Treatment Outcome Articles
The impact of incentives on treatment adherence and attrition: A randomized controlled trial of Parent-Child Interaction Therapy with a primarily Latinx, low-income population. (abstract)
Quetsch, L. B., Girard, E. I., & McNeil, C. B. (2020).
An Evaluation of Parent-Child Interaction Therapy With and Without Motivational Enhancement to Reduce Attrition (abstract)
Webb, H. J., Thomas, R., McGregor, L., Avdagic, E., & Zimmer-Gembeck, M. J. (2017)
Parent-Child Interaction Therapy in a Community Setting: Explaining Outcomes, Attrition, and Treatment Setting (abstract)
Lanier, P., Kohl, P. L., Benz, J., Swinger, D., Moussette, P., & Drake, B. (2011)
An immediate and long-term study of a temperament and Parent-Child Interaction Therapy based community program for preschoolers with behavior problems (abstract)
Pade, H., Taube, D. O., Aalborg, A. E., & Reiser, P. J. (2006)
Parent-Child Interaction Therapy with behavior problem children: One and two year maintenance of treatment effects in the family (abstract)
Eyberg, S. M., Funderburk, B. W., Hembree-Kigin, T. L., McNeil, C. B., Querido, J. G., & Hood, K. K. (2001)
General Outcome Studies
Improving large‐scale implementations by applying research and data analysis: A case study on First 5 LA's implementation of PCIT in Los Angeles County (abstract)
Bahng, G., Taborga, M., Bae, C., & Jimenez, A. (2018).
A mixed-methods study of system-level sustainability of evidence-based practices in 12 large-scale implementation initiatives. (abstract)
Scudder, A. T., Taber-Thomas, S. M., Schaffner, K., Pemberton, J. R., Hunter, L., & Herschell, A. D. (2017).
Effectiveness of Parent-Child Interaction Therapy (PCIT) in the treatment of young children's behavior problems. A randomized controlled study (abstract)
Bjorseth, A., & Wichstrom, L. (2016)
Filling potholes on the implementation highway: Evaluating the implementation of Parent-Child Interaction Therapy in Los Angeles county (abstract)
Timmer, S. G., Urquiza, A. J., Boys, D. K., Forte, L. A., Quick-Abdullah, D., Chan, S., & Gould, W. (2015)
State-wide dissemination and implementation of Parent–Child Interaction Therapy (PCIT): Application of theory (abstract)
Beveridge, R. M., Fowles, T. R., Masse, J. J., McGoron, L., Smith, M. A., Parrish, B. P., Circo, G., & Widdoes, N. (2015)
Utilizing benchmarking to study the effectiveness of Parent-Child Interaction Therapy implemented in a community setting (abstract)
Self-Brown, S., Valente, J. R., Wild, R. C., Whitaker, D. J., Galanter, R., Dorsey, S. & Stanley, J. (2012)
Outcomes of Parent-Child Interaction Therapy: A comparison of treatment completers and study dropouts one to three years later (abstract)
Boggs, S. R., Eyberg, S. M., Edwards, D. L., Rayfield, A., Jacobs, J., Bagner, D., & Hood, K. K. (2004)
Efficacy of Parent-Child Interaction Therapy: Interim report of a randomized trial with short-term maintenance (abstract)
Schuhmann, E. M., Foote, R. C., Eyberg, S. M., Boggs, S. R., & Algina, J. (1998)
Parent-Child Interaction Therapy with behavior problem children: Relative effectiveness of two stages and overall treatment outcome (abstract)
Eisenstadt, T. H., Eyberg, S., McNeil, C. B., Newcomb, K., & Funderburk, B. (1993)
Parent-Child Interaction Therapy with behavior problem children: Generalization of treatment effects to the school setting (abstract)
Funderburk, B., Newcomb, K., McNeil, C. B., Eyberg, S., & Eisenstadt, T. H. (1991)
Treatment Comparison Studies
Cultural adaptation and implementation of evidence-based parent-training: A systematic review and critique of guiding evidence (abstract)
Baumann, A. A., Powell, B. J., Kohl, P. L., Tabak, R. G., Penalba, V., Proctor, E. E., Domenech-Rodriguez, M. M., & Cabassa, L. J. (2015)
Treating child disruptive behavior in high-risk families: A comparative effectiveness trial from a community-based implementation (abstract)
Abrahamse, M. E.; Junger, M., van Wouwe, M. A., Boer, F., & Lindauer, R. J. (2015)
Study protocol for a comparative effectiveness trial of two parent training programs in a fee-for-service mental health clinic: Can we improve mental health services to low-income families? (abstract)
Gross, D. A., Belcher, H. M., Ofonedu, M. E., Breitenstein, S., Frick, K. D., & Chakra, B. (2014)
Emotion Regulation and Attrition in Parent–Child Interaction Therapy.
