Telehealth Services (iPCIT)
Home-based preventive parenting intervention for at-risk infants and their families: An open trial
Bagner, D. M., Rodríguez, G. M., Blake, C. A., & Rosa-Olivares, J. (2013). Home-based preventive parenting intervention for at-risk infants and their families: An open trial. Cognitive and Behavioral Practice, 20, 334-348.
Abstract: The purpose of this study was to examine the feasibility, acceptability, and initial outcome of a home-based adaptation of Parent-Child Interaction Therapy for at-risk infants with externalizing behavior problems. Seven 12- to 15-month-old infants and their families were recruited at a large pediatric primary care clinic to participate in a home-based parenting intervention to prevent subsequent externalizing behavior problems. Home-based assessments were conducted at baseline, postintervention, and a 4- to 6-month follow-up. Six of the 7 (86%) families completed the intervention, and all completers reported high satisfaction with the intervention. All of the mothers demonstrated significant improvements and statistically reliable changes in their interactions with their infant, and most reported clinically significant and statistically reliable changes in infant behavior problems. The current study provides preliminary support for the use of this brief, home-based parenting intervention in addressing behavior problems as early as possible to improve access to an intervention for at-risk infants and their families. Successes and challenges with the development and implementation of this intervention are discussed along with directions for future research and clinical practice.
Keywords: PCIT; Infant Studies; Infancy; Externalizing Behavior Problems; Prevention; Parenting; Risk.
Effectiveness of Parent-Child Interaction Therapy delivered to at-risk families in the home setting
Galanter, R., Self-Brown, S., Valente, J. R., Dorsey, S., Whitaker, D. J., Bertuglia-Haley, M., & Prieto, M. (2012). Effectiveness of Parent-Child Interaction Therapy delivered to at-risk families in the home setting. Child & Family Behavior Therapy, 34, 177-196.
Abstract: An evaluation was conducted for 83 parent-child dyads who participated in parent-child interaction therapy (PCIT) delivered in-home by community agency therapists. Data included self-report measures and therapist observations at baseline and post-treatment. Results indicated significant positive changes in child/parent behavior and parent attitudes for dyad completers. Overall, parents who completed in-home PCIT reported significantly more positive child outcomes than noncompleters and had a significantly lower risk of child abuse. Implications for implementing PCIT into community practice are discussed, including reducing barriers, in-home modifications, and model fidelity in practice with high-risk communities.
Keywords: : PCIT; Home Based Interventions; Child Abuse; Efficacy; In-Home; Parenting; Prevention.
Parent-Child Interaction Therapy in a community setting: Examining outcomes, attrition, and treatment setting
Lanier, P., Kohl, P. L., Benz, J., Swinger, D., Moussette, P., & Drake, B. (2011). Parent-Child Interaction Therapy in a community setting: Examining outcomes, attrition, and treatment setting. Research on Social Work Practice, 1, 689-698.
Abstract: The purpose of this study was to evaluate Parent-Child Interaction Therapy (PCIT) deployed in a community setting comparing in-home with the standard office-based intervention. Child behavior, parent stress, parent functioning, and attrition were examined. Using a quasi-experimental design, standardized measures at three time points were collected from parent-child dyads (n=120) with thirty-seven families completing treatment. Growth modeling analyses indicate significant improvements in child and parent outcomes in both treatment settings with more rapid improvements in parent outcomes within office-based treatment. Attrition was predicted by income and parent functioning. PCIT delivered in the community can produce measurable improvements. In-home PCIT is a feasible option but future research should consider benefits and costs. Treatment completion remains a challenge.
Keywords: PCIT; Attrition Studies; Child Welfare; Children; Community Intervention; Evidence-Based Practice; Intervention; Quantitative; Home Based Interventions.
Efficacy of adjunct in-home coaching to improve outcomes in Parent-Child Interaction Therapy
Timmer, S. G., Zebell, N. M., Culver, M. A., & Urquiza, A. J. (2009). Efficacy of adjunct in-home coaching to improve outcomes in Parent-Child Interaction Therapy. Research on Social Work Practice, 20, 36-45.
Abstract: The purpose of this study is to test whether increasing the exposure to coaching by adding an in-home component to clinic-delivered Parent–Child Interaction Therapy (PCIT) will increase the speed of parenting skill acquisition and show greater improvements in children’s behaviors and parental stress. Methods: Seventy-three parent–child dyads participating in clinic-based PCIT are randomly assigned to an adjunct PCIT or Social Support treatment group. The sample of children is 58% male and ranges in age from 1.7 to 8.2 years. Results: Analyses show that participation in adjunct PCIT services is associated with greater use of positive verbalizations and leads to improvement on measures of parent functioning. Conclusions: The meaning of these findings with respect to change and the process of treatment is discussed.
