Authored by Caraline McDonnell, Program Assistant at The Center for Effective Therapy
Did you know that the phrase “time-out” is shorthand for “time out from positive reinforcement”?
“Time-out” is widely used to refer to a form of discipline used by caregivers when a child misbehaves. Oftentimes, families think of “time-out” as a consequence for their child’s misbehavior, where the child is removed from the space and told to “think about” their actions. However, evidence-based time-outs that have been proven to work look a little different.
In caregiver-based interventions, time-out takes on a consistent, respectful, and structured approach that involves the removal of the child from all types of reinforcement for a specified, short period of time as a direct result of misbehavior. The use of time-out is one strategy in a broader behavioral program that helps to create a warm and rewarding parent-child relationship, encourages self-regulation, and teaches children positive behaviors to replace problematic ones.
How do caregiver-based interventions work?
Caregiver-focused interventions begin with a phase of treatment that focuses on creating a strong and healthy parent-child bond through play, the use of labeled praises for good behavior, and positive relationship building strategies. In these interventions, parents are taught to manage most child behavior through positive attention alone, learning that attention is a superpower that can be harnessed for good!
With such a strong emphasis on increasing the frequency and potency of positive attention, the caregiver-child relationship is strengthened, and the relationship is healthier. Once these positive skills are established and well-practiced, parents are taught to use selective attention strategies such as time outs. At this point in treatment programs, the home environment is often overwhelmingly positive because of the focus on relationship building skills. Introducing time-out within this environment is effective because the absence of positive reinforcement is now very different from their usual interactions with the caregivers.
Time-outs used in caregiver-based interventions are different than what you might think of when you hear the term “time-out.” Therapists provide caregivers with very structured learning about time-out, including why we use time-out, and how to properly deliver the time-out sequence. Prior to any time-outs being given, the therapist will support a family in explaining what time-out is, and how it will be used, to the child in a way that they will understand. When learning how to deliver time-outs, the therapist will walk the caregivers through the steps to ensure that they learn how to use time-outs in a predictable and consistent manner, so that the child is familiar with what happens.
What does an effective time-out look like?
Caregivers are taught to give clear directions and praise to their children when directions are followed. If directions are not followed, caregivers are taught to give “time-out warnings” to their children so that they are aware of why they are getting a time-out and they have the choice to comply. When teaching time-out to caregivers, therapists stress the importance of remaining calm, using a neutral tone of voice, and following through with the time-out in a very structured way to make it safe and predictable for the child.
Time-out is designed to be boring for children, which makes it an effective tool for changing problem behaviors because kids generally do not like to be bored. During the time-out, all fun or distracting toys and items should be removed from the time-out area, and caregivers will be advised to avoid giving the child any attention. Time-out does not need to exceed 3 minutes for children between the ages of 2 and 7 to be effective, although it is important to wait to end time-out until they are able to stay quiet for a few seconds. Waiting until the child is regulated to end time-out helps teach kids that it ends once they are calm. This is one of the ways that time out is a secret emotion regulation strategy!
Once the initial time-out is over, children are directed to complete the original task that they were told to do. If they do not comply, they return to time-out. If they complete the task, they are praised for listening to directions, and the caregiver is coached to return to relationship-building skill. Through the return to these positive skills, children learn that positive behaviors are rewarded, that their caregiver will continue to treat them with respect even in the event of a misbehavior, and that consequences are consistent instead of being driven by emotion. This strategy helps to send a clear message that the caregiver supports the child, does not approve of specific behaviors, and they believe in the child’s ability to demonstrate positive behaviors in their place.
That sounds great, but why have I heard so many bad things about time-out?
Time Magazine has published two separate articles, in 2014 and 2016, where professionals argued that time-out can be damaging for children. Notably, the authors of the 2014 Time article recanted the majority of what they expressed in a Huffington Post release later, saying that they only wished to warn against the inappropriate use of time-outs in general. Even though they are not based in evidence, the Time articles have been widely associated with the growing rejection of time-out as a disciplinary strategy in the parenting community, especially for children who have attachment issues or trauma histories. We can see that message being expressed today through social media parenting influencers and misinformation on the Internet.
However, there is no scientific evidence to show that time-out is harmful for children. In fact, the support for time-out, as used in PCIT, Behavioral Parent Training, and other caregiver-based interventions, is overwhelmingly positive. Parent-based interventions have over 40 years of research behind their practices, demonstrating that when used in a structured manner and as part of a comprehensive parenting program, time-out is a safe and effective intervention. It has been shown that the time-out procedure can decrease both child conduct problems and the risk of abuse and neglect by caregivers.
Additionally, caregivers with histories of abuse are found to be less likely to use physical punishment once they have learned to use time-out in a safe, consistent, and predictable way. Caregiver-based interventions provide tools that help families manage conflict and discipline in a controlled and calm way, providing an alternative to emotion-based reactions and discipline that can often escalate in a moment of frustration.
What treatments teach effective time outs?
Effective time-outs are taught in a handful of caregiver-based treatments, and your clinician will choose the treatment approach most appropriate for your child’s age. Caregivers of younger kids, ages 2-7 years old, often engage with Parent-Child Interaction Therapy (PCIT). Caregivers of kids older than 7 years will often engage with a Behavioral Parent Training (BPT) approach such as “Defiant Child” or “Defiant Teens” based on their developmental stage. These research-based interventions all use the same core strategies of improving the parent-child relationship and structuring consequences with time-out, but they are designed to be developmentally appropriate and specific for each age group.
Want to learn more? Contact our Center for Effective Therapy
Sources
“What Is Time-Out?” Centers for Disease Control and Prevention, 5 Nov. 2019, www.cdc.gov/parents/essentials/toddlersandpreschoolers/timeout/whatistimeout.html.
“Truths about Time Out.” PCIT.Org, 29 Aug. 2017, www.pcit.org/pcit-blog/truths-about-time-out.
“PCIT International Position Statement on Time-Out.” PCIT.Org, 8 Mar. 2018, www.pcit.org/pcit-blog/pcit-international-position-statement-on-time-out.
Woodfield, M.J., Cartwright, C. Parent-Child Interaction Therapy from the Parents’ Perspective. J Child Fam Stud 29, 632–647 (2020). https://doi.org/10.1007/s10826-019-01611-5
Dadds MR, Tully LA. What is it to discipline a child: What should it be? A reanalysis of time-out from the perspective of child mental health, attachment, and trauma. Am Psychol. 2019 Oct;74(7):794-808. doi: 10.1037/amp0000449. Epub 2019 Feb 25. PMID: 30802080.