Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences



Committee Chair

Cheryl B McNeil

Committee Co-Chair

Lesley E Cottrell

Committee Member

Amy D Herschell

Committee Member

Elisa Krackow

Committee Member

Aaron Metzger


Disruptive behavior disorders (e.g., oppositional defiant disorder, conduct disorder) are the leading cause of referrals for children in mental health settings. Significant advancements in the implementation and dissemination of evidence-based family therapies have yielded successful reductions in these problem behaviors while also promoting long-term outcomes. Unfortunately, effective interventions such as Parent-Child Interaction Therapy (PCIT) are plagued with high rates of attrition and low rates of homework completion in community clinics. The current research study focused on evaluating the use of low cost incentives to increase retention and homework adherence in PCIT for a sample of low income, largely Hispanic families. Eighty-four families were randomly assigned to two groups: PCIT as usual or PCIT plus incentives. Findings indicated no significant differences between groups in rates of attendance, homework completion, or attainment of therapeutic skill mastery or graduation from treatment. Significant within-group outcomes were found for child behavior problems, internalizing and externalizing child behaviors, and parental stress, but no between-group differences were detected. A cost analysis between groups also was not significant. Exploratory analyses were conducted on factors contributing to early termination from treatment, therapy attitudes, and barriers to treatment participation. These analyses found that families who terminated from treatment early reported more difficulties with their children refusing to come to sessions, children developing new or different problems since starting treatment, and partners disagreeing with going to treatment. Additional analyses compared Hispanic and non-Hispanic families. Implications and future directions using innovative approaches to address attrition are discussed.