Keywords: PCIT; Home Based Interventions; Treatment Outcomes; Adjunct Services; In-Home Services.
Efficacy of in-home Parent-Child Interaction Therapy
Ware, L. M., McNeil, C. B., Masse, J., & Stevens, S. (2008). Efficacy of in-home Parent-Child Interaction Therapy. Child and Family Behavior Therapy, 30, 99-126.
Abstract: In recent years, there has been much discussion of the efficacy of mental health interventions for children as well as the transportation of empirically-supported treatements (ESTs) to field settings. A logical initial step in this line of research is to examine whether the efficacy of ESTs can be demonstrated in community settings such as in the home environment. The purpose of the study was to examine the efficacy of an in-home Parent-Child Interaction Therapy (PCIT) program using a single-subject. A/B design across five subjects with staggered baselines. Decreases in caregiver use of negative behavior and caregiver-reported child behavior problems were observed for the three families that completed treatment. In addition, completers demonstrated increases in child compliance, caregiver use of positive behavior, and contingent praise. Data regarding caregivers' reported parenting stress and caregiver proportion of direct commands were less convincing. All three dyads completing treatment reported satisfaction with the intervention. Clinical implications regarding the possible benefits of PCIT for improving the effectiveness of home visiting programs are discussed as well as directions for future research.
Keywords: PCIT; Home-Based Interventions; General Outcome Studies.
In-home Parent-Child Interaction Therapy: Clinical considerations
Masse, J. J., & McNeil, C. B. (2008). In-home Parent-Child Interaction Therapy: Clinical considerations. Child & Family Behavior Therapy, 30, 127-135.
Abstract: Parent-Child Interaction Therapy (PCIT) is an empirically-supported behavioral parent training program designed to be administered in a clinic or laboratory-based setting. Recently, an empirical investigation revealed that in-home PCIT produced comparable results as the PCIT trials conducted in more controlled environments (this issue). Administering PCIT in a home setting carries both drawbacks and advantages. This article provides an overview of both the positive and negative clinical aspects of conducting in-home PCIT and presents effective solutions to potential treatment barriers.
Keywords: PCIT; Home Based Interventions; Clinical Modifications; In-Home Treatment Model.
Adapting internet-delivered Parent-Child Interaction Therapy to treat co-occurring disruptive behavior and callous-unemotional traits: A case study
Fleming, G. E., Kimonis, E. R., Datyner, A., & Comer, J. S. (2017). Adapting internet-delivered Parent-Child Interaction Therapy to treat co-occurring disruptive behavior and callous-unemotional traits: A case study. Clinical Case Studies, 16, 1-18.
Abstract: Disruptive behavior disorders (DBD) are highly prevalent, emerge in early childhood, exhibit considerable stability across time, and are associated with profound disability. When DBD co-occur with callous-unemotional (CU) traits (i.e., lack of empathy/guilt), the risk of early-onset, stable, and severe disruptive behavior is even higher, relative to DBD alone. Early intervention is critical, and there is robust empirical support for the efficacy of parent management training (PMT) for reducing disruptive behavior in young children. However, broad access to these interventions is hindered by numerous systemic barriers, including geographic disparities in availability of services. To overcome these barriers and enhance access and quality of care to underserved communities, several PMT programs have been adapted to online delivery formats, including Parent-Child Interaction Therapy (PCIT). PCIT is an evidence-supported treatment that attempts to reduce disruptive child behavior by improving the parent-child relationship and implementing consistent and effective discipline strategies. Comer and colleagues proposed an online adaptation of PCIT (I-PCIT) that is delivered using video teleconferencing (VTC). I-PCIT was implemented with the family of a 5-year-old Australian boy presenting with clinically significant disruptive behavior and CU traits living in a rural community. Findings from this case report (a) document an improvement in disruptive behavior that was maintained to follow-up and (b) provide preliminary support for adapting PCIT to online delivery formats to enhance accessibility of services and improve child and parent outcomes.
Keywords: PCIT; Internet-Based PCIT (iPCIT); Model Adaptation Studies; International & Cultural Studies; Disruptive Behavior Disorders; Internet-based Treatment; Telemethods; Callous-unemotional Traits.
