(PS6-31) Time Out: Caregivers’ Willingness to Implement and Qualitative Reactions

Time Out is a strategy often taught in behaviorally based interventions, including Parent Management Training. Time Out has long-standing empirical evidence for its effectiveness and can be adapted to a variety of child ages, diagnoses, and behaviors. However, the acceptability of this strategy is complicated by negative perceptions of Time Out that are increasingly perpetuated through the internet and social media.

In this study, parents watched brief videos detailing six behavior management strategies (child-directed interaction, effective commands, praise/positive attention, ignoring, time out, and removal of privileges) and rated their willingness to implement each strategy using the Treatment Acceptability Rating Form – Revised (TARF-R). Participants were parents (N=109) of children ages 2-12 with borderline or clinically significant Externalizing scale scores on the Strengths and Difficulties Questionnaire (SDQ). Parents who reported prior participation in PMT or ABA were excluded.

Overall, parents rated their willingness to implement Time Out significantly lower than their willingness to implement the five remaining strategies. A one-way ANOVA indicated a statistically significant difference between at least two strategies at α = .05; F(5, 648) = 11.74, p < .001, partial η2 = 0.08. Tukey’s HSD post-hoc tests followed and revealed significant differences (p < .001) between the mean willingness to implement Time Out (M = 15.7, SD = 5.1) and the mean willingness to implement child-directed interaction (M = 17.8, SD = 2.9), effective commands (M = 18.3, SD = 2.7), praise/positive attention (M = 18.7, SD = 2.5), ignoring (M = 18.1, SD = 3.0), and response cost (M = 18.6, SD = 3.2). Differences between the remaining strategies were insignificant.

Parents who reported low willingness to implement Time Out were given the opportunity to explain their reluctance to use the strategy. Sixteen parents answered this open-response question. Upon qualitative review of responses, five themes emerged. Several parents referenced multiple themes in their response. Thirteen percent of parents indicated that the strategy would not be effective due to their own difficulty with implementation. Twenty five percent indicated negative prior history with the Time Out strategy. Twenty five percent indicated that Time Out is counter to their beliefs about their child’s behavior and needs. Thirty one percent reported that their child was “too old” for the Time Out strategy. Fifty percent reported low willingness to use Time Out due to the expectation that their child would react negatively and not comply with Time Out. Data collection is ongoing to increase the current sample size.

This study supports the need for assessment of parent beliefs, psychoeducation to address misconceptions, and alignment with parent values when clinicians introduce Time Out. Future studies should differentiate which willingness-limiting beliefs have the greatest impact on parent engagement and outcomes.