Differential Attention as a Mechanism of Change in Parent–Child Interaction Therapy: Support from Time-Series Analysis

Although many interventions address children’s externalizing behavior problems, negative treatment outcomes remain common. Reasons for success or failure are frequently unclear, due in part to a lack of research identifying treatment change mechanisms. The current study evaluated differential attention as a mechanism of change in Parent–Child Interaction Therapy (PCIT), a treatment for children with externalizing problems. Using sequential coding and time-series analysis, we examined parent–child interactions across treatment for three families. Contrary to hypotheses, child prosocial behaviors and parent skill use held steady or decreased across coaching periods, with the exception of one family, where the parent’s skill use increased during coaching. Partial support was found for the hypothesis that parent differential attention would predict child prosocial behavior in the next minute. These results provide support for differential attention as a mechanism of change, but also demonstrate that this factor is not the only such mechanism.