Time-out under scrutiny: examining the relationships among the discipline strategy time-out, child well-being and attachment and exposure to adversity

Br J Psychiatry. 2024 Dec 5:1-7. doi: 10.1192/bjp.2024.228. Online ahead of print.

Abstract

Background: Discipline is a crucial aspect of parenting, shaping child development and behaviour. Time-out, a widely used disciplinary strategy with a strong evidence-base, has recently come under scrutiny with concerns about potential adverse effects on children's emotional development and attachment, particularly for those with a history of adversity.

Aims: To contribute critical empirical insights to the current controversy surrounding time-out by exploring the associations among time-out implementation, parent-child attachment and child mental health, and whether adversity exposure moderated these associations.

Method: This cross-sectional study utilised a nationally representative sample of 474 primary caregivers in Australia, with children aged 6-8 years, who completed an online survey. Measures included the Implementation of Time-out Scale, Adverse Life Experiences Scale, Primary Attachment Style Questionnaire, Strengths and Difficulties Questionnaire and Spence Child Anxiety Scale.

Results: Appropriately implemented time-out was associated with enhanced mental health and attachment, while inappropriate time-out correlated with adverse child outcomes. Exposure to adversity moderated the relationship between time-out implementation and child well-being, such that children exposed to adversity were most likely to experience attachment enhancement from appropriately implemented time-out.

Conclusions: Despite recent concerns of harm caused by time-out, particularly for children with a history of adversity, findings support the beneficial impact of time-out on child well-being and attachment when implemented in accordance with evidence-based parameters. Combatting misinformation and disseminating evidence-based time-out guidelines is crucial for promoting child well-being and attachment, especially for children who have experienced adversity.

Keywords: Child and adolescent psychiatry; conduct disorders; mental health services; psychological treatments; trauma and stressor-related disorders.