July 2011 – June 2014
Parent-Child Interaction Therapy (PCIT) is an empirically validated treatment for externalizing behavior problems in young children. Foster children are at an especially high risk of developing externalizing problems, difficulties that their foster parents are not often trained to manage effectively.
PCIT is typically delivered by therapists in 12-14 individual, weekly sessions. Although efficacious, standard PCIT is resource intensive, so it is unlikely to be adopted as a routine service by child welfare agencies. Therefore, the objective of this study was to implement and test the efficacy of a novel adaptation of PCIT with foster families using group-based and in-home treatment.
The intervention coupled two innovative treatment modalities: (1) an intensive PCIT group training with foster parent-child dyads, and (2) daily in-home rehearsal of PCIT skills reinforced by regular telephone counseling sessions. A total of 129 foster families were randomly assigned to three groups, including two experimental conditions receiving different treatment doses. Both treatment groups received a two-day training followed by 8 weeks of in-home clinical services. One of the two treatment groups then received a one-day booster session of PCIT training along with 6 more weeks of in-home services. The two experimental groups were compared to each other and a third waitlist control group.
The study had three central aims: (a) to examine whether two treatment conditions receiving different doses of PCIT demonstrate gains in parent and child outcomes compared to each other and to a control group receiving child welfare services as usual, (b) to identify predictors of treatment non-response, and (c) to explore mediators of main-effect findings. Assessments were conducted at baseline and several subsequent time points for each group. Multiple informants and measures were used to assess study outcomes, including children’s externalizing behaviors, compliance, and emotion regulation as well as caregivers’ behavior management skills, parenting attitudes and stress.