Skip to main content

Advertisement

Log in

A Community Mental Health Implementation of Parent–Child Interaction Therapy (PCIT)

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

Parent–Child Interaction Therapy (PCIT) has been identified as an evidence-based practice in the treatment of externalizing behavior among preschool-aged youth. Although considerable research has established its efficacy, little is known about the effectiveness of PCIT when delivered in a community mental health setting with underserved youth. The current pilot study investigated an implementation of PCIT with primarily low-socioeconomic status, urban, ethnic minority youth and families. The families of 14 clinically referred children aged 2–7 years and demonstrating externalizing behavior completed PCIT initial assessment, and 12 began treatment. Using standard PCIT completion criteria, 4 families completed treatment; and these families demonstrated clinically significant change on observational and self-report measures of parent behavior, parenting stress, and child functioning. Although treatment dropouts demonstrated more attenuated changes, observational data and parent-reported problems across sessions indicated some improvements with lower doses of intervention. Attendance and adherence data, referral source, barriers to treatment participation, and treatment satisfaction across completers and dropouts are discussed to highlight differences between the current sample and prior PCIT research. The findings suggest that PCIT can be delivered successfully in an underserved community sample when families remain in treatment, but that premature dropout limits treatment effectiveness. The findings suggest potential directions for research to improve uptake of PCIT in a community service setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Abidin, R. (1995). Parenting stress manual (3rd ed.). Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  • Achenbach, T. M., & Rescorla, L. A. (2000). Manual of the ASEBA preschool forms & profiles. Burington, VT: University of Vermont, Research Center for Children, Youth, & Families.

    Google Scholar 

  • Achenbach, T. M., & Rescorla, L. A. (2001). Manual of the ASEBA school-age forms and profiles. Burington, VT: University of Vermont, Research Center for Children, Youth, & Families.

    Google Scholar 

  • Aday, L. A. (1994). Health status of vulnerable populations. Annual Review of Public Health, 15, 487–509.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, 4 th edition, text revision (DSM-IV-TR) (4th ed.). Washington, DC: American Psychiatric Association.

    Book  Google Scholar 

  • Bagner, D. M., & Eyberg, S. M. (2007). Parent–Child Interaction Therapy for disruptive behavior in children with mental retardation: A randomized controlled trial. Journal of Clinical Child and Adolescent Psychology, 36, 1–12.

    Google Scholar 

  • Bernal, G., & Scharrón-Del-Río, M. R. (2001). Are empirically supported treatments valid for ethnic minorities? Toward an alternative approach for treatment research. Cultural Diversity and Ethnic Minority Psychology, 7, 328–342.

    Article  PubMed  Google Scholar 

  • Boggs, S. R., Eyberg, S. M., Edwards, D. L., Rayfield, A., Jacobs, J., Bagner, D., et al. (2004). Outcomes of Parent–Child Interaction Therapy: A comparison of treatment completers and study dropouts out to three years later. Child and Family Behavior Therapy, 26, 1–22.

    Article  Google Scholar 

  • Brestan, E. V., & Eyberg, S. M. (1998). Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5,272 kids. Journal of Clinical Child Psychology, 27, 180–189.

    Article  PubMed  Google Scholar 

  • Brestan, E. V., Jacobs, J. R., Rayfield, A. D., & Eyberg, S. M. (1999). A consumer satisfaction measure for parent–child treatments and its relation to measures of child behavior change. Behavior Therapy, 30, 17–30.

    Article  Google Scholar 

  • Bureau of Justice Statistics. (1997). Age patterns of victims of serious violent crime (NCJ-162031). Washington DC: US Department of Justice.

    Google Scholar 

  • Capage, L. C., Bennett, G. M., & McNeil, C. B. (2001). A comparison between African American and Caucasian children referred for treatment of disruptive behavior disorders. Child and Family Behavior Therapy, 23, 1–14.

    Article  Google Scholar 

  • Chaffin, M., Silovsky, J. F., Funderburk, B., Valle, L., Brestan, E. V., Balachova, T., et al. (2004). Parent–Child Interaction Therapy with physically abusive parents: Efficacy for reducing future abuse reports. Journal of Consulting and Clinical Psychology, 72, 500–510.

