Effectiveness of Parent-Child Interaction Therapy (PCIT) in the Treatment of Young Children's Behavior Problems. A Randomized Controlled Study

Åse Bjørseth, Lars Wichstrøm, Åse Bjørseth, Lars Wichstrøm

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.

Trial registration: ClinicalTrials.gov NTC01085305.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Flow of participants from recruitment…
Fig 1. Flow of participants from recruitment through analysis.
PCIT = Parent-Child Interaction Therapy, TAU = Treatment as usual.

References

    1. Wichstrøm L, Belsky J, Jozefiak T, Sourander A, Berg-Nielsen TS. Predicting Service Use for Mental Health Problems Among Young Children. Pediatrics. 2014;133(6):1054–60. 10.1542/peds.2013-3184 .
    1. Wichstrøm L, Berg-Nielsen TS, Angold A, Egger HL, Solheim E, Sveen TH. Prevalence of psychiatric disorders in preschoolers. Journal of Child Psychology and Psychiatry. 2012;53(6):695–705. 10.1111/j.1469-7610.2011.02514.x .
    1. Loeber R, Farrington DP. Young children who commit crime: Epidemiology, developmental origins, risk factors, early interventions, and policy implications. Development and Psychopathology. 2000;12(4):737–62. 10.1017/s0954579400004107 .
    1. Lundahl BW, Risser HJ, Lovejoy MC. A meta-analysis of parent training: Moderators and follow-up effects. Clin Psychol Rev. 2006;26(1):86–104. 10.1016/j.cpr.2005.07.004 .
    1. Fossum S, Handegard BH, Martinussen M, Morch WT. Psychosocial interventions for disruptive and aggressive behaviour in children and adolescents A meta-analysis. Eur Child Adolesc Psychiatry. 2008;17(7):438–51. 10.1007/s00787-008-0686-8 .
    1. Michelson D, Davenport C, Dretzke J, Barlow J, Day C. Do Evidence-Based Interventions Work When Tested in the "Real World?" A Systematic Review and Meta-analysis of Parent Management Training for the Treatment of Child Disruptive Behavior. Clin Child Fam Psychol Rev. 2013;16(1):18–34. 10.1007/s10567-013-0128-0 .
    1. Menting ATA, de Castro BO, Matthys W. Effectiveness of the Incredible Years parent training to modify disruptive and prosocial child behavior: A meta-analytic review. Clin Psychol Rev. 2013;33(8):901–13. 10.1016/j.cpr.2013.07.006 .
    1. de Graaf I, Speetjens P, Smit F, de Wolff M, Tavecchio L. Effectiveness of the Triple P Positive Parenting Program on Parenting: A Meta-Analysis. Family Relations. 2008;57(5):553–66. 10.1111/j.1741-3729.2008.00522.x .
    1. Sanders MR, Kirby JN, Tellegen CL, Day JJ. The Triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support. Clin Psychol Rev. 2014;34(4):337–57. 10.1016/j.cpr.2014.04.003
    1. Nowak C, Heinrichs N. A comprehensive meta-analysis of triple p-positive parenting program using hierarchical linear modeling: Effectiveness and moderating variables. Clin Child Fam Psychol Rev. 2008;11(3):114–44. 10.1007/s10567-008-0033-0 .
    1. Eyberg SM, Nelson MM, Boggs SR. Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. J Clin Child Adolesc Psychol. 2008;37(1):215–37. 10.1080/15374410701820117 .
    1. Thomas R, Zimmer-Gembeck MJ. Behavioral outcomes of parent-child interaction therapy and triple p-positive parenting program: A review and meta-analysis. J Abnorm Child Psychol. 2007;35(3):475–95. 10.1007/s10802-007-9104-9 .
    1. Ogden T, Hagen KA. Treatment effectiveness of Parent Management Training in Norway: A randomized controlled trial of children with conduct problems. J Consult Clin Psychol. 2008;76(4):607–21. 10.1037/0022-006x.76.4.607 .