Rationale and considerations for the internet-based delivery of Parent–Child Interaction Therapy
Comer, J. S., Furr, J. M., Cooper-Vince, C., Madigan, R. J., Chow, C., Chan, P. T., Idrobo, F., Chase, R. M., McNeil, C. B., & Eyberg, S. M. (2015). Rationale and considerations for the internet-based delivery of Parent–Child Interaction Therapy. Cognitive and Behavioral Practice, 22, 302-316.
Abstract: Given the enormous individual, familial, and societal costs associated with early disruptive behavior disorders, transformative efforts are needed to develop innovative options for overcoming traditional barriers to effective care and for broadening the availability of supported interventions. This paper presents the rationale and key considerations for a promising innovation in the treatment of early-onset disruptive behavior disorders—that is, the development of an Internet-based format for the delivery of Parent–Child Interaction Therapy (PCIT) directly to families in their own homes. Specifically, we consider traditional barriers to effective care, and discuss how technological innovations can overcome problems of treatment availability, accessibility, and acceptability. We then detail our current Internet-delivered PCIT treatment program (I-PCIT), which is currently being evaluated across multiple randomized clinical trials relative to waitlist comparison, and to traditional in-office PCIT. Embedded video clips of children treated with I-PCIT are used to illustrate novel aspects of the treatment.
Keywords: PCIT; Internet-Based; iPCIT; Availability; Home-based; Traditional Barriers; Video; Disruptive Behavior Disorders.
Use and feasibility of telemedicine technology in the dissemination of Parent-Child Interaction Therapy
Funderburk, B. W., Ware, L. M., Altshuler, E., & Chaffin, M. (2008). Use and feasibility of telemedicine technology in the dissemination of Parent-Child Interaction Therapy. Child Maltreatment, 13, 377-82.
Abstract: This brief report discusses the use and feasibility of telemedicine technology in the dissemination of Parent-Child Interaction Therapy (PCIT). PCIT is an empirically supported behavioral parent training program for reducing disruptive behavior in young children and for reducing future rates of child physical abuse. The positive impact PCIT has demonstrated in reducing child maltreatment has galvanized interest in widespread dissemination of the PCIT model into child service systems. PCIT has traditionally been taught in university-based training programs in a mentored cotherapy model. By contrast, in field settings, PCIT training typically consists of workshop training supplemented by a period of telephone consultation (PC). Given concerns with the level of practitioner competency and fidelity yielded by the PC model, PCIT training programs have begun to examine Internet-based telemedicine technology to deliver live, mentored PCIT training to trainees at remote locations (Remote Real-Time or RRT) to better approximate the university-based training model. Challenges of disseminating evidence-based practices are discussed, using PCIT as a model of how these challenges are being addressed by telemedicine technology.
Keywords: PCIT; Model Adaptation Studies; Dissemination; Telemedicine; Training.
Effectiveness of group format Parent-Child Interaction Therapy compared to treatment as usual in a community outreach organization
Foley, K., McNeil, C. B., Norman, M., & Wallace, N. M. (2016). Effectiveness of group format Parent-Child Interaction Therapy compared to treatment as usual in a community outreach organization. Child and Family Behavior Therapy, 38, 279-298.
Abstract: : Forty-four participants recruited from a community outreach organization were assigned to receive either group format Parent-Child Interaction Therapy (PCIT) or group format treatment as usual (TAU). The expected interaction between time and condition was such that participants in the PCIT group experienced a significantly greater decrease in internalizing and externalizing behavior problems compared to participants in the TAU group. This interaction was not significant regarding parenting stress or child abuse potential between the PCIT and TAU conditions. There was a significant increase in positive caregiver skills from pretreatment to posttreatment for the PCIT group; however, there was not a significant decrease in caregiver negative talk.
Keywords: PCIT; General Outcome Studies; Child Behavior Problems; Effectiveness Research; Evidence-based Treatment; Parent Training.
Group Parent-Child Interaction Therapy: A randomized control trial for the treatment of conduct problems in young children
Niec, L. N., Barnett, M. L., Prewett, M. S., & Shanley Chatham, J.R. (2016). Group Parent-Child Interaction Therapy: A randomized control trial for the treatment of conduct problems in young children. Journal of Consulting and Clinical Psychology, 84, 682-98.