    Article  PubMed  Google Scholar 

  • Chaffin, M., Valle, L. A., Funderburk, B., Gurwitch, R., Silovsky, J., Bard, D., et al. (2009). A motivational intervention can improve retention in PCIT for low-motivation child welfare clients. Child Maltreatment, 14, 356–368.

    Article  PubMed  Google Scholar 

  • Chambless, D. L., Sanderson, W. C., Shoman, V., Bennett-Johnson, S., Pope, K. S., Crits-Christoph, P., et al. (1996). An update on empirically validated therapies. The Clinical Psychologist, 49, 5–18.

    Google Scholar 

  • Chase, R. M., & Eyberg, S. M. (2008). Clinical presentation and treatment outcome for children with comorbid externalizing and internalizing symptoms. Journal of Anxiety Disorders, 22, 273–282.

    Article  PubMed  Google Scholar 

  • Eisenstadt, T. H., Eyberg, S., McNeil, C. B., Newcomb, K., & Funderburk, B. (1993). Parent–Child Interaction Therapy with behavior problem children: Relative effectiveness of two stages and overall treatment outcome. Journal of Clinical Child Psychology, 22, 42–51.

    Article  Google Scholar 

  • Eyberg, S. M. (1993). Consumer satisfaction measures for assessing parent training programs. In L. VandeCreek, S. Knapp, & T. L. Jackson (Eds.), Innovations in clinical practice: A sourcebook (Vol. 12). Sarosota, FL: Professional Resource Press.

    Google Scholar 

  • Eyberg, S. M. (2005). Tailoring and adapting Parent–Child Interaction Therapy to new populations. Education and Treatment of Children, 28, 191–205.

    Google Scholar 

  • 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 and Family Behavior Therapy, 23, 1–20.

    Article  Google Scholar 

  • Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology, 37, 215–237.

    Article  PubMed  Google Scholar 

  • Eyberg, S. M., Nelson, M. M., Duke, M., & Boggs, S. R. (2005). Manual for the Dyadic Parent–Child Interaction Coding System (3rd ed.). Retrieved July 1, 2006 from http://pcit.phhp.ufl.edu/DPICSfiles/DPICS%20Draft%203.03.pdf.

  • Eyberg, S. M., & Pincus, D. (1999). Eyberg Child Behavior Inventory and Sutter-Eyberg Student Behavior Inventory: Professional manual. Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  • Eyberg, S. M., & Robinson, E. A. (1982). Parent–Child Interaction Training: Effects on family functioning. Journal of Clinical Child Psychology, 11, 130–137.

    Google Scholar 

  • Eyberg, S. M., & Child Study Lab. (1999). Parent–Child Interaction Therapy: Integrity checklists and materials. Retrieved July 1, 2005 from: http://pcit.phhp.ufl.edu.

  • Farrington, D. P. (1995). The development of offending and antisocial behavior from childhood: Key findings from the Cambridge study in delinquent development. Journal of Child Psychology and Psychiatry and Allied Disciplines, 36, 929–964.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Friars, P. M., & Mellor, D. J. (2007). Drop out from behavior management training programs for ADHD: A prospective study. Journal of Child and Family Studies, 16, 427–441.

    Article  Google Scholar 

  • Funderburk, B. W., Eyberg, S. M., Newcomb, K., McNeil, C. B., Hembree-Kigin, T., & Capage, L. (1998). Parent–Child Interaction Therapy with behavior problem children: Maintenance of treatment effects in the school setting. Child and Behavior Therapy, 20, 17–38.

    Article  Google Scholar 

  • Gallagher, N. (2003). Effects of Parent–Child Interaction Therapy on young children with disruptive behavior disorders. Bridges, 1, 1–17.

    Google Scholar 

  • Garcia, J. A., & Weisz, J. R. (2002). When youth mental health care stops: Therapeutic relationship problem and other reasons for ending youth outpatient treatment. Journal of Consulting and Clinical Psychology, 70, 439–443.

