Child Maltreatment Articles
Child Maltreatment Articles
Domestic Violence Articles
Child-Adult Relationship Enhancement Article
Child Maltreatment Articles
Parent-Child Interaction Therapy for sexual concerns of maltreated children: A preliminary investigation
Allen, B., Timmer, S. G., & Urquiza, A. J. (2016). Parent-Child Interaction Therapy for sexual concerns of maltreated children: A preliminary investigation. Child Abuse & Neglect, 56, 80-88. https://doi.org/10.1016/j.chiabu.2016.04.008
Abstract: The current study examines whether an evidence-based treatment for externalizing behavior problems may reduce sexual concerns among children with maltreatment histories. An archival analysis identified 44 children between the ages of 3 and 8 exhibiting externalizing problems and co-morbid sexual concerns who were treated using Parent-Child Interaction Therapy (PCIT). A second group of children receiving PCIT for externalizing behaviors without sexual concerns was included for comparison purposes (n=143). Wilcoxon Signed-Ranks Tests indicated significant improvement among the group with sexual concerns, with 63.6% of children no longer displaying clinically significant sexual concerns at post-treatment. In addition, these children showed a decline in general externalizing problems comparable to that observed among the group of children receiving PCIT and not displaying sexual concerns. Lastly, logistic regression analyses showed that pre-treatment posttraumatic stress scores did not moderate improvement of sexual concerns, suggesting that posttraumatic stress-related sexual concerns may improve from PCIT treatment. These findings suggest that evidence-based parent training interventions, specifically PCIT, may successfully reduce sexual concerns among children who experienced maltreatment.
Keywords: PCIT; Child Maltreatment; Sexual Behavior; Sexual Concerns; Externalizing Problems ;Sexual Abuse; Post-traumatic Stress.
Preventing maltreatment with a community-based implementation of Parent-Child Interaction Therapy
Lanier, P., Kohl, P. L., Benz, J., Swinger, D., & Drake, B. (2014). Preventing maltreatment with a community-based implementation of Parent-Child Interaction Therapy. Journal of Child & Family Studies, 23, 449-460. https://doi.org/10.1007/s10826-012-9708-8
Abstract: The purpose of this study was to examine rates of child abuse and neglect reports following a community implementation of Parent-Child Interaction Therapy (PCIT), an evidence-supported intervention for the prevention of maltreatment. Among a group of families receiving PCIT, predictors of reports were examined including family demographics, course of treatment, changes in clinical measures, and caregiver report for prior maltreatment victimization and perpetration. Participants (n=120) included families at-risk for future maltreatment with and without prior maltreatment history. Agency case records were linked with state administrative records of child welfare reports. Time to follow-up ranged from 13-40 months. Bivariate and multivariate survival analyses are used to model risk for a later report. During the follow-up period, 12.5% of families had a report for physical abuse or neglect. Reports of prior victimization as a child and prior perpetration as an adult were strong predictors of a report of perpetration after PCIT. Dosage of PCIT and change in clinical measures did not increase risk for a later report. PCIT can be an effective intervention for preventing maltreatment. Family history of child welfare involvement is a prominent factor in assessing risk for future involvement.