Abstract: Although efficacious interventions exist for childhood conduct problems, a majority of families in need of services do not receive them. To address problems of treatment access and adherence, innovative adaptations of current interventions are needed. This randomized control trial investigated the relative efficacy of a novel format of parent-child interaction therapy (PCIT), a treatment for young children with conduct problems.|Eighty-one families with 3- to 6-year-old children (71.6% boys, 85.2% White) with diagnoses of oppositional defiant or conduct disorder were randomized to individual PCIT (n = 42) or the novel format, Group PCIT. Parents completed standardized measures of children's conduct problems, parenting stress, and social support at intake, posttreatment, and 6-month follow-up. Therapist ratings, parent attendance, and homework completion provided measures of treatment adherence. Throughout treatment, parenting skills were assessed using the Dyadic Parent-Child Interaction Coding System.|Parents in both group and individual PCIT reported significant improvements from intake to posttreatment and follow-up in their children's conduct problems and adaptive functioning, as well as significant decreases in parenting stress. Parents in both treatment conditions also showed significant improvements in their parenting skills. There were no interactions between time and treatment format. Contrary to expectation, parents in Group PCIT did not experience greater social support or treatment adherence.|Group PCIT was not inferior to individual PCIT and may be a valuable format to reach more families in need of services. Future work should explore the efficiency and sustainability of Group PCIT in community settings.
Keywords: PCIT; Clinical Disorders; Oppositional Defiant Disorder; Conduct Disorder; Childhood Conduct Problems; Group Treatment; Parent Management Training.
Parent-Child Interaction Therapy: The rewards and challenges of a group format
Niec, L.N., Hemme, J.M., Yopp, J.M., & Brestan, E.V. (2005). Parent-Child Interaction Therapy: The rewards and challenges of a group format. Cognitive and Behavioral Practice, 12, 113-125.
Abstract: Parent-Child Interaction Therapy (PCIT) is an evidence-based treatment for young children with severe behavior problems. Typically, it is individually administered to families by a therapist and a cotherapist. However, converting PCIT to a group format can be a cost-effective way to reach a larger number of families in need of treatment. In addition, PCIT offers techniques to facilitate parents' skill development and generalization of skills that are not commonly used in group parent training programs. This article has multiple goals: (a) to review the structure of a group PCIT program, (b) to discuss the empirical rationale for use of the program, and (c) to provide a case example that illustrates the rewards and challenges of group PCIT.
Keywords: PCIT; General Outcome Studies; Group; Family; Parents; Training; Case Study.
Training parents as therapists: A comparison between individual parent-child interaction training and parent group didactic training
Eyberg, S. M., & Matarazzo, R. G. (1980). Training parents as therapists: A comparison between individual parent-child interaction training and parent group didactic training. Journal of Clinical Psychology, 36, 492-499.
Abstract: Children with home behavior problems frequently are treated via training their parents to become behavior therapists for their own children. One well-established approach has been to use didactic group training. Another approach involves parent training in specific parent-child interaction patterns through the use of modeling, in vivo practice, and immediate feedback. In this study, the effectiveness of these two methods was compared via multiple outcome measures, which included both direct therapist observation and parent report. Twenty-nine children between the ages of 4 and 9 were divided into didactic group-treatment, individual mother-child interaction training, and controls. After five training sessions, therapist observation revealed improvement in the facilitative behavior of the mothers who received individual, in-vivo instruction, as well as improvement in the children's behavior. No significant changes were observed in the group treatment or control conditions. Specific home management behaviors were improved in all three groups according to mothers' reports. The individually trained mothers expressed significantly more satisfaction with the program. It is suggested that direct observation of mother-child behavior, with immediate feedback, reinforcement, and further practice, may be related to the superiority of the individual training method.
Keywords: PCIT; Behavior Therapy; Child; Child Behavior Disorders; Child, Preschool; Female; Humans; Language Disorders; Male; Parent-Child Relations; Parents; Speech Disorders.
Feasibility of Intensive Parent–Child Interaction Therapy (I-PCIT): Results from an open trial
Graziano, P. A., Bagner, D. M., Slavec, J., Hungerford, G., Kent, K., Babinski, D., & Pasalich, D. (2014). Feasibility of Intensive Parent–Child Interaction Therapy (I-PCIT): Results from an open trial. Journal of Psychopathology and Behavioral Assessment, 37, 38-49.
