Consider your future practice as a counselor, keeping in mind a population and/or setting for your work. The Final Course Project is a synthesis of literature and it is aimed to help you determine the

PCIT has demonstrated ef ficacy in treating young children with conduct problems (e.g., Boggs et al., 2005 ). The treat- ment model emphasizes the parent –child relationship and uses in vivo coaching to develop parent skills, which are features associated with larger effect sizes in BPT (Kaminski, Valle, Boyle, & Filene, 2008). PCIT is conducted in two phases, a parent –child relationship-enhancement phase (Child-Directed Interaction [CDI]) and a discipline- focused phase (Parent-Directed Interaction). During CDI, parents are taught to increase their positive, child-centered verbalizations (praises, re flections, and descriptions of child behavior) while decreasing their demanding and leading ver- balizations (questions, commands, and criticisms) as a way to reinforce their children ’s positive behaviors and improve the parent –child relationship. Parents complete the CDI phase when they demonstrate mastery of the child-centered skills as measured during a weekly 5-min behavior observation, which typically occurs after five to six sessions (Harwood & Eyberg, 2006 ). Parents then learn developmentally appro- priate discipline during Parent-Directed Interaction, includ- ing how to give effective commands and provide consistent follow-through for child compliance and noncompliance.

Reductions in parenting stress and dysfunctional parenting practices often occur during CDI (Harwood & Eyberg, 2006 ), but families need to complete both phases of treatment for clinically signi ficant changes in children ’s conduct problems to occur and persist (Boggs et al., 2005 ). Therapists ’coaching of parents, a core component of PCIT, has been identi fied as a strategy that leads to ef ficient acquisition of parenting skills (Shanley & Niec, 2010 ) and improved treatment outcomes (Kaminski, Valle, Filene, & Boyle, 2008 ). Coaching techniques have been classi fied as being directive or responsive (Borrego & Urquiza, 1998 ). Directive techniques tell the parent what to do (e.g., ‘‘Praise her for sharing ’’), whereas responsive techniques reinforce the parent ’s use of a skill (e.g., ‘‘Excellent labeled praise ’’). A third technique, constructive criticism , corrects the par- ent ’s behavior (e.g., ‘‘Don ’t ask questions ’’;Herschell, Capage, Bahl, & McNeil, 2008 ). PCIT experts recommend that therapists utilize frequent positive and responsive tech- niques in order to shape parents ’behaviors. In a clinical sample, responsive coaching was associated with parents ’ behavior change between two subsequent PCIT sessions, whereas directive coaching was not related (Barnett, Niec, & Acevedo-Polakovich, 2013 ). Investigations of the relation between therapists ’in vivo feedback techniques and treatment outcomes lag behind other areas of PCIT research; the need for this research is ‘‘impera- tive ’’ (McNeil & Hembree-Kigin, 2010 , p. 20). Therapist behaviors during the noncoaching portions of initial PCIT sessions predict dropout (Harwood & Eyberg, 2004 ), but limited research has investigated how therapist behaviors during the core component of PCIT —coaching —impact par- ents ’engagement. To address this gap in the empirical litera- ture, we used a measure of therapist coaching, the Therapist – Parent Interaction Coding System (TPICS; Barnett, Niec, & Peer, 2013 ), to explore an important question: How does coaching in fluence parental engagement in PCIT? Speci fically, we investigated how coaching techniques in flu- ence (a) attrition from PCIT and (b) parents ’speed of skill acquisition during the first phase of PCIT. Given the relation between directive therapist behavior and parental resistance (Patterson & Forgatch, 1985 ) and the relation between responsive coaching and parent behavior change (Barnett, Niec, & Acevedo-Polakovich, 2013 ), we predicted that therapist coaching techniques during the first CDI coaching session (CDI 1) would discriminate between parents who successfully completed treatment and those who discontinued prematurely. Speci fically, we predicted that less directive coaching and more responsive coaching would sig- nificantly predict treatment completion, over and above par- ent stress and parental criticisms of their children at intake, which have been associated with PCIT attrition (Werba et al., 2006 ). We further hypothesized that responsive coaching in CDI 1 would predict parents ’speed of acquisition of the child-centered skills, over and above the contribution of parent stress and child conduct problems at intake. METHOD Participants Parent –child dyads. Data for this study were archival from a clinical evaluation of PCIT. Participants included 51 parent –child dyads (41 mothers, 10 fathers). To avoid problems with nesting, only one caregiver was included in the analyses if both caregivers participated in treatment. Fathers were included if they were the primary caregiver or if the mother was not coached for at least 10 min in CDI 1. Families were referred for treatment if their primary presenting concern was distress regarding their children ’s conduct and/or if the family was designated by a child welfare agency as being at risk for physical abuse.

