UC Santa Barbara

Behavioral parent training programs are effective interventions in addressing a wide range of child behavior problems. Historically, these interventions have engaged a narrowly defined conception of caregivers, focusing on biological mothers, in part due to limited guidance on how to engage other caregivers and utilize their reports of child behavior problems in clinical decision making. Recent advances in methodological strategies to compare agreement between informants in the context of children’s mental health allow us to identify domain-relevant information in instances when disagreement between caregivers yields clinically-relevant information about the child in services. The current study utilized concordance as measured by difference scores and correlations between two caregiver ratings in the context of a parent-child interaction therapy (n = 57). Comparison between concordance at pre-treatment and post-treatment suggest that there was a significant increase in caregiver agreement over the course of treatment for the level of intensity of child behavior problems. Regression models, used to test effects of child and caregiver characteristics on pre- and post-treatment concordance, found that only secondary caregiver stress was significantly associated with caregiver disagreement. A final regression showed that there were no significant predictors in the change in agreement over the course of treatment. Findings provide preliminary evidence of domain-relevant information in regards to multiple caregiver ratings of child behavior problems. Clinical implications, including the importance of capturing when parents might be at risk for ending treatment in lower states of agreement, are discussed.