Abstract: The current pilot study examined the feasibility, acceptability, and initial outcome of an intensive and more condensed version of Parent–child Interaction Therapy (90 min sessions for 5 days/week over the course of 2 weeks). Using an open trial design, 11 children (M child age=5.01 years) and their mothers completed a baseline period of 2 weeks, a treatment period of 2 weeks, and a post-treatment evaluation. A follow-up evaluation was also conducted 4 months following treatment completion. Across all assessments, mothers completed measures of child behavior and parenting stress, and observational data was collected during three 5-min standard situations that vary in the degree of parental control (child-led play, parent-led play, & clean-up). All 11 families completed the intervention with extremely high attendance and reported high satisfaction. Results across both mother report and observations showed that: a) externalizing behavior problems were stable during the baseline period; b) treatment was effective in reducing externalizing behavior problems (ds=1.67–2.50), improving parenting skills (ds=1.93–6.04), and decreasing parenting stress (d=0.91); and c) treatment gains were maintained at follow-up (ds=0.53– 3.50). Overall, preliminary data suggest that a brief and intensive format of a parent-training intervention is a feasible and effective treatment for young children with externalizing behavior problems with clinical implications for improving children’s behavioral impairment in a very brief period of time.
Keywords: PCIT; Model Adaptation Studies; Parenting Training; Externalizing behavior; Problems; Child; Brief Treatment.
Early identification and intervention for behavior problems in primary care: A comparison of two abbreviated versions of Parent-Child Interaction Therapy
Berkovits, M. D., O'Brien, K. A., Carter, C. G., & Eyberg, S. M. (2010). Early identification and intervention for behavior problems in primary care: A comparison of two abbreviated versions of Parent-Child Interaction Therapy. Behavior Therapy, 41, 375-287.
Abstract: Behavioral screening and preventive intervention were implemented for 3- to 6-year-olds in pediatric primary care with subclinical behavior problems. One hundred eleven children were screened with the Eyberg Child Behavior Inventory. Thirty children who scored within one standard deviation of the normative mean whose mothers indicated wanting help for their child's behavior were randomized to one of two abbreviated versions of Parent-Child Interaction Therapy (PCIT) for use in pediatric primary care: (a) a 4-session group preventive intervention called Primary Care PCIT (PC-PCIT); or (b) written materials describing basic steps of PCIT and guidelines for practice, called PCIT Anticipatory Guidance (PCIT-AG). Decreases in child problem behaviors and ineffective parenting strategies, and increases in parental feelings of control were not significantly different between versions at post-intervention or 6-month follow-up. Changes during intervention were significantly larger for both groups than changes during pretreatment baseline, with moderate to large effect sizes. These brief versions of PCIT are both promising primary care preventive interventions that deserve further study.
Keywords: PCIT; Model Adaptation Studies.
Parent-Child Interaction Therapy: One- and two-year follow-up of standard and abbreviated treatments for oppositional preschoolers
Nixon, R. D., Sweeney, L., Erickson, D. B., & Touyz, S. W. (2004). Parent-Child Interaction Therapy: One- and two-year follow-up of standard and abbreviated treatments for oppositional preschoolers. Journal of Abnormal Child Psychology, 32, 263-271.
Abstract: The long-term effect of two parent training programs for conduct problem preschoolers is reported. Families of 54 behaviorally disturbed preschool-aged children were randomly assigned to 1 of 3 treatment conditions: standard Parent-Child Interaction Therapy (STD), an abbreviated form of PCIT (ABB), and a no-treatment waitlist control group (WL). Of the families who completed treatment (STD and ABB), data were collected on 97% and 94% of families at 1- and 2-year follow-up, respectively. Follow-up assessment of parent report and independent observations indicated that treatment gains were largely maintained for both treatment conditions with little difference between the two treatments. The findings suggest that an abbreviated form of PCIT has long-term benefits for families with young children displaying early conduct problems.
Keywords: PCIT; Follow-up Studies - Longitudinal Research; Clinical Disorders; Oppositional Defiant Disorder; Preschoolers; ODD; Externalizing Behavior Problems; Treatment.
Parent-Child Interaction Therapy: A comparison of standard and abbreviated treatments for oppositional defiant preschoolers
Nixon, R. D., Sweeney, L., Erickson, D. B., & Touyz, S. W. (2003). Parent-Child Interaction Therapy: A comparison of standard and abbreviated treatments for oppositional defiant preschoolers. Journal of Consulting and Clinical Psychology, 71, 251-260.