Keywords: PCIT; Child Maltreatment; Prevention; Child Behavior; Follow-up Studies
Disseminating child maltreatment interventions: Research on implementing evidence-based programs
Self-Brown, S., Whitaker, D., Berliner, L., & Kolko, D. (2012). Disseminating child maltreatment interventions: Research on implementing evidence-based programs. Child Maltreatment, 17, 5-10. https://doi.org/10.1177/1077559511436211
Abstract: Evidence-based practices (EBPs) have the promise to reduce child maltreatment andimprove the lives of countless families and children, but effective implementation entailsmany challenges. Efficacious interventions now exist for parents at risk for or who haveperpetrated maltreatment (i.e., Chaffin et al., 2004; Chaffin, Hecht, Bard, Silovsky, &Beasley, in press; Kolko, Iselin, & Gully, 2011; Prinz, Sanders, Shapiro, Whitaker, &Lutzker 2009; Webster-Stratton, 2010) and for youth victimized by maltreatment (Cohen,Mannarino, Berliner, & Deblinger, 2000; Deblinger & Heflin, 1996). Despite thedevelopment of such programs, many families involved in the child welfare and foster caresystems are not provided interventions or services with strong empirical support (Barth etal., 2005; Hurlburt, Barth, Leslie, Landsverk, & McCrae. 2007). For example, whileparenting interventions are virtually de rigueur on service plans, extant parenting servicesoften consist of didactic classroom-centered parent training or mix systems therapy and casemanagement that bear little resemblance to the evidence-based parent behavior managementprograms that are proven effective (Barth et al., 2005; Casanueva, Martin, Runyan, Barth, &Bradley, 2007).
Keywords: PCIT; Child Maltreatment; Dissemination; Implementation; Evidence-based Child Maltreatment Programs
Parent–Child Interaction Therapy: An Evidence-Based Treatment for Child Maltreatment
Thomas, R., &Zimmer-Gembeck, M. J.(2012). Parent–Child Interaction Therapy: An evidence-based treatment for child maltreatment. Child Maltreatment, 17, 253-266.
Abstract: It is common practice to augment efficacious treatment protocols for special populations (Durlak & DuPre, 2008), but this is often done before establishing that standard services are not appropriate. In this randomized controlled trial with families at risk or with a history of maltreatment (N ¼ 151), we investigated the effectiveness of standard 12-session Parent–Child Interaction Therapy (PCIT). This is in contrast to other PCIT studies with similar parents, which have allowed for longer and sometimes variable treatment length and with modifications to PCIT protocol. After treatment and compared to Waitlist, mothers reported fewer child externalizing and internalizing behaviors, decreased stress, and were observed to have more positive verbalizations and maternal sensitivity. These outcomes were equivalent or better than outcomes of our previous PCIT trial with high-risk families (Thomas & Zimmer-Gembeck, 2011) when treatment length was variable and often longer. These findings support standard protocol PCIT as an efficacious intervention for families in the child welfare system.
Keywords: PCIT; Child Maltreatment; Evidence-based treatment; Intervention Research
A combined motivation and Parent-Child Interaction Therapy package reduces child welfare recidivism in a randomized dismantling field trial
Chaffin, M., Funderburk, B., Bard, D., Valle, L. A., & Gurwitch, R. (2011). A combined motivation and Parent-Child Interaction Therapy package reduces child welfare recidivism in a randomized dismantling field trial. Journal of Consulting and Clinical Psychology, 79, 84-95.
Abstract: A package of parent– child interaction therapy (PCIT) combined with a self-motivational (SM) orientation previously was found in a laboratory trial to reduce child abuse recidivism compared with services as usual (SAU). Objectives of the present study were to test effectiveness in a field agency rather than in a laboratory setting and to dismantle the SM versus SAU orientation and PCIT versus SAU parenting component effects. Method: Participants were 192 parents in child welfare with an average of 6 prior referrals and most with all of their children removed. Following a 2 2 sequentially randomized experimental design, parents were randomized first to orientation condition (SM vs. SAU) and then subsequently randomized to a parenting condition (PCIT vs. SAU). Cases were followed for child welfare recidivism for a median of 904 days. An imputation-based approach was used to estimate recidivism survival complicated by significant treatment-related differences in timing and frequency of children returned home. Results: A significant orientation condition by parenting condition interaction favoring the SM PCIT combination was found for reducing future child welfare reports, and this effect was stronger when children were returned to the home sooner rather than later. Conclusions: Findings demonstrate that previous laboratory results can be replicated in a field implementation setting and among parents with chronic and severe child welfare histories, supporting a synergistic SM PCIT benefit. Methodological considerations for analyzing child welfare event history data complicated by differential risk deprivation are also emphasized.