    1. Sigmarsdottir M, Degarmo DS, Forgatch MS, Gudmundsdottir EV. Treatment effectiveness of PMTO for children's behavior problems in Iceland: Assessing parenting practices in a randomized controlled trial. Scand J Psychol. 2013;54(6):468–76. 10.1111/sjop.12078 .
    1. Drugli MB, Larsson B, Fossum S, Morch WT. Five- to six-year outcome and its prediction for children with ODD/CD treated with parent training. Journal of Child Psychology and Psychiatry. 2010;51(5):559–66. 10.1111/j.1469-7610.2009.02178.x .
    1. Gerards S, Dagnelie PC, Gubbels JS, van Buuren S, Hamers FJM, Jansen MWJ, et al. The Effectiveness of Lifestyle Triple P in the Netherlands: A Randomized Controlled Trial. PLoS One. 2015;10(4). 10.1371/journal.pone.0122240 .
    1. Abrahamse ME, Junger M, Wouwe MAMM, Boer F, Lindauer RJ. Treating child disruptive behavior in high-risk families: A comparative effectiveness trial from a community-based implementation. Journal of Child and Family Studies. 2015;November 26:No Pagination Specified. 10.1007/s10826-015-0322-4
    1. Leung C, Tsang S, Sin TCS, Choi S-y. The Efficacy of Parent-Child Interaction Therapy With Chinese Families: Randomized Controlled Trial. Research on Social Work Practice. 2015;25(1):117–28. 10.1177/1049731513519827 .
    1. Lenze SN, Pautsch J, Luby J. Parent-Child Interaction Therapy Emotion Development: A Novel Treatment for Depression in Preschool Children. Depress Anxiety. 2011;28(2):153–9. 10.1002/da.20770 .
    1. Puliafico AC, Comer JS, Pincus DB. Adapting Parent-Child Interaction Therapy to Treat Anxiety Disorders in Young Children. Child Adolesc Psychiatr Clin N Am. 2012;21(3):607–+. 10.1016/j.chc.2012.05.005 .
    1. Carpenter AL, Puliafico AC, Kurtz SMS, Pincus DB, Comer JS. Extending Parent-Child Interaction Therapy for Early Childhood Internalizing Problems: New Advances for an Overlooked Population. Clin Child Fam Psychol Rev. 2014;17(4):340–56. 10.1007/s10567-014-0172-4 .
    1. Bagner DM, Coxe S, Hungerford GM, Garcia D, Barroso NE, Hernandez J, et al. Behavioral parent training in infancy: A window of opportunity for high-risk families. J Abnorm Child Psychol. 2015;October8:No Pagination Specified. 10.1007/s10802-015-0089-5
    1. Kohlhoff J, Morgan S. Parent-Child Interaction Therapy for Toddlers: A Pilot Study. Child Fam Behav Ther. 2014;36(2):121–39. 10.1080/07317107.2014.910733 .
    1. Foros PB, Vetlesen AJ. Angsten for oppdragelse: Et samfunnsetisk perspektiv på dannelse Oslo, Norway: Universitetsforlaget; 2012.
    1. Weisz JR, Kuppens S, Eckshtain D, Ugueto AM, Hawley KM, Jensen-Doss A. Performance of Evidence-Based Youth Psychotherapies Compared With Usual Clinical Care A Multilevel Meta-analysis. Jama Psychiatry. 2013;70(7):750–61. 10.1001/jamapsychiatry.2013.1176 .
    1. Weisz JR, Doss AJ, Hawley KM. Youth psychotherapy outcome research: A review and critique of the evidence base. Annu Rev Psychol. Annual Review of Psychology. 562005 p. 337–63.
    1. Lyon AR, Budd KS. A Community Mental Health Implementation of Parent-Child Interaction Therapy (PCIT). Journal of Child and Family Studies. 2010;19(5):654–68. 10.1007/s10826-010-9353-z .
    1. Budd KS, Hella B, Bae H, Meyerson DA, Watkin SC. Delivering Parent-Child Interaction Therapy in an Urban Community Clinic. Cogn Behav Pract. 2011;18(4):502–14. .