For study inclusion, parent and child had to speak and understand English, and children could not have signi ficant impairments in receptive language (Standard Score ≤ 70) on the Peabody Picture Vocabulary Test, Fourth Edition (Dunn & Dunn, 2007 ). Seventy-three 896 BARNETT ET AL. percent of families reported that they were bilingual (English/Spanish). Children included in this study were 2 to 9 years old ( M = 5.03, SD =1.65). Children older than 7 ( n=4) were included if the family was referred for risk of child physical abuse, as PCIT has been identi fied as an ef ficacious intervention for abusive parents with children in this age range (Chaf finetal., 2004 ). On average, child behavior problems were rated by parents as clinically signi ficant at intake (Eyberg Child Behavior Inventory [ECBI]: M =150.20, SD = 29.85). The majority of children were male (77%) and parent-identi fied as White Hispanic (63%). The sample came from an urban center with a heterogeneous Hispanic population primarily from the Caribbean, South America, and Central America.

Therapists Therapists in this study included three postdoctoral fellows, seven predoctoral interns, and six practicum students who were enrolled in doctoral clinical psychology programs.

Therapists were predominately female ( n= 15) and non- Hispanic White (69%; Asian: n= 2, Hispanic: n= 4). A licensed clinical psychologist and certi fied PCIT trainer provided training and supervision. All predoctoral interns and practicum students conducted cotherapy with a post- doctoral fellow. If cotherapy occurred, the therapist who provided coaching to the parent during CDI 1 was included in the analyses. Measures Demographics form. Parents completed demographic information (e.g., race, ethnicity, and ages) about themselves and their children. Treatment attrition. Attrition was de fined as occurring when participants discontinued treatment after completing at least one session of CDI coaching and before meeting criteria for successful treatment graduation as de fined by the PCIT protocol (Eyberg & Funderburk, 2011 ). Speed of parenting skill acquisition. The speed with which parents acquired the CDI skills was de fined as the number of sessions it took for caregivers to meet the mastery criteria as de fined by the current PCIT protocol (i.e., at least 10 Labeled Praises, 10 Behavior Descriptions, and 10 Re flections, and fewer than three combined Questions, Commands, and Negative Talks during the weekly 5-min behavior observation of parent –child interactions; Eyberg & Funderburk, 2011 ). Therapist –Parent Interaction Coding System. The TPICS (Barnett, Niec, & Peer, 2013 ) is a behavioral observation coding system that assesses therapists ’coaching statements and categorizes them as directive, responsive, or critical ( Ta b l e 1 ). The TPICS has been found to have excellent TABLE 1 Therapist –Parent Interaction Coding System Therapist Categories Coaching Technique Definition Example Directive Techniques Modeling Therapist verbalization of a parent –child interaction therapy parenting skill. “Thank you for sharing with me. ” Prompting Therapist verbalization of the beginning of an appropriate skill intended toallow a parent to finish the statement. “Thank you for …” Direct Command Therapist declarative statement that contains a direction for a behavior to beperformed by the parent. “Praise him for sharing. ” Indirect Command Therapist suggestion for a behavior to be performed by the parent. “Can you think of something to praise himfor? ” Drill An exercise during which the therapist tells the parent to focus on one targetedparenting behavior for a speci fied duration or frequency. “We are going to see how many labeled praisesyou can give him in one minute. ” Child Observation Any therapist observation about the child that is used to draw the parent ’s attention to the child. “He just shared with you. ” Responsive Techniques Labeled Praise Therapist verbalization that provides a positive evaluation of a speci fic behavior, activity, product, or verbalization of the parent. “That was a great labeled praise you gave him. ” Process Comment Therapist statement that ties a child ’s behavior to the parent ’s treatment-related behavior. “She shared again because you praised her forthat. ” Reflective Description Therapist non-evaluative, declarative sentence or phrase about the parent ’s most recent verbalization or behavior. “That was an unlabeled praise. ” Unlabeled Praise Therapist verbalization that provides nonspeci fic positive evaluation of the parent or parent ’s behavior. “Excellent job! ” Corrective Criticism Therapist verbalization that is negatively stated or gently critical of a parent ’s behaviors. “Stop paying attention to that behavior. ” Note : From Barnett, Niec, and Peer ( 2013 ). SUCCESSFUL THERAPIST –PARENT COACHING 897 reliability and can predict parents ’skill acquisition from one session to the next (Barnett, Niec, & Acevedo-Polakovich, 2013 ). In this study, approximately 25% of video-recorded coaching sessions were coded for interrater reliability, which was good to excellent for the majority of behavioral codes (intraclass correlation coef ficient [ICC] =.74 –1.00), and fair for two codes ( Ta bl e 2 ). Dyadic Parent –Child Interaction Coding System- III. The Dyadic Parent –Child Interaction Coding System- III (DPICS-III; Eyberg, Nelson, Duke, & Boggs, 2005 )isa behavioral observation coding system that was designed to assess the quality of parent –child interactions. The measure has good interrater reliability (Eyberg et al., 2005 )and treatment sensitivity (e.g., McCabe & Yeh, 2009 ). Consistent with the PCIT protocol, this study used the following DPICS- III categories —Behavior Description, Labeled Praise, Unlabeled Praise, Re flection, Question, Negative Talk, Indirect Command, and Direct Command —to measure parents ’skill use in CDI 1 and determine when parents met the CDI mastery criteria. We used parents ’frequency of Negative Talk (i.e., criticism) at intake to predict dropout, based on previous findings that it relates to attrition. Of the 51 video-recorded intakes and CDI 1 sessions, 13 ( ≈25%) of each session type were randomly selected for reliability coding. Interrater reliability was excellent (ICC = .88) for Negative Talk at intake, good to excellent for the majority of codes in CDI 1 (ICC =.70 –.93), and poor for Negative Talk in CDI 1 (ICC =.26; Ta bl e 3 ). Eyberg Child Behavior Inventory. The ECBI (Eyberg & Pincus, 1999 ) is a 36-item parent-rating scale of conduct problems for children between the ages of 2 to 16. Parents rate the frequency of each disruptive behavior on a 7-point Likert scale from 1 ( never )to7( always ), which are summed to yield the Intensity Scale. The ECBI is sensitive to treatment effects (McCabe & Yeh, 2009 ) and has excellent internal reliability ( α= .92 –.95; Burns & Patterson, 2001 ). The ECBI was used to control for children ’s conduct problems. Parenting Stress Index –Short Form. The PSI-SF (Abidin, 1995 ) is a 36-item self-report measure of parenting stress, with acceptable internal consistency ( α = .74 –.88) and test –retest reliability (Haskett, Ahern, Ward, & Allaire, 2006 ). The PSI-SF was used to control for parenting stress.

