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Engaging families in a Group Attachment Based Intervention (GABI): Treatment retention and parent-child relationships

Fri, March 22, 7:45 to 9:15am, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Dropout rates in the area of parent-child and family psychotherapies are of particular concern. This study assesses factors that identify families more and less likely to engage in treatment. The current report analyzed attendance rates for families referred to a Group Attachment-Based Intervention program (GABI), to identify factors that may contribute to treatment retention and allow for clinicians to better engage at-risk parents and children.

Participants included 98 parents (47% Hispanic, 28% African American, 23% Multiracial, 2% White) and their children (0-3 years of age), who attended an early intervention treatment program, Group Attachment Based Intervention (GABI), administered at Center for Babies, Toddlers, and Families (CBTF) in the Bronx, New York. The intervention was developed to treat vulnerable families due to concerns with the parent-child relationship and/or perceived risk for child abuse and neglect (Murphy et. al., 2015).

GABI is offered three times each week over the course of a 6-month treatment period. Overall, sessions attended ranged from 0-74% (mean=14%), with families attending 8 sessions on average. Reasons for dropout included unresponsive/lack of interest in treatment, relocation, or parental work/school conflict.

At baseline and end of treatment, families completed the Adverse Child Experiences Questionnaire (ACEs), a measure evaluating childhood trauma (Felitti et. al., 1998) and partook in a 10-minute free play session, which was assessed using the Coding Interactive Behavior (CIB) paradigm, a scheme rating interactions between adults and children (Feldman, 1998). 64 baseline and 43 end of treatment parent-child interactions were coded with the CIB system by trained graduate students. Additional demographic characteristics were assessed through psychosocial evaluations completed at intake.

Families who attend GABI more often were characterized at baseline by lower CIB scores in parental consistency of style, and child competent use of the environment. Additionally, higher scores in parental ignoring were associated with greater attendance, suggesting that problematic aspects within the parent-child relationship may motivate parents to attend GABI. Higher attendance also positively and significantly correlated with mothers’ experience of emotional abuse (ACEs) in childhood. Families who successfully completed GABI also demonstrated greater improvements in parent-child relationships.

Rates of attendance in terms of outcome: Those who successfully completed GABI exhibited more positive interactive behaviors compared to parents who participated in the control group, a parent education program. For example, families that completed GABI exhibited higher rates of dyadic reciprocity, than families in the control group, suggesting that dosage may be particularly important in interventions aimed at treating the parent-child relationship.
Gaining a better understanding of retention in parent-child psychotherapy is essential in improving treatment outcomes. Identifying potential risk factors at intake may allow clinicians to identify patients at greater risk for dropout.

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