    1. Pearl E, Thieken L, Olafson E, Boat B, Connelly L, Barnes J, et al. Effectiveness of Community Dissemination of Parent-Child Interaction Therapy. Psychological Trauma-Theory Research Practice and Policy. 2012;4(2):204–13. 10.1037/a0022948 .
    1. Chaffin M, Funderburk B, Bard D, Valle LA, Gurwitch R. A Combined Motivation and Parent-Child Interaction Therapy Package Reduces Child Welfare Recidivism in a Randomized Dismantling Field Trial. J Consult Clin Psychol. 2011;79(1):84–95. 10.1037/a0021227 .
    1. Bagner DM, Eyberg SM. Parent-child interaction therapy for disruptive Behavior in children with mental retardation: A Randomized controlled trial. J Clin Child Adolesc Psychol. 2007;36(3):418–29. .
    1. Werba BE, Eyberg SM, Boggs SR, Algina J. Predicting outcome in parent-child interaction therapy—Success and attrition. Behav Modif. 2006;30(5):618–46. 10.1177/0145445504272977 .
    1. Schuhmann EM, Foote RC, Eyberg SM, Boggs SR, Algina J. Efficacy of parent-child interaction therapy: Interim report of a randomized trial with short-term maintenance. J Clin Child Psychol. 1998;27(1):34–45. 10.1207/s15374424jccp2701_4 .
    1. McCabe K, Yeh M. Parent-Child Interaction Therapy for Mexican Americans: A Randomized Clinical Trial. J Clin Child Adolesc Psychol. 2009;38(5):753–9. 10.1080/15374410903103544 .
    1. Eisenstadt TH, Eyberg S, McNeil CB, Newcomb K, Funderburk B. Parent-Child Interaction Therapy with Behavior Problem Children—Relative Effectiveness of 2 Stages and Overall Treatment Outcome. J Clin Child Psychol. 1993;22(1):42–51. 10.1207/s15374424jccp2201_4 .
    1. Nixon RDV, Sweeney L, Erickson DB, Touyz SW. Parent-child interaction therapy: A comparison of standard and abbreviated treatments for oppositional defiant preschoolers. Journal of Consulting and Clinical Psychology. 2003;71(2):251–60. 10.1037/0022-006x.71.2.251 .
    1. Comer JS, Chow C, Chan PT, Cooper-Vince C, Wilson LAS. Psychosocial Treatment Efficacy for Disruptive Behavior Problems in Very Young Children: A Meta-Analytic Examination. Journal of the American Academy of Child and Adolescent Psychiatry. 2013;52(1):26–36. 10.1016/j.jaac.2012.10.001 .
    1. McCabe K, Yeh M, Lau A, Argote CB. Parent-Child Interaction Therapy for Mexican Americans: Results of a Pilot Randomized Clinical Trial at Follow-up. Behavior Therapy. 2012;43(3):606–18. 10.1016/j.beth.2011.11.001
    1. Eyberg SM, Funderburk BW, Hembree-Kigin TL, McNeil CB, Querido JG, Hood KK. Parent-Child Interaction Therapy with behavior problem children: One and two year maintenance of treatment effects in the family. Child & Family Behavior Therapy. 2001;23(4):1–20. 10.1300/J019v23n04_01 .
    1. Hood KK, Eyberg SM. Outcomes of parent-child interaction therapy: Mothers' reports of maintenance three to six years after treatment. J Clin Child Adolesc Psychol. 2003;32(3):419–29. 10.1207/s15374424jccp3203_10 .
    1. Eyberg SM, Pincus DB. Eyberg Child Behavior Inventory and Sutter-Eyberg Behavior Inventory-Revised: Professional manual Odessa, Fl.: Psychological Assessment Resources; 1999.
    1. Reedtz C, Bertelsen B, Lurie J, Handegard BH, Clifford G, Morch WT. Eyberg Child Behavior Inventory (ECBI): Norwegian norms to identify conduct problems in children. Scand J Psychol. 2008;49(1):31–8. 10.1111/j.1467-9450.2007.00621.x
    1. Egger HL, Erkanli A, Keeler G, Potts E, Walter BK, Angold A. Test-retest reliability of the Preschool Age Psychiatric Assessment (PAPA). Journal of the American Academy of Child and Adolescent Psychiatry. 2006;45(5):538–49. 10.1097/01.chi.0000205705.71194.b8 .
