Date of Award

2025

Document Type

Thesis

Degree Name

MA in Psychology

Department

Psychology

First Advisor

Andrea Bergman

Abstract

Child maltreatment is linked to a range of adverse outcomes, including posttraumatic stress disorder (PTSD), anxiety and mood disorders, and behavioral and interpersonal problems (Copeland et al., 2007; McLaughlin et al., 2013; Silverman et al., 2008). Children subjected to abuse by caregivers have the highest risk of PTSD onset (Alisic et al., 2014). To mitigate these effects, Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT; Kolko, et al., 2011) was developed to improve caregiver-child relationships. AF-CBT has proven effective in reducing family conflict, improving child symptomatology, and minimizing the potential for child abuse (Kolko, 1996a, 1996b; Swenson & Brown, 1999). Despite treatment advancements, youth who have experienced abuse are at high risk for treatment attrition (Lau & Weisz, 2003). Caregivers play a critical role in therapy attendance and their active participation is required for AF-CBT, yet there is a paucity of research on caregiver-related predictors of treatment completion within this population. The present study aims to investigate caregiver distress and parenting practices as predictors of treatment completion in AF-CBT within community settings. Participants were drawn from a randomized controlled trial evaluating the effectiveness of AF-CBT versus waitlist control for families characterized by abuse. Our sample comprised 126 caregiver-child dyads referred for treatment following youth exposure to family violence. Caregiver distress was assessed with the Everyday Stressors Index (ESI; Hall, 1983) and the Hostility subscale of the Brief Symptom Inventory (BSI; Derogatis, 1993). Parenting practices (positive parenting, involvement, poor monitoring, corporal punishment) were assessed with child and caregiver reports on the Alabama parenting Questionnaire (APQ; Frick, 1991). Separate binary logistic regression analyses were conducted with baseline caregiver distress and parenting practices as the predictor variables and Treatment Status (attrition, completion) as the criterion variable. Caregiver BSI Hostility at low and moderate levels significantly predicted treatment completion. Caregiver ESI did not significantly predict treatment completion. Child report of poor monitoring at low levels significantly predicted treatment completion. Caregiver report of parenting practices and child report of positive parenting, involvement, and corporal punishment did not significantly predict treatment completion. Clinical implications and future research recommendations are discussed.

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