    Article  PubMed  Google Scholar 

  • Gross, D., Fogg, L., Young, M., Ridge, A., Cowell, J. M., Richardson, R., et al. (2006). The equivalence of the Child Behavior Checklist/1½-5 across parent race/ethnicity, income level, and language. Psychological Assessment, 18, 313–323.

    Article  PubMed  Google Scholar 

  • Gross, D., Fogg, L., Young, M., Ridge, A., Cowell, J., Sivan, A., et al. (2007). Reliability and validity of the Eyberg Child Behavior Inventory with African-American and Latino parents of young children. Research in Nursing and Health, 30, 213–223.

    Article  PubMed  Google Scholar 

  • Gross, D., Julion, W., & Fogg, L. (2001). What motivates participation and dropout among low-income urban families of color in a prevention intervention? Family Relations, 50, 246–254.

    Article  Google Scholar 

  • Harrison, M. E., McKay, M. M., & Bannon, W. M. (2004). Inner-city child mental health service use: The real question is why youth and families do not use services. Community Mental Health Journal, 40, 119–131.

    Article  PubMed  Google Scholar 

  • Harwood, M. D., & Eyberg, S. M. (2006). Child-directed interaction: Prediction of change in mother-child functioning. Journal of Abnormal Child Psychology, 34, 335–347.

    Article  PubMed  Google Scholar 

  • 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, 419–429.

    Article  PubMed  Google Scholar 

  • Huey, S. J., & Polo, A. J. (2008). Evidence-based psychosocial treatments for ethnic minority youth: A review and meta-analysis. Journal of Clinical Child and Adolescent Psychology, 37, 262–301.

    Article  PubMed  Google Scholar 

  • Jacobson, N. S., Follette, W. C., & Revenstorg, D. (1984). Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance. Behavior Therapy, 15, 336–352.

    Article  Google Scholar 

  • Jacobson, N. S., Roberts, L. J., Berns, S. B., & McGlinchey, J. B. (1999). Methods for defining and determining the clinical significance of treatment effects: Description, application, and alternatives. Journal of Consulting and Clinical Psychology, 67, 300–307.

    Article  PubMed  Google Scholar 

  • Jacobson, N. S., & Traux, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.

    Article  PubMed  Google Scholar 

  • Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among US children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159, 1548–1555.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E. (1996). Dropping out of child therapy: Issues for research and implications for practice. Clinical Child Psychology and Psychiatry, 1, 133–156.

    Article  Google Scholar 

  • Kazdin, A. E. (2003). Psychotherapy for children and adolescents. Annual Review of Psychology, 54, 253–276.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., Holland, L., Crowley, M., & Breton, S. (1997). Barriers to Treatment Participation Scale: Evaluation and validation in the context of child outpatient treatment. Journal of Child Psychology and Psychiatry, 38, 1051–1062.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., Mazurick, J. L., & Siegel, T. C. (1994). Treatment outcome among children with externalizing disorder who terminate prematurely versus those who complete psychotherapy. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 271–281.

    Article  Google Scholar 

  • Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.

    Article  PubMed  Google Scholar 

  • Loeber, R., Green, S. M., Keenan, K., & Lahey, B. B. (1995). Which boys will fare worse? Early predictors of the onset of conduct disorder in a six-year longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 499–509.

    Article  PubMed  Google Scholar 

  • Matos, M., Torres, R., Santiago, R., Jurado, M., & Rodríguez, I. (2006). Adaptation of Parent–Child Interaction Therapy for Puerto Rican families: A preliminary study. Family Process, 45, 205–222.

    Article  PubMed  Google Scholar 

  • McCabe, K., & Yeh, M. (2009). Parent–Child Interaction Therapy for Mexican Americans: A randomized clinical trial. Journal of Clinical Child & Adolescent Psychology, 38, 753–759.

    Article  Google Scholar 

  • McKay, M. M., & Bannon, W. M. (2004). Engaging families in child mental health services. Child and Adolescent Psychiatric Clinics of North America, 13, 905–921.

    Article  PubMed  Google Scholar 

  • McKay, M. M., Stoewe, J., McCadam, K., & Gonzales, J. (1998). Increasing access to child mental health services for urban children and their caregivers. Health and Social Work, 23, 9–16.

