Internet-delivered Parent-Child Interaction for Parents of Children 2-7 Years With Disruptive Behaviors (iPCIT pilot)

The goal of this feasibility study is to evaluate feasibility of Internet-delivered Parent-Child Interaction Therapy for parents of children 2-7 years with disruptive behaviors. The main questions it aims to answer are:

1. Could a brief online version of PCIT (iPCIT) be feasible for reducing disruptive behaviors and internalizing problems in young children, and for improving the quality of parent-child interaction?
2. How is iPCIT experienced by participating parents?

Participants will receive a 10-week online intervention of Parent-Child Interaction Therapy and answer questionnaires online weekly.

Study Overview

• Status: Active, not recruiting
• Conditions: Disruptive Behavior
• Intervention / Treatment: Behavioral: Internet-delivered Parent-Child Interaction Therapy

Detailed Description

Severe early behavioral problems increase the risk of impaired functioning in childhood and later life. Parent-Child Interaction Therapy (PCIT) is particularly effective for young children (age 2-7) with disruptive behaviors but is unimplemented in Sweden. Barriers to PCIT implementation include time constraints for parents and therapist challenges. An abbreviated internet-delivered version, iPCIT, may address these barriers. The objective of the study is to evaluate feasibility and acceptability of iPCIT.

Research questions

This study will use an uncontrolled pretest-posttest design, all participants will receive the intervention. The intervention consists of 10 weekly modules delivered over the Internet with guided support from an experienced CBT-trained psychologist and 5 biweekly videosessions where parents practice parental skills in a play situation with their child while receiving feedback and support from their therapist.

Assessments will be made pretreatment, weekly during treatment for the primary outcome and potential mediators, posttreatment, at the primary endpoint 2 months after treatment completion and at follow up 6 months after treatment completion. Twenty participants (parents of children aged 2-7 years) will be included. All outcome data will be collected digitally and include for feasibility: treatment credibility, working alliance, compliance with the treatment (number of modules completed), any adverse events, subjective overall relief and satisfaction with treatment. For potential efficacy, the clinical effect in the group will be analyzed on pre- to post-measurements, including weekly measurements and 2 months follow up after treatment termination (primary endpoint). The participants will be followed 6 months after treatment completion to analyze long term clinical effects.

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Stockholm, Sweden
    • Centre for Psychiatry Research, Karolinska Institutet

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Children aged 2-7 years
• Disruptive behaviors as assessed with Eyberg Child Behavior Inventory (ECBI) ≥126 for boys and ≥121 for girls (which corresponds to the 90th percentile according to Swedish norms)
• Language ability equivalent to at least an average 2-year-old, defined as a vocabulary of ≥ 25 word and ability to understand simple instructions, assessed with a language screening form

Exclusion Criteria:

• Severe autism spectrum condition (autism level 2 or 3 or equivalent functioning)
• parents who are not proficient enough in the Swedish language to complete questionnaries and receive therapy without an interpreter
• Presence of severe parental psychiatric disorders such as psychosis or suicidal ideations
• Ongoing severe psychosocial distress such as custody dispute.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: iPCIT; Online parent management training (PMT) to teach parental skills (10 weekly online modules) combined with videosession for coaching of parental skills (5 biweekly sessions)	Behavioral: Internet-delivered Parent-Child Interaction Therapy; Parent management training delivered online where Internet-modules are combined with video sessions for live coaching.; Other Names: Internet-CBT; Internet-delivered cognitive behavior therapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Eyberg Child Behavior Inventory	Caregiver report form measuring disruptive behaviors in children. 36 items with answers ranging from 1 (never) to 7 (always). Minimum value: 36. Maximum value: 252. A higher score means worse outcome.	From pretreatment to 18 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dyadic Parent-Child Interaction Coding System	Observation System measuring parental behavior and child behavior. The frequency of specified behaviors are measured during a five minute long standardized play situation.	From pretreatment to 10 weeks
Weekly assessment of Child Behavior Forms	Short caregiver report form measuring disruptive behaviors in children. Two scales with 9 items each with answers ranging from 1 (never) to 7 (always). Minimum value: 9. Maximum value: 63. A higher score means worse outcome.	From pretreatment to 18 weeks
Child Behavior Checklist	Caregiver report form identifying problem behavior in children. 99 items with answers ranging from 0 (do not agree) to 2 (strongly agree). Minimum value: 0. Maximum value: 198. A higher score means worse outcome.	From pretreatment to 10 weeks
Brunnsviken Brief Quality of Life Scale	Questionnaire about quality of life. 12 items with answers ranging from 1 (strongly disagree) to 4 (strongly agree). Minimum value: 0. Maximum value: 96. A higher score means better outcome.	From pretreatment to 18 weeks
Perceived Stress Scale	Questionnaire measuring overall stress. A 7-item version of the scale will be used with answers ranging from 0 (never) to 4 (very often). Minimum value: 0. Maximum value: 28. A higher score means worse outcome.	From pretreatment to 18 weeks
Parental Stress Scale	Questionnaire measuring stress induced by parenthood. 18 items with answers from 1 ("strongly disagree") to 5 ("strongly agree"). Minimum value: 18. Maximum value: 90. A higher score means worse outcome.	From pretreatment to 18 weeks
Difficulties in Emotion Regulation Scale	Questionnaire measuring emotion regulation ability. 16 items with answers ranging from 1 (almost never) to 5 (almost always). Minimum value: 16. Maximum value: 80. A higher score means worse outcome.	From pretreatment to 18 weeks
Parenting Young Children Scale	Questionnaire measuring parental strategies. 6 items with answers ranging from 1 (never) to 7 (many times a day). Minimum value: 6. Maximum value: 42. A higher score means better outcome.	From pretreatment to 18 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Subjective Adequate Relief Questionnaire	Questionnaire that measures self-perceived change in symptoms as a result of the treatment. The scale consists of 1 item rated from 0 (much worse) to 6 (much better).	Posstreatment (treatment week 10)
Adverse events questionnaire	Short 6-item questionnaire to identify if any adverse events have occurred due to treatment	Posstreatment (treatment week 10)
Working Alliance Inventory	Questionnaire measuring alliance with therapist. 6 items scored on a scale from 1 (never) to 7 (always). Minimum value: 6. Maximum value: 42. A higher score means better outcome.	Treatment week 3
Credibility Rating Scale	Questionnaire measuring treatment credibility. 5 items scored on a scale from 0 (not at all) to 10 (very). Minimum value: 0. Maximum value: 50. A higher score means better outcome.	Treatment week 3
The Client Satisfaction Questionnaire	Questionnaire measuring satisfaction with treatment. 8 items with answers ranging from 1 (bad) to 4 (very good). Minimum value: 8. Maximum value: 32. A higher score means better outcome.	Posstreatment (treatment week 10)

Collaborators and Investigators

• Sponsor: Karolinska Institutet
• Investigators: Principal Investigator: Marianne Bonnert, PhD, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Stockholm Sweden

Study record dates

Study Major Dates

• Study Start (Actual): March 10, 2025
• Primary Completion (Actual): September 30, 2025
• Study Completion (Estimated): June 15, 2026

Study Registration Dates

• First Submitted: February 10, 2025
• First Submitted That Met QC Criteria: February 10, 2025
• First Posted (Actual): February 14, 2025

Study Record Updates

• Last Update Posted (Actual): December 8, 2025
• Last Update Submitted That Met QC Criteria: December 1, 2025
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Keywords: Children; Parent; Parent-Child Interaction Therapy; Internet-CBT
• Additional Relevant MeSH Terms: Behavioral Symptoms; Behavior; Child Behavior; Problem Behavior
• Other Study ID Numbers: EPM Dnr: 2024-06544-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No