Lieneman, C. C., Girard, E. I., Quetsch, L. B., & McNeil, C. B. (2020). Emotion Regulation and Attrition in Parent–Child Interaction Therapy. Journal of Child & Family Studies, 29(4), 978–996.
Abstract: Objectives: As evidence of the importance of emotion regulation (ER) continues to mount, little is known about how families dealing with child behavior problems can better develop this important ability. We explored the relations among a caregiver training program for children with severe problem behavior (Parent–Child Interaction Therapy; PCIT), child ER, caregiver ER, parenting stress, and attrition. This study was part of a larger investigation evaluating the impact of incentives on treatment outcomes. Methods: Measures of caregiver and child ER, child behavior problems, and parenting stress were completed by caregivers referred for PCIT from a predominantly low-income community sample of 66 caregiver–child dyads. Caregiver–child interactions were coded for caregiver verbalizations during three play situations. ANCOVA, t-test, and correlational analyses were conducted to examine changes in ER across treatment and compare those who completed treatment with those who dropped out of treatment early. Results: Caregiver ER and child ER lability/negativity improved significantly across both phases of PCIT. Child adaptive ER improved significantly from pre- to post-treatment and during the second phase of treatment for those children in the non-incentives group only. Baseline levels of child and caregiver ER were not significant predictors of attrition. Conclusions: Findings are discussed with respect to the importance of both caregiver and child ER in the provision of PCIT and other behavioral parent training programs.
Keywords: Disruptive behavior; Emotion regulation; Parent–Child Interaction Therapy; Parenting stress; PCIT.
The impact of incentives on treatment adherence and attrition: A randomized controlled trial of Parent-Child Interaction Therapy with a primarily Latinx, low-income population.
Quetsch, L. B., Girard, E. I., & McNeil, C. B. (2020). The impact of incentives on treatment adherence and attrition: A randomized controlled trial of Parent-Child Interaction Therapy with a primarily Latinx, low-income population. Children & Youth Services Review, 112, N.PAG. https://doi.org/10.1016/j.childyouth.2020.104886
Abstract: • Attrition and homework nonadherence are common issues in parent training programs. • Families eceived either PCIT with or PCIT without incentives for treatment adherence. • Families who received incentives no-showed their therapy appointments less often. • Incentives were largely ineffective for other measures of attendance and adherence. Advancements in the implementation of evidence-based family therapies have yielded successful reductions in child disruptive behavior. Unfortunately, effective interventions such as Parent-Child Interaction Therapy (PCIT) are plagued with high rates of attrition and low rates of homework completion in community clinics. To evaluate the use of low-cost incentives on attendance and homework adherence in PCIT in a community mental health center. Families referred for PCIT (N = 84; 63.1% Latinx) were randomly assigned to receive PCIT as usual or PCIT plus incentives. Families were able to earn incentives for attendance, homework completion, and therapeutic skill mastery. Attrition rates (59.5%) were reflective of other community-based intervention studies, with a significant reduction in no-show rates for families receiving incentives. No significant changes were found between groups on attainment of therapeutic skill mastery or number of sessions prior to termination. Families completed homework at low rates with no differences between groups. Low-cost incentives largely did not impact meaningful outcomes for attendance in parent training, although no-shows were less likely. These findings suggest that adherence is a complex phenomenon requiring multi-faceted solutions.