Abstract: Families of 54 behaviorally disturbed preschool-aged children (3 to 5 years) were randomly assigned to 1 of 3 treatment conditions: standard parent-child interaction therapy (PCIT; STD); modified PCIT that used didactic videotapes, telephone consultations, and face-to-face sessions to abbreviate treatment; and a no-treatment waitlist control group (WL). Twenty-one nondisturbed preschoolers were recruited as a social validation comparison condition. Posttreatment assessment indicated significant differences in parent-reported externalizing behavior in children, and parental stress and discipline practices from both treatment groups on most measures compared with the WL group. Clinical significance testing suggested a superior effect for the STD immediately after intervention, but by 6-month follow-up, the two groups were comparable. The findings indicate that abbreviated PCIT may be of benefit for families with young conduct problem children.
Keywords: PCIT; Clinical Disorders; Oppositional Defiant Disorder; Modified PCIT.
Child-Adult Relationship Enhancement in Primary Care (PriCare): A randomized trial of parent training for child behavior problems
Schilling, S., French, B., Berkowitz, S. J. Dougherty, S. L., Scribano, P. V., & Wood, J. N. (2017). Child-Adult Relationship Enhancement in Primary Care (PriCare): A randomized trial of parent training for child behavior problems. Academic Pediatrics, 17, 53-60.
Abstract: OBJECTIVE : Child–Adult Relationship Enhancement in Primary Care (PriCARE) is a 6-session group parent training designed to teach positive parenting skills. Our objective was to measure PriCARE’s impact on child behavior and parenting attitudes.
METHODS : Parents of children 2 to 6 years old with behavior concerns were randomized to PriCARE (n = 80) or control (n= 4 0). Child behavior and parenting attitudes were measured at baseline (0 weeks), program completion (9 weeks), and 7 weeks after program completion (16 weeks) using the Eyberg Child Behavior Inventory (ECBI) and the Adult Adolescent Parenting Inventory 2 (AAPI2). Linear regression models compared mean ECBI and AAPI2 change scores from 0 to 16 weeks in the PriCARE and control groups, adjusted for baseline scores.
RESULTS : Of those randomized to PriCARE, 43% attended 3 or more sessions. Decreases in mean ECBI intensity and problem scores between 0 and 16 weeks were greater in the PriCARE group, reflecting a larger improvement in behavior problems [intensity: - 22 ( - 29, - 16) vs - 7 ( - 17, 2), P = .012; problem: - 5 ( - 7, - 4) vs - 2 ( - 4, 0), P = .014]. Scores on 3 of the 5 AAPI2 subscales reflected greater improvements in parenting attitudes in the PriCARE group compared to control in the following areas: empathy toward children’s needs [0.82 (0.51, 1.14) vs 0.25 ( - 0.19, 0.70), P = .04], corporal punishment [0.22 (0.00, 0.45) vs - 0.30 ( - 0.61, 0.02), P = .009], and power and independence [0.37 ( - 0.02, 0.76) vs - 0.64( - 1.19, - 0.09), P = .003].
CONCLUSIONS: PriCARE shows promise in improving parent reported child-behavior problems in preschool-aged children and increasing positive parenting attitudes.
Keywords: PCIT; Child-Adult Relationship Enhancement – CARE; Behavioral Problems; Corporal Punishment; Parent Training; Primary Care.
Parent-Child Interaction Therapy with an eight-year-old child: A case study
Stokes, J. O., Scudder, A., Costello, A. H., & McNeil, C. B. (2017). Parent-Child Interaction Therapy with an eight-year-old child: A case study. Evidence-Based Practice in Child and Adolescent Mental Health, 2, 1-11.
Abstract: We examined the outcome of Parent–Child Interaction Therapy (PCIT) with an 8-year-old child diagnosed with oppositional defiant disorder. We presented a theoretical basis for the use of PCIT with some children older than 6 and suggested clinical considerations as well as adaptations and modifications that may make PCIT applicable with this population. “Curtis,” a Caucasian male, made clinically significant improvements and no longer met diagnostic criteria for oppositional defiant disorder at posttreatment. His scores on the Child Behavior Checklist and Eyberg Child Behavior Inventory improved from the clinical range at pretreatment to within the normative range at posttreatment. Further research should examine the efficacy of PCIT with children older than 6 and the feasibility of the suggested adaptations and modifications for this population.
Keywords: PCIT; Clinical Disorders; Oppositional Defiant Disorder; Model Adaptation Studies.