Keywords: PCIT; Child Maltreatment; Parenting; Child Abuse; Child Neglect.
Change trajectories for parent-child interaction sequences during Parent-Child Interaction Therapy for child physical abuse
Hakman, M., Chaffin, M., Funderburk, B., Silovsky, J. F. (2009). Change trajectories for parent-child interaction sequences during Parent-Child Interaction Therapy for child physical abuse. Child Abuse & Neglect, 33, 461-470. https://doi.org/10.1016/j.chiabu.2008.08.003
Abstract: Parent-child interaction therapy (PCIT) has been found to reduce future child abuse reports among physically abusive parents. Reductions in observed negative parenting behaviors mediated this benefit. The current study examined session-by-session interaction sequences in order to identify when during treatment these changes occur and how much the trajectory varies from case-to-case.
Keywords: PCIT; Child Maltreatment; physical abuse; treatment; parent-child interactions; Dyadic Parent Child Interaction Coding System.
Parent-Child Interaction Therapy: Application to maltreating parent-child dyads
Timmer, S. G., Urquiza, A. J., Zebell, N. M., & McGrath, J. M. (2005). Parent-Child Interaction Therapy: Application to maltreating parent-child dyads. Child Abuse & Neglect, 29, 825-847. https://doi.org/10.1016/j.chiabu.2005.01.003
Abstract: Objective: Parent-Child Interaction Training (PCIT), which uses a social learning framework, is a dyadic intervention that is designed to alter specific patterns of interaction found in parent-child relationships. Previous research suggests that maladaptive and high-risk characteristics found in maltreating parent-child dyads may be responsive to PCIT. The primary focus of this study is to examine the effectiveness of PCIT with maltreating parent-child dyads.
Methodology: This study describes the effectiveness of PCIT with 136 biological parent-child dyads in which 66.9% (N= 91) of the children had been maltreated. Of the 91 maltreated children, 64.8% (N= 59) of the parents had maltreated their children, and were thus considered to be at high risk of repeating the abuse.
Results: Primary outcomes of this study show the following: (1) a decrease in child behavior problems, (2) a decrease in parental stress, and (3) a decrease in abuse risk from pre- to post-treatment for dyads with and without a history of maltreatment.
Conclusions: Our results add to the body of research supporting PCIT as a promising intervention and as a means to aid both children and parents in high-risk families for maltreatment.
Keywords: PCIT; Child Maltreatment; Parent-Child interaction; Therapy; treatment outcomes.
Herschell, A.D., & McNeil, C.B. (2005). Theoretical and empirical underpinnings of Parent-Child Interaction Therapy with child physical abuse populations. Treatment of Children, 28, 142-162.
Abstract: Children who experience physical abuse often suffer numerous negative short- and long-term difficulties in comparison to non-abused children. Considerable effort has been invested in developing and identifying treatment interventions to attenuate these negative outcomes. Parent-Child Interaction Therapy (PCIT), originally developed for the treatment of externalizing behavior problems in children aged two to seven years, has also been used to treat child physical abuse populations. The results of emerging treatment outcome studies indicate that PCIT is a promising treatment approach for child physical abuse. This article will review the theoretical rationale for applying PCIT to physically abusive parent-child dyads as well as provide details on the clinical modification made to PCIT for this population. Emerging treatment outcome studies will be critiqued and future research directions will be highlighted.
Keywords: PCIT; Child Maltreatment; treatment; parent-child dyad.
Parent-Child Interaction Therapy with physically abusive parents: Efficacy for reducing future abuse reports
Chaffin, M., Silovsky, J. F., Funderburk, B., Valle, L. A., Brestan, E. V., Balachova, T., Jackson, S., Lensgraf, J., & Bonner, B. L. (2004). Parent-Child Interaction Therapy with physically abusive parents: Efficacy for reducing future abuse reports. Journal of Consulting and Clinical Psychology, 72, 500-510.