    PubMed  Google Scholar 

  • McNeil, C. B. (2007). Dissemination of PCIT: Lessons learned from the front lines. Keynote address presented at the 7th National PCIT Conference: Oklahoma City, OK.

  • Miller, G. E., & Prinz, R. J. (2003). Engagement of families in treatment for childhood conduct problems. Behavior Therapy, 34, 517–534.

    Article  Google Scholar 

  • Miranda, J., Bernal, G., Lau, A., Kohn, L., Hwang, W., & LaFramboise, T. (2005). State of the science on psychosocial interventions for ethnic minorities. Annual Review of Clinical Psychology, 1, 113–142.

    Article  PubMed  Google Scholar 

  • Nixon, R. D., Sweeny, 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.

    Article  PubMed  Google Scholar 

  • Nock, M. K., & Ferriter, C. (2005). Parent management of attendance and adherence in child and adolescent therapy: A conceptual and empirical review. Clinical Child and Family Psychology Review, 8, 149–166.

    Article  PubMed  Google Scholar 

  • Nock, M. K., & Kazdin, A. E. (2005). Randomized controlled trial of a brief intervention for increasing participation in parent management training. Journal of Consulting and Clinical Psychology, 73, 872–879.

    Article  PubMed  Google Scholar 

  • Owens, P. L., Hoagwood, K., Horwitz, S. M., Leaf, P. J., Poduska, J. M., Kellam, S. G., et al. (2002). Barriers to children’s mental health services. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 731–738.

    Article  PubMed  Google Scholar 

  • Pearl, E. S. (2008). Parent–Child Interaction Therapy with an immigrant family exposed to domestic violence. Clinical Case Studies, 7, 25–41.

    Article  Google Scholar 

  • Phillips, J., Morgan, S., Cawthorne, K., & Barnett, B. (2008). Pilot evaluation of Parent–Child Interaction Therapy delivered in an Australian community early childhood clinic setting. Australian and New Zealand Journal of Psychiatry, 42, 712–719.

    Article  PubMed  Google Scholar 

  • Proctor, B., & Kalaker, J. (2002). U.S. Census Bureau, Current Population Reports. Poverty in the United States: 2001 (pp. 60–219). Washington DC: U.S. Government Printing Office.

    Google Scholar 

  • Rawal, P., Romansky, R., Jenuwine, M., & Lyons, J. S. (2004). Racial differences in the mental health needs and service utilization of youth in the juvenile justice system. Journal of Behavioral Health Services & Research, 31, 242–255.

    Google Scholar 

  • Reid, J. B. (1993). Prevention of conduct disorder before and after school entry: Relating interventions to developmental findings. Development and Psychopathology, 5, 243–262.

    Article  Google Scholar 

  • Reitman, D., Currier, R. O., & Stickle, T. R. (2002). A critical evaluation of the parenting stress index-short form (PSI-SF) in a head start population. Journal of Clinical Child and Adolescent Psychology, 31, 384–392.

    PubMed  Google Scholar 

  • Richardson, L. A. (2001). Seeking and obtaining mental health services: What do parents expect? Archives of Psychiatric Nursing, 15, 233–241.

    Article  Google Scholar 

  • Rowe, R., Maughan, B., Costell, E. J., & Angold, A. (2005). Defining oppositional defiant disorder. Journal of Child Psychology and Psychiatry, 46, 1309–1316.

    Article  PubMed  Google Scholar 

  • Schuhmann, E. M., Foote, R. C., Eyberg, S. M., Boggs, S. R., & Algina, J. (1998). Efficacy of Parent–Child Interaction Therapy: Interim report of a randomized trial with short-term maintenance. Journal of Clinical Child Psychology, 27, 34–45.

    Article  PubMed  Google Scholar 

  • Serketich, W. J., & Dumas, J. E. (1996). The effectiveness of behavioral parent training to modify antisocial behavior in children: A meta-analysis. Behavior Therapy, 27, 171–186.

    Article  Google Scholar 

  • Snowden, L. R. (1999). African American service use for mental health problems. Journal of Community Psychology, 27, 303–314.