Parent-Child Interaction Therapy and its adaptations
Elkins, R. M., Mian, N. D., Comer, J. S., & Pincus, D. B. (2017). Parent-Child Interaction Therapy and its adaptations. In J.L. Luby (Ed.). Handbook of preschool mental health: Development, disorders, and treatment (pp. 271-291).New York: Guilford Publications, Inc.
Keywords: Keywords: PCIT; Book Chapters; Model Adaptation Studies.
A case study of Parent-Child Interaction Therapy: Flexible client-centered adaptation of an EST
Gordon, H. M., & Cooper, L. D. (2016). A case study of Parent-Child Interaction Therapy: Flexible client-centered adaptation of an EST. Clinical Case Studies, 15, 126-142.
Abstract: The authors present a case study of “Katie,” a 4-year-old girl diagnosed with oppositional defiant disorder (ODD). Treatment was conducted with Katie and her family using Parent–Child Interaction Therapy (PCIT). However, client-centered adaptations were made to improve the feasibility of the treatment and its ecological validity in a community setting. Katie demonstrated marked reduction in ODD symptoms during treatment and no longer met criteria for ODD at discharge and throughout follow-up periods. A hybrid model was utilized whereby PCIT components were delivered in both clinic and in-home settings. Client-centered adaptations and the benefits of treatment in the in-home setting are discussed. The authors contend that use of appropriate client-centered clinical flexibility, when implementing a manualized, empirically supported, and evidence-based treatment, can assist in bridging the “science–practice gap” allowing for appropriate flexibility and individualization, while also promoting the use of empirically supported and validated treatment approaches.
Keywords: PCIT; Home Based Interventions; Clinical Disorders; Oppositional Defiant Disorder; Model Adaptation Studies; Adaptations; Clinical Flexibility; In-Home Therapy.
Enhancing Parent-Child Interaction Therapy with motivational interviewing techniques
N'zi, A. M., Lucash, R. E., Clionsky, L. N., & Eyberg, S. H. (2016). Enhancing Parent-Child Interaction Therapy with motivational interviewing techniques. Cognitive and Behavioral Practice, 24, 131-141.
Abstract: Parent–child interaction therapy (PCIT) is an evidence-based family intervention for young children with disruptive behavior. Parents and children who complete PCIT show greater immediate and long-term treatment gains than those who discontinue treatment prematurely. PCIT is a time- and effort-intensive treatment, and parents ambivalent about its value for their child or their ability to master the treatment skills may discontinue treatment before engaging sufficiently to experience change. Motivational interviewing (MI) is a client-centered therapeutic method of increasing motivation for change through the resolution of ambivalence. This paper describes how clinicians may incorporate MI strategies into PCIT to enhance parental motivation when signs of ambivalence arise. Vignettes and scripted therapy exchanges illustrate use of the strategies to decrease ambivalence in PCIT, improve homework adherence, increase parenting self-efficacy, and reduce attrition, thereby improving outcomes for young children with disruptive behaviors and their families.
Keywords: PCIT; Enhancement Studies; Motivational Interviewing; Motivation; Parent Training.
An evaluation of Parent-Child Interaction Therapy with and without motivational enhancement to reduce attrition
Webb, H. J., Thomas, R., McGregor, L., Avdagic, E., & Zimmer-Gembeck, M. J. (2016). An evaluation of Parent-Child Interaction Therapy with and without motivational enhancement to reduce attrition. Journal of Clinical Child and Adolescent Psychology, 1-14.
Abstract: Although many interventions for child externalizing behavior report promising outcomes for families, high attrition prior to program completion remains a problem. Many programs report dropout rates of 50% or higher. In this trial we sought to reduce attrition and improve outcomes by augmenting a well-known evidence-based intervention, Parent–Child Interaction Therapy (PCIT), with a 3-session individual motivational enhancement component. Participants were 192 Australian caregivers (91.7% female; Mage = 34.4 years) and their children (33.3% female; Mage = 4.4 years). Families (51% referred from child welfare or health services for risk of maltreatment) were assigned to PCIT or a supported waitlist, with families assigned to PCIT receiving either standard PCIT (S/PCIT) or motivation-enhanced PCIT (M/PCIT), depending on their time of entry to the study. Waitlist families received phone calls every week for 12 weeks. Parents in M/PCIT reported more readiness to change their behavior from preassessment to after the motivation sessions. Also, parents who reported high, rather than low, motivation at preassessment did have a lower attrition rate, and there was some evidence that enhancing motivation was protective of premature attrition to the extent that caregivers achieved a high degree of change in motivation. Yet comparison of attrition rates and survival analyses revealed no difference between M/PCIT and S/PCIT in retention rate. Finally, there were greater reductions in externalizing and internalizing child behavior problems and parental stress among families in S/PCIT and M/PCIT compared with waitlist, and there was generally no significant difference between the two treatment conditions.