Abstract: A randomized trial was conducted to test the efficacy and sufficiency of parent-child interaction therapy (PCIT) in preventing re-reports of physical abuse among abusive parents. Physically abusive parents (N=110) were randomly assigned to one of three intervention conditions: (a) PCIT, (b) PCIT plus individualized enhanced services, or (c) a standard community-based parenting group. Participants had multiple past child welfare reports, severe parent-to-child violence, low household income, and significant levels of depression, substance abuse, and antisocial behavior. At a median follow-up of 850 days, 19% of parents assigned to PCIT had a re-report for physical abuse compared with 49% of parents assigned to the standard community group. Additional enhanced services did not improve the efficacy of PCIT. The relative superiority of PCIT was mediated by greater reduction in negative parent-child interactions, consistent with the PCIT change model.
Keywords: Adult; Child; Child Abuse; Female; Forecasting; Humans; Male; Parent-Child Relations
Physically abusive mothers' responses following episodes of child noncompliance and compliance
Borrego, J., Jr., Timmer, S. G., Urquiza, A. J., & Follette, W. C. (2004). Physically abusive mothers' responses following episodes of child noncompliance and compliance. Journal of Consulting and Clinical Psychology, 72(5), 897–903. https://doi.org/10.1037/0022-006X.72.5.897
Abstract: The authors used sequential analysis to examine specific interaction patterns between physically abusive mothers and their children following episodes of noncompliance and compliance. Fifteen abusive and 15 nonabusive, low-risk mother-child dyads were observed, and their behaviors were coded for specific interactions. The children in the study ranged in age from 2 to 6 years. Results indicated that after noncompliance occurred, physically abusive mothers were more likely than nonabusive mothers to respond negatively and give another command. When child compliance occurred, there were no group differences in the likelihood of praising their children's prosocial behavior, but physically abusive mothers were less likely than nonabusive mothers to engage in other forms of positive behavior (e.g., positive touch) after compliance. Clinical implications are discussed in the context of working with physically abusive families.
Clinical issues in Parent-Child Interaction Therapy
Herschell, A. D., Calzada, E. J., Eyberg, S. M., & McNeil, C. B. (2002). Clinical issues in Parent-Child Interaction Therapy. Cognitive and Behavioral Practice, 9, 16-27. https://doi.org/10.1016/S1077-7229(02)80035-9
Abstract: The scientist-practitioner model depends on the interplay of research and clinical work. Just as research informs and improves clinical practice, clinical practice leads to the generation of important and practical research questions. The purpose of this article is to describe the clinical application of Parent-Child Interaction Therapy (PCIT), detailing its essential clinical components and presenting a case example that illustrates the application of PCIT to the treatment of child physical abuse. Recommendations for common implementation difficulties are presented through the case example.
Keywords: : PCIT; Child Maltreatment.
Parent-Child Interaction Therapy with a family at high risk for physical abuse
Borrego, J., Urquiza A. J., Rasmussen R. A. & Zebell, N. (1999). Parent-Child Interaction Therapy with a family at high risk for physical abuse. Child Maltreatment, 4, 331-342. https://doi.org/10.1177/1077559599004004006
Abstract: The use of empirically validated treatments with physically abusive and at-risk families continues to be an issue requiring further clinical and research attention. This single-case study discusses the effectiveness of Parent-Child Interaction Therapy (PCIT) with a mother-child dyad considered to be at high risk for physical abuse. Although PCIT is effective with different populations and in different settings, no study to date has demonstrated the effectiveness of PCIT with physically abusive families or families at risk for physical abuse. Data are presented from behavioral observations and standardized measures. Results suggest that PCIT was effective in reducing the child's behavior problems and the mother's stress. and increasing the number of positive parent-child interactions. Finally, implications for future clinical and research work on physically abusive and at-risk families are discussed.
Keywords: PCIT; Abuse; At-risk families; mother-child dyad; behavior problems.