Keywords: Attrition; Homework; Incentives; Latinx; Parent-Child Interaction Therapy; Treatment barriers.
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. (2017). An Evaluation of Parent–Child Interaction Therapy With and Without Motivational Enhancement to Reduce Attrition. Journal of Clinical Child & 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
Outcomes of Parent–Child Interaction Therapy in an urban community clinic: A comparison of treatment completers and dropouts
Danko, C.M., Garbecz, L.L., & Budd, K.S. (2016). Outcomes of Parent–Child Interaction Therapy in an urban community clinic: A comparison of treatment completers and dropouts. Children and Youth Service Review, 60, 42-51
Abstract: This study examined outcomes of Parent–Child Interaction Therapy (PCIT) for 52 clinically referred children with oppositional behavior and their parents treated in an urban, community mental health clinic serving demographically (i.e., income level, ethnicity) diverse families. Standardized observations of parent–child interactions and parent reported measures of child behavior were collected at pre- and post-treatment. We addressed two primary research questions: (1) What are pre-treatment predictors of treatment completion? (2) What are treatment outcomes both for families who successfully completed PCIT and for treatment dropouts? Multiple logistic regression results showed a significantly greater likelihood of treatment completion related to higher parent education, male child gender, and two parent households. Among families who completed treatment, pre–post data demonstrated significant parent change in observed skill use and improvement in parent reported disruptive behaviors with medium to large effect sizes. Findings also documented early treatment benefits for families who completed the first phase of PCIT but dropped out in the final phase prior to meeting full graduation criteria. We discuss the findings and implications for community-based applications of PCIT in the context of community mental health's mission to provide effective treatment and maximize community access to services.
Keywords: Behavior problemsParent–child relationsCommunity mental healthTreatment outcomePreschool children
Parent-Child Interaction Therapy in a Community Setting: Explaining 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, 21(6), 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
A motivational intervention can improve retention in PCIT for low-motivation child welfare clients
Chaffin M, Valle LA, Funderburk B, Gurwitch R, Silovsky J, Bard D, McCoy C, Kees M. (2009). A motivational intervention can improve retention in PCIT for low-motivation child welfare clients. Child Maltreat, 14(4):356-68.
Abstract: A motivational orientation intervention designed to improve parenting program retention was field tested versus standard orientation across two parenting programs, Parent-Child Interaction Therapy (PCIT) and a standard didactic parent training group. Both interventions were implemented within a frontline child welfare parenting center by center staff. Participants had an average of six prior child welfare referrals, primarily for neglect. A double-randomized design was used to test main and interaction effects. The motivational intervention improved retention only when combined with PCIT (cumulative survival = 85% vs. around 61% for the three other design cells). Benefits were robust across demographic characteristics and participation barriers but were concentrated among participants whose initial level of motivation was low to moderate. There were negative effects for participants with relatively high initial motivation. The findings suggest that using a motivational intervention combined with PCIT can improve retention when used selectively with relatively low to moderately motivated child welfare clients.
Keywords: Drop-out; Retention; Parenting; PCIT; Child Abuse; Child Neglect.