    1. Webster-Stratton C, Hancock L. Training for parents of young children with conduct-problems: content, methods and therapeutic processes In: Briesmeister JM, Schaefer CE, editors. Handbook of parent training: Parents as co-therapists for childrens behaviour problems. New-York: Wiley; 1998.
    1. Patterson GR, Reid J, Dishion T. A social interactional approach: Antisocial boys 4: Castalia, Eugene, OR; 1992.
    1. DeGarmo DS, Patterson GR, Forgatch MS. How do outcomes in a specified parent training intervention maintain or wane over time? Prevention Science. 2004;5(2):73–89. 10.1023/B:PREV.0000023078.30191.e0 .
    1. Websterstratton C. Randomized trial of 2 parent-training programs for families with conduct-disordered children. J Consult Clin Psychol. 1984;52(4):666–78. 10.1037/0022-006x.52.4.666 .
    1. Beauchaine TP, Webster-Stratton C, Reid MJ. Mediators, moderators, and predictors of 1-year outcomes among children treated for early-onset conduct problems: A latent growth curve analysis. J Consult Clin Psychol. 2005;73(3):371–88. 10.1037/0022-006x.73.3.371 .
    1. Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149–60. 10.3758/brm.41.4.1149 .
    1. Organization WH. ICD-10 Psykiske lidelser og atferdsforstyrrelser In: helsetilsyn S, editor. Oslo: Gyldendal Norsk Forlag AS; 2000.
    1. Tripp G, Luk SL, Schaughency EA, Singh R. DSM-IV and ICD-10: A comparison of the correlates of ADHD and hyperkinetic disorder. J Am Acad Child Adolesc Psychiatry. 1999;38(2):156–64. 10.1097/00004583-199902000-00014 .
    1. Lahey BB, Pelham WE, Chronis A, Massetti G, Kipp H, Ehrhardt A, et al. Predictive validity of ICD-10 hyperkinetic disorder relative to DSM-IV attention-deficit/hyperactivity disorder among younger children. Journal of Child Psychology and Psychiatry. 2006;47(5):472–9. 10.1111/j.1469-7610.2005.01590.x .
    1. Integrity checklists and session materials. Parent-child interaction therapy manual [Internet]. 1999.
    1. Eyberg SM, Funderburk B. Parent-child interaction therapy. Integrity checklists and session materials. Gainesville, FL.: ; 1999.
    1. McNeil CB, Hembree-Kigin TL. Parent-Child Interaction Therapy. New York: Springer; 2010
    1. Hembree-Kigin TL, McNeil CB. Parent-child interaction therapy New York: Springer; 1995.
    1. Hedenbro M, Wirtberg I, editors. Samspillets kraft; Marte Meo—mulighet til utvikling Oslo: Kommuneforlaget; 2002.
    1. Webster-Stratton C, Reid MJ, Hammond M. Treating children with early-onset conduct problems: Intervention outcomes for parent, child, and teacher training. Journal of Clinical Child and Adolescent Psychology. 2004;33(1):105–24. 10.1207/s15374424jccp3301_11 .
    1. Larsson B, Fossum S, Clifford G, Drugli MB, Handegard BH, Morch WT. Treatment of oppositional defiant and conduct problems in young Norwegian children Results of a randomized controlled trial. Eur Child Adolesc Psychiatry. 2009;18(1):42–52. 10.1007/s00787-008-0702-z .
    1. Achenbach TM, Rescorla L. Manual for the ASEBA preschool forms and profiles Burlington, VT: University of Vermont; 2000.
    1. Achenbach TM, Rescorla LA. Manual for the ASEBA school age forms and profile Burlington: University of Vermont Research Center for Children, Youth and Families; 2001.
    1. Jozefiak T, Larsson B, Wichstrom L, Rimehaug T. Competence and emotional/behavioural problems in 7-16-year-old Norwegian school children as reported by parents. Nordic Journal of Psychiatry. 2012;66(5):311–9. 10.3109/08039488.2011.638934 .
