Abstract
Time-out is a component of many evidence-based parent training programmes for the treatment of childhood conduct problems. Existing comprehensive reviews suggest that time-out is both safe and effective when used predictably, infrequently, calmly and as one component of a collection of parenting strategies—i.e., when utilised in the manner advocated by most parent training programmes. However, this research evidence has been largely oriented towards the academic community and is often in conflict with the widespread misinformation about time-out within communities of parents, and within groups of treatment practitioners. This dissonance has the potential to undermine the dissemination and implementation of an effective suite of treatments for common and disabling childhood conditions. The parent-practitioner relationship is integral to the success of Parent-Child Interaction Therapy (PCIT), an evidence-based treatment which involves live coaching of parent(s) with their young child(ren). Yet this relationship, and practitioner perspectives, attitudes and values as they relate to time-out, are often overlooked. This practitioner review explores the dynamics of the parent-practitioner relationship as they apply to the teaching and coaching of time-out to parents. It also acknowledges factors within the clinical setting that impact on time-out’s use, such as the views of administrators and professional colleagues. The paper is oriented toward practitioners of PCIT but is of relevance to all providers of parent training interventions for young children.
Highlights
Parent training— known as Behavioural Parent Training or Parent ManagementTraining—is a term used to describe an empirically sound suite of programmes for the treatment of childhood conduct problems and other childhood psychopathology [1]
The intention is to consider the milieu within which time-out is situated in the clinical or treatment setting, and to highlight aspects of the literature that are of relevance to providers—a style of review which has been described as a practitioner review elsewhere e.g., [20]
Given that several recent high-quality reviews relating to time-out have been conducted, this paper aims to distil and apply these findings to the clinical context, with specific reference to time-out within Parent-Child Interaction Therapy (PCIT)
Summary
Training—is a term used to describe an empirically sound suite of programmes for the treatment of childhood conduct problems and other childhood psychopathology [1]. Time-out (technically, time-out from positive reinforcement) involves a brief preplanned withdrawal of parental attention (typically while the parent remains in the room) and restriction of access to desirable items such as toys, in response to a child’s defiance or non-compliance with a parent’s clear and fair instruction It is incorporated in the second phase of almost all of the prominent, evidence-based parent training interventions. Several recent reviews provide a useful and comprehensive overview of the empirical literature on time-out [12,15,16,17], including observation that “there is no empirical evidence for iatrogenic or harmful effects of time-out” [13] Despite this empirical evidence of time-out’s safety when used appropriately, the strategy remains one of the more divisive and technically challenging parenting techniques. In recent years there has been growing public concern around the safety and appropriateness of time-out [12,18], fuelled by articles in popular press publications and online material; these claims have been described as “wild and unsubstantiated, yet highly visible” [19]
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