Predicting Treatment and Follow-Up Attrition in Parent-Child Interaction Therapy
Fernandez, M. A., & Eyberg, S. M. (2009) Predicting treatment and follow-up attrition in parent-child interaction therapy. Journal of Abnormal Child Psychology, 37, 431-441
Abstract: Predictors of attrition from individual parent-child interaction therapy were examined for 99 families of preschoolers with disruptive behavior disorders. Seventy-one percent of treatment dropouts were identified by lower SES, more maternal negative talk, and less maternal total praise at pretreatment. Following PCIT, families were randomly assigned to an Assessment-Only or Maintenance Treatment condition. Higher maternal distress predicted 63% of dropouts in the Assessment-Only condition. Lower maternal intellectual functioning predicted 83% of dropouts from Maintenance Treatment. Findings highlight a continuing need for evidence-based retention strategies at various phases of engagement in PCIT.
Keywords: PCIT; attrition studies; low-income; child; disruptive behavior disorders; dropout; evidence-based treatment; follow-up; prediction; treatment
Parent-Child Interaction Therapy: An Examination of Cost Effectiveness
Goldfine, M. E., Wagner, S. M., Branstetter, S. A., & McNeil, C. B. (2008). Parent-child interaction therapy: An examination of cost-effectiveness. Journal of Early and Intensive Behavior Intervention, 5(1), 119-141.
Abstract: An empirically supported treatment for children with disruptive behavior disorders, Parent-Child
Interaction Therapy (PCIT), has received increased interest from policymakers and mental health administrators regarding its cost-effectiveness (i.e., ratio of treatment costs to behavior gains). This paper examines the projected costs and treatment outcomes associated with implementing and completing PCIT and demonstrates favorable cost-effectiveness ratios. For example, startup costs of PCIT, including equipment and training, were estimated at approximately $14,000 and the average cost of providing PCIT from intake to termination was estimated at approximately $1,000 per client. Benefits include clinically significant improvements on multiple measures of disruptive behavior and strong maintenance data, suggesting the PCIT is an effective and financially viable form of treatment for child disruptive behavior disorders.
Keywords: PCIT; attrition studies; cost-effectiveness; disruptive behavior disorders
Predicting Outcome in Parent-Child Interaction Therapy: Success and Attrition
Werba, B., Eyberg, S.M., Boggs, S.R., & Algina, J. (2006). Predicting Outcome in Parent-Child Interaction Therapy: Success and Attrition. Behavior Modification, 30, 618-646.
Abstract: This study explored predictors of treatment response and attrition in Parent-Child Interaction
Therapy (PCIT). Participants were 99 families of 3- to 6-year-old children with disruptive behavior disorders. Multiple logistic regression was used to identify those pretreatment child, family, and accessibility factors that were predictive of success or attrition. For all study participants, waitlist group assignment and maternal age were the significant predictors of outcome. For treatment participants (study participants excluding those who dropped out after the initial evaluation but before treatment began), only maternal ratings of parenting stress and maternal inappropriate behavior during parent-child interactions were significant predictors of treatment outcome. These results suggest that for treatment studies of disruptive preschoolers, the benefits of using a waitlist control group may be outweighed by the disproportionate number of dropouts from this group. Once families begin PCIT, however, parent-related variables become salient in predicting treatment outcome
Keywords: PCIT; attrition studies; treatment outcome; responsiveness; success; attrition; dropout; parent training; preschool; child; family; disruptive behavior
Keeping Families In Once They've Come Through the Door: Attrition in Parent-Child Interaction Therapy
Fernandez, M. A., & Eyberg, S. M. (2005). Keeping families in once they've come through the door: Attrition in Parent-Child Interaction Therapy. Journal of Early and Intensive Behavior Intervention, 2(3), 207-212.
Abstract: We review existing studies of attrition in Parent-Child Interaction Therapy (PCIT), an empirically supported treatment for preschool-aged children with disruptive behavior disorders. Variables identified as pretreatment predictors of attrition in a statistically derived search for pretreatment predictors included maternal distress, negative maternal verbal behaviors during parent-child interaction, and therapist verbal behaviors during initial parent-therapist interactions. The most frequently reported reasons provided by mothers for premature termination of treatment were logistical problems such as difficulty finding transportation or sibling child care. Continued study of variables related to attrition in PCIT is essential to retention of a greater number of families in treatment.