    1. Achenbach TM, Becker A, Doepfner M, Heiervang E, Roessner V, Steinhausen H-C, et al. Multicultural assessment of child and adolescent psychopathology with ASEBA and SDQ instruments: research findings, applications, and future directions. Journal of Child Psychology and Psychiatry. 2008;49(3):251–75. 10.1111/j.1469-7610.2007.01867.x .
    1. Novik TS. Child Behavior Checklist item scores in Norwegian children. Eur Child Adolesc Psychiatry. 2000;9(1):54–60. .
    1. Eyberg SM, Nelson MM, Duke M, Boggs SR. Manual for the Dyadic Parent-Child Interaction Coding System. 3. ed. Gainesville 2005.
    1. van de Schoot R, Kaplan D, Denissen J, Asendorpf JB, Neyer FJ, van Aken MAG. A Gentle Introduction to Bayesian Analysis: Applications to Developmental Research. Child Dev. 2014;85(3):842–60. 10.1111/cdev.12169 .
    1. Muthén LK, Muthén BO. Mplus User's Guide. 7th ed. Los Angeles, CA: Muthén & Muthén; 1998–2015.
    1. Ellis PD. Effect size equations 2009 [cited 2015 03.01].
    1. Hedges LV. Distribution theory for Glass estimatior of effect size and related estimators. Journal of Educational Statistics. 1981;6(2):106–28.
    1. Hagen KA, Ogden T, Bjornebekk G. Treatment Outcomes and Mediators of Parent Management Training: A One-Year Follow-Up of Children with Conduct Problems. J Clin Child Adolesc Psychol. 2011;40(2):165–78. 10.1080/15374416.2011.546050 .
    1. Griffin C, Guerin S, Sharry J, Drumm M. A multicentre controlled study of an early intervention parenting programme for young children with behavioural and developmental difficulties. Int J Clin Health Psychol. 2010;10(2):279–94. .
    1. Lindhiem O, Higa J, Trentacosta CJ, Herschell AD, Kolko DJ. Skill Acquisition and Utilization During Evidence-Based Psychosocial Treatments for Childhood Disruptive Behavior Problems: A Review and Meta-analysis. Clinical Child and Family Psychology Review. 2014;17(1):41–66. 10.1007/s10567-013-0136-0 .
    1. Lundahl BW, Tollefson D, Risser H, Lovejoy MC. A meta-analysis of father involvement in parent training. Research on Social Work Practice. 2008;18(2):97–106. 10.1177/1049731507309828 .
    1. Coplin JW, Houts AC. Father involvement in parent training for oppositional child-behavior—progress or stagnation. Child Fam Behav Ther. 1991;13(2):29–51. .
    1. Bagner DM, Eyberg SM. Father involvement in parent training: When does it matter? J Clin Child Adolesc Psychol. 2003;32(4):599–605. 10.1207/s15374424jccp3204_13 .
    1. Krol N, De Bruyn EEJ, Coolen JC, van Aarle EJM. From CBCL to DSM: A comparison of two methods to screen for DSM-IV diagnoses using CBCL data. J Clin Child Adolesc Psychol. 2006;35(1):127–35. 10.1207/s15374424jccp3501_11 .
    1. Brasil HHA, Bordin IA. Convergent validity of K-SADS-PL by comparison with CBCL in a Portuguese speaking outpatient population. BMC Psychiatry. 2010;10 10.1186/1471-244x-10-83 .
    1. Connolly JJ, Glessner JT, Kao C, Elia J, Hakonarson H. Attention-Deficit Hyperactivity Disorder and PharmacotherapyPast, Present, and Future: A Review of the Changing Landscape of Drug Therapy. Therapeutic Innovation & Regulatory Science. 2015;49(5):632–42. 10.1177/2168479015599811 .
    1. Bagner DM, Graziano PA. Barriers to Success in Parent Training for Young Children With Developmental Delay: The Role of Cumulative Risk. Behav Modif. 2013;37(3):356–77. 10.1177/0145445512465307 .

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