Impact of an 8-Week, Intensive Summer Treatment Program on Improving Coercive Caregiver-Child Interactions Among Children With and Without Callous Unemotional Traits

The coercive process is the primary explanatory mechanism implicated in the maintenance of disruptive behavior disorders (DBDs), and understanding the coercive cycle may be especially important for caregivers with children with elevated callous-unemotional (CU) traits. The purpose of the current pilot study is twofold. First, we assessed whether the Summer Treatment Program (STP), an established intensive behavioral intervention for children with DBDs, reduced coercive caregiver-child interactions using a novel parent-report measure of coercive interactions. We then sought to assess whether the STP improved coercive caregiver-child interactions among children with elevated CU traits (i.e., moderated the effect). Thirty-three caregivers and their children who had been diagnosed with DBDs participated in the STP, which involved the children receiving behavior modification for 9 hours per day and caregivers attending a weekly behavioral parent training group session over the course of 8 weeks. Children (M_age = 8.51 years old, SD = 1.70, range 6–12) were primarily male (78.5%) and Hispanic/Latine (84.8%). A linear multilevel model revealed a statistically significant improvement in caregiver-child coercive interactions from pre- to posttreatment. However, child pretreatment CU traits moderated this effect such that families with children with elevated CU traits did not show improvement in caregiver-child coercive cycles following treatment. Results suggest the benefits of intensive behavioral treatment on the caregiver-child coercive cycle for many families, but the need to modify the intensity or dose of treatments for those with children with DBDs and elevated CU traits.