Keywords: Attrition, Dropout, Parent-Child Interaction Therapy
An immediate and long-term study of a temperament and Parent-Child Interaction Therapy based community program for preschoolers with behavior problems
Pade, H., Taube, D. O., Aalborg, A. E., & Reiser, P. J. (2006). An immediate and long-term study of a temperament and Parent-Child Interaction Therapy based community program for preschoolers with behavior problems. Family Behavior Problem, 28, 1-28.
Abstract: The immediate and long-term effects of a Parent Child Interaction Therapy (PCIT) derived program offered at a Kaiser Permanente facility were evaluated. There were 73 participants in the initial sample and 23 in the 5-6 year follow-up sample. Child behaviors improved significantly immediately following treatment and some improvements were maintained at follow-up. Over 75% of the follow-up participants utilized additional therapy services following completion. Thus, sustained improvements may have been related to posttreatment services. Parent appraisals of their child's behaviors appeared to be as important as actual child behaviors when behavioral improvements were assessed. The benefits of this modified PCIT program are discussed.
Keywords: PCIT; Follow Up Studies; Longitudinal Research; Preschoolers and Behavior Problems; Temperament and Behavior; Modified PCIT.
Outcomes of Parent-Child Interaction Therapy: Mothers' reports of maintenance three to six years after treatment
Hood, K. K., & Eyberg, S. M. (2003). Outcomes of Parent-Child Interaction Therapy: Mothers' reports of maintenance three to six years after treatment. Journal of Clinical Child and Adolescent Psychology, 32, 419-29.
Abstract: Examined the long-term maintenance of changes following parent-child interaction therapy (PCIT) for young children with oppositional defiant disorder (ODD) and associated behavior disorders. Three to 6 years after treatment, 29 of 50 treatment completers were located for this study. The mothers of 23 children between the ages of 6 and 12 participated in telephone and mail follow-up assessments. Results indicated that the significant changes that mothers reported in their children's behavior and their own locus of control at the end of treatment were maintained at long-term follow-up. Child behavior reported at the posttreatment assessment and length of time since treatment were strong predictors of long-term outcome. Mothers' reports of disruptive behavior decreased with time since treatment. The results of this study support the long-term effectiveness of PCIT.
Keywords: PCIT; Follow-up Studies; Longitudinal Research; Parental Factors; Attention Deficit and Disruptive Behavior Disorders; Oppositional Defiant Disorders.
Parent-Child Interaction Therapy with behavior problem children: One and two year maintenance of treatment effects in the family
Eyberg, S. M., Funderburk, B. W., Hembree-Kigin, T. L., McNeil, C. B., Querido, J. G., & Hood, K. K. (2001). Parent-Child Interaction Therapy with behavior problem children: One and two year maintenance of treatment effects in the family. Child & Family Behavior Therapy, 23, 1-19.
Abstract: Parent-Child Interaction Therapy (PCIT) is an empirically supported treatment for conduct-disordered young children in which parents learn the skills of child-directed interaction (CDI) in the first phase of treatment and parent-directed interaction (PDI) in the second. This study examined the long-term treatment outcome for 13 families who had participated in a treatment study examining the effects of treatment phase sequence one and two years earlier. Seven families were in the CDI-First treatment group and six families were in the PDI-First group. Immediately after treatment, 11 or 13 families had achieved clinically significant changes on both observational and parent report measures, and there is no significant difference between treatment groups. Treatment effects were maintained at one-year follow-up for eight of the 13 families, and at two-year follow-up for nine families, with no long-term impact of phase sequence evident at either at either follow-up assessment. This study represents the first long-term follow-up of families treated with PCIT. Results suggest that this treatment may be successful in achieving long-term gains for most families of conduct-disordered preschoolers and that phase sequence has little impact on treatment outcome.
