 different licensed psychiatric outpatient clinics across one state and were part of a larger study (RO1 MH09750; A Statewide Trial to Compare Three Training Models for Implementing an EBT; PI: Herschell). The effects of caregivers’ attitudes toward therapy, expectations of therapy, perceived therapist cultural competence, and commitment on the likelihood that families left PCIT prematurely were examined using Binomial Logistic Regression. The logistic regression model explained 36.1% of the variance in attrition and correctly classified 73.1% of cases. Therapy expectations and commitment to treatment added significantly to the model predicting attrition. Fleiss’ kappa was used to examine caregiver-therapist agreement on completion status, reasons PCIT ended, barriers to treatment experienced by families, and caregiver compliance with post-treatment therapist referrals. Results suggest low agreement across each variable, suggesting that therapists may not be aware of caregiver barriers or reasons they leave PCIT prematurely. Limitations, suggestions for future research, and clinical implications are discussed.