Understanding treatment effectiveness for aggressive youth: the importance of regulation in mother-child interactions.

Reviews summarizing hundreds of studies cite parent management training (PMT) and cognitive-behavior therapy (CBT) as some of the most effective interventions for aggressive youth. However, studies continue to report variability in outcomes, and researchers have yet to understand why certain interventions only produce behavior change in some children. Using a clinical sample of 57 children (53 boys, 4 girls; mean age = 9.33, standard deviation = 1.16) and their mothers enrolled in a combined PMT/CBT program, the current study examined the relation between changes in real-time mother-child interactions, and children's externalizing outcomes from pre- to posttreatment. Results showed that dyads who were regulated in their interactions over time reported greater reductions in externalizing symptoms from pre- to posttreatment as compared with dysregulated dyads. Changes in mean levels of affective content (e.g., negativity) were not associated with externalizing outcomes. Findings suggest that dyadic regulation may be an important process associated with treatment success for aggressive youth.