Procedure Treatment. Parents first completed a phone call with clinic staff and a screening packet. If they did not rate their child ’s behaviors as clinically signi ficant on the ECBI, they were offered less intensive services but were allowed to receive PCIT if they felt it was the best match for their family. Treatment was conducted in one clinic on a medical campus and was grant-funded. Prior to participation, adult participants signed a written informed consent, and children 7 years and older signed a written informed assent, both of which had been approved by the University of Miami Miller School of Medicine Institutional Review Board.

Treatment followed the evidence-based PCIT protocol (Eyberg & Funderburk, 2011 ). Therapists promoted family engagement through the use of motivational interviewing strategies, support in addressing treatment barriers, flexibility in rescheduling missed sessions, and phone consultations to promote skill acquisition. Coder training. Coders included graduate and undergraduate research assistants. Training included tutorial and discussion of the DPICS-III and TPICS codes and practice coding transcripts and video-recorded sessions.

Prior to beginning coding for the study, the coders exceeded the criterion of k≥.80 with the expert rating tapes for both the DPICS-III and TPICS. Biweekly coding meetings were completed to reduce rater drift. Video-recorded session samples. All sessions were video-recorded. Of the 113 families who were enrolled in treatment, 51 families were included in the current study. The additional 62 cases had problems with video-recordings (e.g., sessions lost due to a corrupted computer drive). Institutional Review Board approval was TABLE 2 Interrater Reliability of the Therapist –Parent Interaction Coding System Coaching Techniques Directive Coaching Responsive Coaching MO PR DC IC DR CO LP RD PC UP CC ICC 1.00 .96 .97 .98 .93 .65 .98 .92 .77 .74 .51 Note : MO = Modeling; PR = Prompt; DC = Direct Command; IC = Indirect Command; DR = Drill; CO = Child Observation; LP = Labeled Praise; RD = Re flective Description; PC = Process Comment; UP = Unlabeled Praise; CC = Constructive Criticism; ICC = intraclass correlation coef ficient. TABLE 3 Interrater Reliability of the Dyadic Parent –Child Interaction Coding System for CDI 1 BD LP UP RF QU CM NTA ICC .91 .93 .70 .84 .73 .82 .26 Note : CDI 1 = Child-Directed Interaction first coaching session; BD = Behavior Description; LP = Labeled Praise; UP = Unlabeled Praise; RF = Reflection; QU = Question; CM = Command; NTA = Negative Talk; ICC = intraclass correlation coef ficient. 898 BARNETT ET AL. obtained prior to accessing the video-recorded sessions for the current study. The first 10 min of coaching of the first CDI coaching session were coded.