Keywords: PCIT; Longitudinal Studies; Parent-Child Interaction Therapy; Clinical Disorders; Psychosocial Treatment; Treatment Outcome; Preschooler; Oppositional Defiant Disorder; Maintenance; Long-Term Follow-Up; Child Behavior Problems; Family.
Parent-Child Interaction Therapy from the Parents' Perspective.
Woodfield, M. J., & Cartwright, C. (2020). Parent-Child Interaction Therapy from the Parents’ Perspective. Journal of Child & Family Studies, 29(3), 632–647.
Abstract: Objectives: Parent-Child Interaction Therapy (PCIT) is an evidence-based parent training programme, distinctive in its live coaching of parents with children via an ear-piece and one-way mirror. Yet few studies have explored the acceptability of PCIT to parents—and those which do exist have typically relied upon quantitative methods such as inventories or rating scales. The current study aimed to gain in-depth insight into parents' experiences, and perspectives of PCIT utilising a qualitative methodology. Methods: Sixteen parents who had participated in PCIT in a community setting in New Zealand took part in semi-structured face-to-face interviews. Thematic analysis of verbatim transcripts led to the emergence of several themes. Results: Despite early scepticism, self-consciousness, and initial discomfort with the use of particular strategies (e.g., time out), parents described an effective treatment that facilitated a progression from feelings of inadequacy to confidence, and despair to optimism. Child-led play, an essential component of PCIT, was viewed as surprisingly effective by parents. Parenting skills which initially felt awkward and un-natural, became more intuitive and instinctive through repeated rehearsal and coaching support. Parents also consistently described the influential role of the coach in facilitating change—particularly in improving parent emotion regulation abilities. Conclusions: This detailed account of the parent experience of progression through PCIT enhances existing knowledge of factors related to parent engagement with, and attrition from the programme. It also highlights the multidimensional role of the therapist coach in supporting parent emotion regulation abilities—an area which warrants further empirical research.
Keywords: Acceptability; Coaching; Parent training; Parent-Child Interaction Therapy; Qualitative.
Improving large‐scale implementations by applying research and data analysis: A case study on First 5 LA's implementation of PCIT in Los Angeles County
Bahng, G., Taborga, M., Bae, C., & Jimenez, A. (2018). Improving large‐scale implementations by applying research and data analysis: A case study on First 5 LA’s implementation of PCIT in Los Angeles County. Journal of Public Affairs (14723891), 18(4), N.PAG.https://doi.org/10.1002/pa.1712
Abstract: This paper presents the case of First 5 LA's 5‐year countywide implementation of the Parent–Child Interaction Therapy (PCIT) program. Enthusiasts of PCIT point to it as a high‐quality parenting program with the potential to positively influence child behavior, reduce recidivism into the child welfare system, and increase caregiver's confidence and self‐esteem. In September 2012, First 5 LA, an independent County agency in Los Angeles that advocates on behalf of parents with young children, began a $20 million countywide implementation of PCIT. The collaborative effort between First 5 LA, the Los Angeles County Department of Mental Health, the Los Angeles County Department of Children and Family Services, and the University of California, Davis demonstrates the role that research and data analysis can play in improving large‐scale implementations. The authors of this paper were contracted to conduct an evaluation of the implementation of the countywide PCIT program, and preliminary outcomes were analyzed after the first round of data collection in early 2015. This paper will discuss this case and provide examples of how research and data analysis were used effectively to make key improvements to the design and implementation of the program. The paper will then discuss bureaucratic challenges and constraints with the collaborative use of research and data. The paper will conclude with some recommendations on how research and data can effectively be used to influence policy implementation in large‐scale implementations involving collaboration among multiple organizations.
Keywords: Parent-child interaction therapy; Parent-child relationships; Child psychology; Child welfare; Acquisition of data
A mixed-methods study of system-level sustainability of evidence-based practices in 12 large-scale implementation initiatives.
