Clinic observations of structured parent-child interaction designed to evaluate externalizing disorders

Observing structured parent-child interaction in clinic analogs has been a tradition in child clinical assessment since the 1960s. The clinic analog is designed to re-create important conditions from natural contexts such that dysfunctional parent-child patterns can be observed and modified. To those basic goals, the modern clinician would add diagnosis and treatment evaluation. Three classes of parent-child clinic analogs designed to evaluate preadolescent children with externalizing disorders were reviewed: free play, parent-directed play, and parent-directed chores. Free-play analogs and parent-directed chore analogs were found to have merit, but remain psychometrically underdeveloped. Practitioner reliance on questionnaires and interviews appears likely to continue until observational analogs have attained sufficient psychometric qualities to facilitate routine clinical decisions.