Data Analysis Treatment attrition. A general linear model that controlled for nesting at the therapist level was used to determine if signi ficant differences existed between therapist coaching techniques in CDI 1 for treatment completers and dropouts. Predictors of attrition in earlier PCIT studies (parenting stress and the number of parent-to- child criticisms at intake) were examined for differences between groups to determine if these variables would be included in the model (Werba et al., 2006 ). Discriminant function analysis (DFA), which can detect group differences in small samples, was used to determine whether group membership (i.e., successful completer or dropout) could be predicted reliably from the set of hypothesized variables. The eight dropouts were distributed among seven therapists; therefore, therapist was not controlled in the DFA. Speed of parents ’skill acquisition. A mixed-effects model was used to evaluate the relation between child conduct problems, parental stress, therapist use of responsive coaching in CDI 1 and the length of the CDI phase of treatment. Parental stress (PSI-SF Total Stress), child conduct problems (ECBI Intensity Scale), and therapist responsive coaching techniques were included as fixed effects. To control for nesting, the therapist was entered as a random effect. The random effect (i.e., therapist) estimate was not signi ficant (Estimate = 1.26, SE = 1.33, p = 34), suggesting that nesting was not of concern; therefore, a linear regression was conducted to evaluate the in fluence of coaching techniques on parents ’ rate of skill acquisition. RESULTS Who Completed Treatment?

Parents completed treatment in an average of 13 sessions ( M = 13.38, SD = 4.14). Of the 51 parent –child dyads, 43 success- fully completed treatment and eight dropped out. No signi fi- cant differences existed between dropouts and completers on the demographic variables, parent stress, use of criticisms at intake, or level of children ’s conduct problems ( Ta b l e 4 ). Parents who completed treatment had somewhat higher skills at CDI 1 than those who dropped out, using signi ficantly more Behavior Descriptions and fewer Questions ( Ta b l e 5 ). Does Therapist Coaching In fluence Family Retention? As predicted, therapists provided signi ficantly more respon- sive coaching statements for treatment completers than dropouts. The overall level of directive coaching did not differ across groups, but the technique drill approached signi ficance in the hypothesized direction, and thus was also included in the DFA ( Table 6 ). Treatment completers received fewer drills than dropouts. There was a signi ficant violation of the homogeneity of variance –covariance assumption for responsive coaching and drills (Box ’sM =78.27, F=23.30, p< .001), which was likely in fluenced by the discrepancy between the two groups ’ TABLE 4 Parent and Child Variables for Treatment Completers and Dropouts Completers Dropouts % or M n or SD % or M n or SD t or χ2 p Child Age 5.07 1.69 4.83 1.47 t(49) =.37 .63 Child Gender χ2(1) = 2.31 .13 Boys 77% 33 100% 8 Girls 23% 10 0% 0 Child Ethnicity (Hispanic) 65% 28 75% 6 χ2(1) =.30 .59 Child Race χ2(3) = 1.27 .74 White 77% 33 75% 6 Black 14% 6 25% 2 Other 9% 4 0% 0 Caregiver Age 38.08 7.13 38.84 8.07 t(49) =−.27 .79 Caregiver Gender χ2(1) = 1.77 .18 Female 81% 35 100% 8 Male 19% 8 0% 0 ECBI Intensity Scale 148.81 31.29 157.63 20.39 t(49) = −.76 .45 PSI-SF Total Stress 94.90 29.56 91.38 28.24 t(45) =.31 .76 Criticisms 9.97 9.36 13.25 15.27 t(45) =−.80 .43 Note : Completers N= 43; Dropouts N= 8. ECBI = Eyberg Child Behavior Inventory; PSI-SF = Parent Stress Inventory Short Form. SUCCESSFUL THERAPIST –PARENT COACHING 899 sizes. Results should be interpreted with some caution due to this violation. The linear composite of these therapist beha- viors predicted group membership, Wilks ’sλ= .84, χ2=8.64, p< .05. Analysis of the structure matrix revealed that drills (.93) were a stronger predictor of attrition than responsive coaching ( −.49). These therapist and parent behaviors com- bined correctly classi fied actual group membership for 86% of families. All 43 families were correctly classi fied as treat- ment completers; however, only one out of eight families was correctly classi fied as treatment dropouts. Does Therapist Coaching In fluence Parents ’Speed of Skill Acquisition?