Keywords: PCIT; Attrition Studies; International & Cultural Research; Motivational Enhancement; Externalizing Behaviors; Internalizing Behaviors; MPCIT.
The Holding Hands Project: Effectiveness in promoting positive parent-child interactions
Rait, S. (2012). The Holding Hands Project: Effectiveness in promoting positive parent-child interactions. Educational Psychology in Practice, 28, 353-371.
Abstract: It is now generally accepted that training parents can be effective in supporting children with behaviour difficulties and given the current climate of decreasing resources there is a strong case for evaluating effectiveness. This study evaluated the effectiveness of a significantly modified version of the standard clinic-based; Parent–Child Interaction Therapy (S-PCIT) programme, referred to as the Holding Hands Project. Thirty parents and their children were assessed at pre- and post-intervention, and of these a total of 25 parents were also assessed at two month follow-up. A significant trend towards a positive development in all of the areas explored was found. Furthermore, an overall significant change in observed children’s behavior was found between pre-intervention to follow-up. This study adds to the growing evidence that a well-established clinical programme such as S-PCIT can produce positive outcomes even when it has been significantly modified and “transported” to a UK community setting.
Keywords: PCIT; Model Adaptation Studies; Behavior Difficulties; Parenting Programmes; Pre-school; Community Programme.
Using Parent–Child Interaction Therapy to develop a pre-parent education module
Lee, E. L., Wilsie, C. C., & Brestan-Knight, E. (2011). Using Parent–Child Interaction Therapy to develop a pre-parent education module. Children and Youth Services Review, 33, 1254-1261.
Abstract: Ineffective parenting skills, poor knowledge of child development, rigidity, and harsh physical punishment have been identified as risk factors for abuse and child disruptive behavior. Due to the long-term negative consequences of child maltreatment and behavior disorders on child functioning prevention is needed. Primary prevention program developers posit that pre-parenthood is an ideal time for training to prevent child maltreatment. Child and family-focused researchers suggest that by increasing effective parenting the likelihood of childhood disruptive behavior disorders and child maltreatment can be reduced; however no published studies have investigated the use of a pre-parent training intervention to increase parenting knowledge and use of effective parenting behaviors in undergraduate non-parents. The current study examined the vi influence that exposure to a pre-parent education module based on PCIT principles has on students’ knowledge and use of effective behavioral parenting skills as measured by scores on a PCIT content quiz developed by the researcher and the Dyadic Parent-Child Interaction Coding System – 3rd edition with a sample of 300 undergraduate non-parents aged 19 to 25. A subsample of students participated in an analog DPICS CDI observation that required them to play with an undergraduate research assistant role-playing a three-year-old child. Participants were instructed to follow the “child’s” lead and play the role of parent during the observation. The hypothesis that exposure to the pre-parent education module would result in significant increase in scores on PCIT content quiz was supported. The hypothesis that exposure to the pre-parent education module would result in significant increase in the frequency of praise, reflection and behavior description during the role play observation was partially supported. The hypothesis that exposure to developmental psychology course material would result in significant increase in knowledge of child development was partially supported. Implications of the current study and future directions are discussed.
Keywords: PCIT; Dissertations; Child Maltreatment; Clinical Disorders.
Tailoring and adapting Parent-Child Interaction Therapy to new populations
Eyberg, S. M. (2005). Tailoring and adapting Parent-Child Interaction Therapy to new populations. Treatment of Children, 28, 197-201.
Abstract: This paper discusses the processes of tailoring and adapting empirically supported treatments (ESTs) for application to new populations, using examples from the five papers in this special issue on innovative approaches to parent-child interaction therapy (PCIT), The applications of PCIT in this issue represent a range of approaches to tailoring and adapting ESTs in ways likely to maintain and improve upon efficacy or efficiency in the new population. The discussion emphasizes the ways in which the new applications maintain the theoretical and empirical foundation of PCIT and its core defining features as they address new populations, target problems, belief systems, and settings.
Keywords: PCIT; Attrition Studies; Model Adaptation Studies; Review Articles.