    Article  Google Scholar 

  • Snowden, L. R., Storey, C., & Clancey, T. (1989). Ethnicity and continuation in treatment at a Black community mental health center. Journal of Community Psychology, 17, 111–118.

    Article  Google Scholar 

  • Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2003). Youth with anxiety disorders in research and service clinics: Examining client differences and similarities. Journal of Clinical Child and Adolescent Psychology, 32, 375–385.

    Article  PubMed  Google Scholar 

  • Sue, S., Fujino, D. C., Hu, L., Takeuchi, D. T., & Zane, N. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting and Clinical Psychology, 59, 533–541.

    Article  PubMed  Google Scholar 

  • Takeuchi, D. T., Bui, K. T., & Kim, L. (1993). The referral of minority adolescents to community mental health centers. Journal of Health and Social Behavior, 34, 153–164.

    Article  PubMed  Google Scholar 

  • Thomas, R., & Zimmer-Gembeck, M. J. (2007). Behavioral outcomes of Parent–Child Interaction Therapy and Triple P–Positive Parenting Program: A review and meta-analysis. Journal of Abnormal Child Psychology, 35, 475–495.

    Article  PubMed  Google Scholar 

  • Timmer, S. G., Urquiza, A. J., Zebell, N. M., & McGrath, J. M. (2005). Parent–Child Interaction Therapy: Application to maltreating parent–child dyads. Child Abuse and Neglect, 29, 825–842.

    PubMed  Google Scholar 

  • Vitelli, R. (1997). Prevalence of childhood conduct and attention-deficit hyperactivity disorders in adult maximum-security inmates. International Journal of Offender Therapy & Comparative Criminology, 40, 263–271.

    Article  Google Scholar 

  • Watt, B. D., & Dadds, M. R. (2007). Facilitating treatment attendance in child and adolescent mental health services: A community study. Clinical Child Psychology and Psychiatry, 12, 105–116.

    Article  PubMed  Google Scholar 

  • Weersing, V. R., & Weisz, J. R. (2002). Community clinic treatment of depressed youth: Benchmarking usual care against CBT clinical trials. Journal of Consulting and Clinical Psychology, 70, 299–310.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Doss, A. J., & Hawley, K. M. (2005a). Youth psychotherapy outcome research: A review and critique of the evidence base. Annual Review of Psychology, 56, 337–363.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Han, S. S., & Valeri, S. M. (1997). More of what? Issues raised by the Fort Bragg study. American Psychologist, 52, 541–545.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Jensen, A. L., & McLeod, B. D. (2005b). Development and dissemination of child and adolescent psychotherapies: Milestones, methods, and a new deployment-focused model. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatments for child, adolescent disorders: Empirically based strategies for clinical practice. Washington, DC: American Psychological Association.

    Google Scholar 

  • Werba, B. E., Eyberg, S. M., Boggs, S. R., & Algina, J. (2006). Predicting outcome in Parent–Child Interaction Therapy: Success and attrition. Behavior Modification, 30, 618–646.

    Article  PubMed  Google Scholar 

  • Zane, N., Sue, S., Change, J., Huang, L., Lowe, S., Srinivasan, S., et al. (2005). Beyond ethnic match: Effects of client-therapist cognitive match in problem perception, coping orientation, and therapy goals on treatment outcomes. Journal of Community Psychology, 33, 585–596.

    Article  Google Scholar 

  • Zisser, A., & Eyberg, S. M. (2008). Parent–Child Interaction Therapy and the treatment of oppositional children. In A. E. Kazdin & J. R. Weisz (Eds.), Evidence-based psychotherapist for children and adolescents (2nd ed., pp. 204–223). New York: Guilford Press.

    Google Scholar 

Download references

Acknowledgments

This project was supported in part by funding provided by the DePaul University Research Council, awarded to the second author. In addition, the authors would like to thank the project research assistants, participating therapists, and families, without whom this project would not have been possible.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karen S. Budd.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lyon, A.R., Budd, K.S. A Community Mental Health Implementation of Parent–Child Interaction Therapy (PCIT). J Child Fam Stud 19, 654–668 (2010). https://doi.org/10.1007/s10826-010-9353-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-010-9353-z

Keywords

Navigation