Parents met CDI mastery criteria in an average of five to six coaching sessions ( M = 5.67, SD = 2.51). Child conduct problems and parenting stress were not included in the linear regression, as they did not signi ficantly correlate to the length of the CDI phase. As predicted, therapists ’ responsive coaching during the first 10 min of CDI 1 was found to signi ficantly predict the speed with which parents ’ acquired the child-centered skills, β=−.30, t(43) =−2.04, p < .05, with higher levels of responsive coaching related to quicker mastery of the skills. Directive, β=−.10, t(43) = −.66, p> .05, and critical coaching techniques, β=−.05, t (43) =−.31, p> .05, did not signi ficantly predict parents ’ speed of mastery. DISCUSSION To improve families ’engagement in PCIT, it is impor- tant to understand the role of therapists ’coaching. This study sought to investigate how coaching techniques influence parents ’treatment retention and rate of skill acquisition, which are important markers of treatment engagement (Holden et al., 1990 ). Findings suggest that coaching, speci fically more responsive techniques and fewer drills, was associated with treatment comple- tion. However, although all treatment completers were accurately predicted, only one family who dropped out was correctly predicted. As hypothesized, higher rates of responsive coaching predicted quicker mastery of the child-centered interaction s kills, whereas directive and critical coaching techniques did not. It is notable that the first 10 min of therapists ’ coaching signi ficantly influenced parents ’mastery of the child-directed interac- tion skills, which typically occurred more than 1 month later. Parents in this sample demonstrated high levels of treatment engagement. Treatment attrition was only 16%, lower than has previously been reported (e.g., Fernandez & Eyberg, 2009 ), and on average, child-centered skill mastery occurred after five sessions, similar to ef ficacy trials of PCIT (Harwood & Eyberg, 2006 ). This is especially signi ficant because families were predominately from ethnic minority backgrounds, which has been associated with higher rates of premature termination (Holden et al., 1990 ) and slower skill acquisition (McCabe & Ye h , 2009 ). In addition, parents and therapists rarely matched in race or ethnicity, which can negatively impact treatment outcomes (Halliday-Boykins, Schoenwald, & Letourneau, 2005 ). It is still unclear what cultural adaptations may need to be made to improve BPT outcomes and engagement for minority families, but behavioral rehearsal seems especially important (Lau, 2012 ). An important step to increase minority parents ’engagement in BPT may be identifying therapist behaviors, such as responsive coaching, that promote skill acquisition during behavioral rehearsal. Although the high retention rate in this study is a strength of the implementation of the intervention, it limited our ability to predict attrition. Therefore, replication is warranted, and TABLE 5 Parenting Behaviors in CDI 1 for Treatment Completers and Dropouts Completers Dropouts M SD M SD t(49) p d Behavior Description 3.90 4.19 .71 1.11 2.17 .04 1.04 Reflection 6.51 6.69 5.14 5.82 .56 .58 .22 Labeled Praise 3.76 4.14 .86 2.29 1.97 .06 .87 Unlabeled Praise 4.73 3.98 2.86 2.27 1.32 .19 .58 Question 9.88 7.14 17.43 12.61 −2.51 .02 −.74 Command 4.41 4.46 4.71 3.99 −.18 .86 −.07 Negative Talk .47 1.14 .99 1.68 −1.69 .10 −.33 Note : Completers N= 43; Dropouts N= 8. CDI 1 = Child-Directed Interaction first coaching session; d= Cohen ’sd. TABLE 6 Coaching Techniques in CDI 1 for Treatment Completers and Dropouts Completers Dropouts M SD M SD F(1, 38) p η2 p Total Directive 51.56 26.98 68.86 24.41 2.73 .11 .07 Modeling 21.98 17.94 36.43 20.20 1.84 .18 .05 Prompting 2.70 3.86 1.57 1.62 0.15 .70 .00 Indirect Command 13.00 10.04 14.43 11.77 0.12 .73 .00 Direct Command 9.18 6.52 11.14 11.14 3.33 .08 .08 Child Observation 4.68 4.58 4.71 3.77 0.01 .94 .00Drills 0.02 0.15 1.57 1.13 3.82 .06 .09 Total Responsive 65.58 19.18 54.38 17.47 4.57 .04 .11 Labeled Praises 44.36 16.17 37.86 14.92 3.36 .08 .08 Process Comments 2.91 2.43 2.00 2.00 0.51 .48 .01Reflective Descriptions 3.64 3.58 5.29 3.95 0.27 .61 .01 Unlabeled Praises 14.32 8.03 9.86 6.36 1.73 .20 .04Corrective Criticism 1.39 2.41 2.43 3.95 0.57 .46 .02 Note : Completers N= 43. Dropouts N= 8. Estimated marginal means used in analyses, with unadjusted means reported for clarity. CDI 1 = Child-Directed Interaction first coaching session; η2 p= partial = partial eta-squared. 900 BARNETT ET AL. recommendations based on our findings regarding optimal coaching techniques and the training of PCIT therapists should be made with caution. Although the aim of this study was not to investigate system-level factors that supported family reten- tion, it may be that the engagement strategies of the clinical team (e.g., flexible scheduling, motivation enhancement state- ments) positively impacted retention. These strategies were similar to those implemented in other evaluations of PCIT with higher attrition (e.g., Niec, Barnett, Prewett, & Shanley, 2015 ) but deserve additional attention in the future.