Scudder, A. T., Taber-Thomas, S. M., Schaffner, K., Pemberton, J. R., Hunter, L., & Herschell, A. D. (2017). A mixed-methods study of system-level sustainability of evidence-based practices in 12 large-scale implementation initiatives. Health Research Policy & Systems, 15, 1–13. https://doi-org.rsulibproxy.rsu.edu/10.1186/s12961-017-0230-8
Abstract: Background: In recent decades, evidence-based practices (EBPs) have been broadly promoted in community behavioural health systems in the United States of America, yet reported EBP penetration rates remain low. Determining how to systematically sustain EBPs in complex, multi-level service systems has important implications for public health. This study examined factors impacting the sustainability of parent-child interaction therapy (PCIT) in large-scale initiatives in order to identify potential predictors of sustainment. Methods: A mixed-methods approach to data collection was used. Qualitative interviews and quantitative surveys examining sustainability processes and outcomes were completed by participants from 12 large-scale initiatives. Results: Sustainment strategies fell into nine categories, including infrastructure, training, marketing, integration and building partnerships. Strategies involving integration of PCIT into existing practices and quality monitoring predicted sustainment, while financing also emerged as a key factor. Conclusions: The reported factors and strategies impacting sustainability varied across initiatives; however, integration into existing practices, monitoring quality and financing appear central to high levels of sustainability of PCIT in community-based systems. More detailed examination of the progression of specific activities related to these strategies may aide in identifying priorities to include in strategic planning of future large-scale initiatives.
Keywords: Sustainability, Sustainment, Evidence-based practice, Large-scale training, Implementation, Parent-child interaction therapy, Mixed methods
Effectiveness of Parent-Child Interaction Therapy (PCIT) in the treatment of young children's behavior problems. A randomized controlled study
Bjorseth, A., & Wichstrom, L. (2016). Effectiveness of Parent-Child Interaction Therapy (PCIT) in the treatment of young children's behavior problems. A randomized controlled study. PluS ONE, 11.
Abstract: Objective: The aim of the present investigation was to compare the effectiveness of Parent-Child Interaction Therapy (PCIT) with treatment as usual (TAU) in young children who were referred to regular child and adolescent mental health clinics for behavior problems.
Method: Eighty-one Norwegian families with two- to seven-year-old children (52 boys) who had scored 120 on the Eyberg Child Behavior Inventory (ECBI) were randomly assigned to receive either PCIT or TAU. The families were assessed 6 and 18 months after beginning treatment. Parenting skills were measured using the Dyadic Parent-Child Interaction Coding System (DPICS), and child behavior problems were measured using the ECBI and the Child Behavior Checklist (CBCL).
Results: Linear growth curve analyses revealed that the behavior problems of children receiving PCIT improved more compared with children receiving TAU according to mother reports (ECBI d = .64, CBCL d = .61, both p < .05) but not according to father report. Parents also improved with regard to Do and Don’t skills (d = 2.58, d = 1.46, respectively, both p .001). At the 6-month assessment, which often occurred before treatment was finished, children who had received PCIT had lower father-rated ECBI and mother-rated CBCL-scores (p = .06) compared with those who had received TAU. At the 18-month follow-up, the children who had received PCIT showed fewer behavior problems compared with TAU according to mother (d = .37) and father (d = .56) reports on the ECBI and mother reports on the CBCL regarding externalizing problems (d = .39). Parents receiving PCIT developed more favorable Do Skills (6-month d = 1.81; 18-month d = 1.91) and Don’t Skills (6-month d = 1.46; 18-month d = 1.42) according to observer ratings on the DPICS compared with those receiving TAU.
Conclusion: Children receiving PCIT in regular clinical practice exhibited a greater reduction in behavior problems compared with children receiving TAU, and their parents' parenting skills improved to a greater degree compared with those receiving TAU
Keywords: PCIT; International & Cultural Research.