Parent-Child Interaction Therapy: An intensive dyadic intervention for physically abusive families
Urquiza, A. J., & McNeil, C. B. (1996). Parent-Child Interaction Therapy: An intensive dyadic intervention for physically abusive families. Child Maltreatment, 1, 134-144. https://doi.org/10.1177/1077559596001002005
Abstract: A designated priority in the field of child maltreatment is the development of empirical approaches for treating abusive families. This article describes parent-child interaction therapy (PCIT), an intervention that has been shown to be effective for helping parents manage young children with severe behavioral problems. The potential application of this treatment program to the child maltreatment field is examined by (a) providing a social learning perspective to explain the development and stability of some physically abusive parent-child relationships, (b) outlining the effectiveness of PCIT with similar populations, and (c) discussing the unique benefits that PCIT may offer the field of child maltreatment. The limitations of PCIT with physically abusive families are also discussed.
Keywords: PCIT; Child Maltreatment
Domestic Violence Articles
Feasibility and effectiveness of Parent-Child Interaction Therapy with victims of domestic violence: A pilot study
Herschell, A. D., Scudder, A. B., Schaffner, K. F., & Slagel, L. A. (2017). Feasibility and effectiveness of Parent-Child Interaction Therapy with victims of domestic violence: A pilot study. Journal of Child and Family Studies, 26, 271-283. https://doi.org/10.1007/s10826-016-0546-y
Abstract: Parent–Child Interaction Therapy is an evidence-based treatment for young children (aged 2.5–7 years) with externalizing behavior problems. Since its development, Parent–Child Interaction Therapy has been applied to a wide array of childhood problems and has a significant evidence base for families with histories of child physical abuse. The current study extended the existing literature by testing the effectiveness and feasibility of Parent–Child Interaction Therapy in an urban domestic violence shelter with community-based clinicians delivering the treatment. Seven clinicians implemented Parent–Child Interaction Therapy with parent–child dyads, which included 21 preschool (M= 4.57 years; SD = 1.50) children. Families completed assessments at baseline, mid-treatment, and posttreatment. Nine families completed Parent–Child Interaction Therapy (43 %). Completion of Parent–Child Interaction Therapy was associated with improved child behavior, parenting practices, and mental health symptoms. Considerations for treatment delivery and future directions are discussed.
Keywords: PCIT; Child Maltreatment; Domestic Violence; Interpersonal Violence; Aggression; Treatment Effectiveness; Dyadic Parent Child Interaction Coding System; Externalizing Disorders.
A domestic violence shelter parent training program for mothers with young children
Keeshin, B. R., Oxman, A., Schindler, S., & Campbell, K. A. (2015). A domestic violence shelter parent training program for mothers with young children. Journal of Family Violence, 30, 461-466.
Abstract: Eight mother-child dyads living at an urban domestic violence extended stay shelter participated in a parent training program modeled on the Child Directed Interaction (CDI) component of Parent Child Interaction Therapy (PCIT). The goal of this study is to report mother’s capacity to learn and practice the parenting skills taught in the model while living in the shelter environment. Labeled praises, behavioral descriptions, and reflections were coded as positive comments and criticisms, commands and questions were coded as negative comments during the first 5 min of each session. Positive comments increased from a median of five positive comments during the first session to 30 positive comments at their last session for a median increase of 17.5 positive comments between the first and last sessions. A significant decrease in the use of negative comments was also observed. Mothers demonstrated an increased capacity for using positive comments and an ability to omit negative comments during individual coaching sessions with their children. Further research on the acceptability, practicality, and efficacy of parent training programs in extended stay domestic violence shelters for mothers with young children is warranted.
Keywords: PCIT; Child Maltreatment; Child Abuse Prevention; Parent Child Interaction Therapy; Homeless; Therapy Adaptation; Child Behaviors.
The effectiveness of Parent-Child Interaction Therapy for victims of interparental violence
Timmer, S. G., Ware, L. M., Urquiza, A. J., & Zebell, N. M. (2010). The effectiveness of Parent-Child Interaction Therapy for victims of interparental violence. Violence and Victims, 25, 486-503.