This study has begun to address how therapist coaching impacts parental engagement, but further work is needed to better understand what is likely to be a bidirectional in flu- ence between therapists ’and parents ’behaviors. Previous research suggests that parental resistance might lead thera- pists to become more directive or confrontational, which in turn can lead to more resistance from the parent and even- tual dropout (Patterson & Forgatch, 1985 ). In PCIT, parents who independently generate fewer skills or who are resistant to therapist coaching may elicit more directive statements and corrective criticisms and fewer responsive statements from therapists. In our sample, treatment completers began CDI 1 with signi ficantly higher skills in two parenting behaviors (behavior descriptions, questions). It is possible that this difference impacted therapist behaviors, which in turn may have impacted the parents ’engagement. Finally, coaching in CDI 1 is somewhat different from later coach- ing sessions in that coaches are recommended to avoid correcting parents to keep the experience positive (Eyberg & Funderburk, 2011 ). Sequential coding of therapist and parent behaviors in PCIT coaching across sessions would help to illuminate how different coaching techniques impact parental engagement in the moment and over time.

Implications Within the first 10 min of the first PCIT coaching session, signi ficant differences in therapists ’in vivo feedback techni- ques existed between families who completed treatment and those who did not, and also predicted the speed with which parents acquired the child-cent ered interaction skills. Although it is striking that such a short segment of early therapist –parent interactions can have a signi ficant association with engage- ment, these findings are consistent with past research of non- coaching interactions. Therapist verbalizations in 30 min of early PCIT sessions correctly predicted family attrition (Harwood & Eyberg, 2004 ). It appears that the therapist –parent interactions arising in the earliest moments of treatment may be important indicators of the ultimate success of treatment. This study further supports the TPICS as a valuable psy- chometric tool that can be used both to investigate important therapeutic processes and to guide PCIT training. To provide the most effective training for therapists, it is valuable to have the ability to (a) understand the empirical links between coaching techniques and treatment outcome, (b) reliably identify the coaching techniques used by PCIT trainees, and (c) evaluate changes in trainees ’ coaching over time. Consistent with previous research (Barnett, Niec, & Acevedo-Polakovich, 2013 ) and expert recommendations (Eyberg & Funderburk, 2011 ), our findings suggest that responsive coaching is a critical skill for therapists to master.

Although directive techniques are likely also valuable teach- ing tools for parents, our study suggests that these techniques may need to be balanced with a high level of responsiveness to maintain parent engagement. The identi fication of therapist behaviors that promote parents ’skill acquisition is important, as it may help to move families more quickly through treat- ment. Future studies investigating the utility of the TPICS as a therapist training tool may also play a part in improving treatment outcomes for families in community settings. FUNDING Funding for this project was provided by The Children ’s Trust. REFERENCES Abidin, R. R. (1995). Parenting stress index: Professional manual (3rd ed.). Odessa, FL: Psychological Assessment Resources.Barnett, M. L., Niec, L. N., & Acevedo-Polakovich, I. D. (2013). Assessingthe key to effective coaching in parent –child interaction therapy: The therapist –parent interaction coding system. 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