Abstract: This study compares the effectiveness of Parent-Child Interaction Therapy (PCIT) in reducing behavior problems (e.g., aggression, defiance, anxiety) of 62 clinic-referred, 2- to 7-year-old, maltreated children exposed to interparental violence (IPV) with a group of similar children with no exposure to IPV (N=67). Preliminary analyses showed that IPV-exposed dyads were no more likely to terminate treatment prematurely than non IPV-exposed dyads. Results of repeated-measures MANCOVAs showed significant decreases in child behavior problems and caregivers' psychological distress from pre- to posttreatment for IPV-exposed and IPV nonexposed groups, and no significant variation by exposure to IPV. Stress in the parent role related to children's difficult behaviors and the parent-child relationship decreased from pre- to posttreatment, but parental distress did not decrease significantly over the course of PCIT. Results of an analysis testing the benefits of a full course of treatment over the first phase of treatment showed that dyads completing the full course of treatment reported significantly greater improvements in children's behavior problems than those receiving only the first phase of treatment.
Keywords: PCIT; Child Maltreatment; Clinical Disorders; Externalizing Disorders; Internalizing Disorders; Interparental Violence; Treatment Outcomes.
Parent-Child Interaction Therapy with domestic violence populations
Borrego, J., Gutow, M., Reicher, S., & Barker, C. (2008). Parent-Child Interaction Therapy with domestic violence populations. Journal of Family Violence, 23, 495-505. https://doi.org/10.1007/s10896-008-9177-4
Abstract: Domestic violence continues to be a significant social problem impacting our society. Battered women and their children experience a myriad of negative consequences as a result of domestic violence. Of the possible negative sequelae that mothers and children experience, the disrupted parent-child relationship has received relatively little attention in the literature. Though psychosocial interventions are available to treat women who experience violence and children who witness violence, few interventions focus on the parent-child relationship. This article describes parent-child interaction therapy (PCIT) has unique characteristics that make it a promising intervention with this population. A rationale for the use of PCIT with battered women and their child is presented.
Keywords: PCIT; Parental Factors; Domestic Violence; Parent-Child Relationships.
Child-Adult Relationship Enhancement
Child-Adult Relationship Enhancement (CARE): An evidence-informed program for children with a history of trauma and other behavioral challenges
Gurwitch, R. H., Messer, E. P., Masse, J., Olafson, E., Boat, B. W., & Putnam, F. W. (2016). Child-Adult Relationship Enhancement (CARE): An evidence-informed program for children with a history of trauma and other behavioral challenges. Child Abuse & Neglect, 53, 138-45.
Abstract: Child maltreatment impacts approximately two million children each year, with physical abuse and neglect the most common form of maltreatment. These children are at risk for mental and physical health concerns and the ability to form positive social relationships is also adversely affected. Child Adult Relationship Enhancement (CARE) is a set of skills designed to improve interactions of any adult and child or adolescent. Based on parent training programs, including the strong evidence-based treatment, Parent-Child Interaction Therapy (PCIT), CARE was initially developed to fill an important gap in mental health services for children of any age who are considered at-risk for maltreatment or other problems. CARE subsequently has been extended for use by adults who interact with children and youth outside of existing mental health therapeutic services as well as to compliment other services the child or adolescent may be receiving. Developed through discussions with Parent-Child Interaction Therapy (PCIT) therapists and requests for a training similar to PCIT for the non-mental health professional, CARE is not therapy, but is comprised of a set of skills that can support other services provided to families. Since 2006, over 2000 caregivers, mental health, child welfare, educators, and other professionals have received CARE training with a focus on children who are exposed to trauma and maltreatment. This article presents implementation successes and challenges of a trauma-informed training designed to help adults connect and enhance their relationships with children considered at-risk.
Keywords: PCIT; Child-Adult Relationship Enhancement (CARE); Evidence-Informed; Parent-Child Interaction Therapy; Child Maltreatment; Child Behavior Problems; Implementation; Dissemination.