Parent-Child Interaction Therapy
Promising Intervention for Physically Abusive Parents and Foster Parent – Foster Child Dyads
Parent-Child Interaction Therapy (PCIT) was initially developed in the 1970s as a treatment for families with children ages 2 to 7 with oppositional and defiant behavior. More recently, PCIT has been adapted for use with physically abusive parents with children aged 4 to 12, and is an appropriate treatment when physical abuse occurs within the context of child discipline, which is consistent with most cases of physical abuse.
This treatment consists of highly specified, step-by-step, live-coached sessions with both the caregiver and the child. The therapist watches the parent and child interact from behind a 1-way mirror and provides coaching to the parent through a wireless earphone. This treatment is typically conducted over 12 to 20 sessions and consists of two parts: (1) Child Direction Interaction, which teaches the use of positive reinforcement and ignoring minor misbehavior (includes strategies such as praise, reflection, imitation, and description); and (2) Parent-Direction Interaction, which teaches discipline skills (including how to give specific instructions, consistency, and following step-by-step procedures when their child is non-compliant).
Recent research has investigated the efficacy of PCIT in preventing future incidents of child physical abuse among physically abuse parents. In one of the most cited of these studies, participants were randomly assigned to one of the three structured conditions: PCIT, PCIT with additional services, and standard community-based services. Post-treatment follow-up was completed and subsequent maltreatment reports were obtained from child protective services databases. Nineteen percent of parents in the PCIT condition had a re-report for physical abuse, as compared to 39% of those in the EPCIT condition, and 49% of parents in the standard, community-based group (Chaffin, et al., 2004). The authors cite research that has shown that with each new maltreatment incident, the probability of subsequent occurrences increases. Thus, is not only important to intervene with these families, but to implement treatments that have strong research support and the best chance of slowing or stopping this downward spiral
In addition, recent research has also evaluated the effectiveness of PCIT in reducing foster parent stress in coping with a foster child’s behavior problems. The authors note the importance of evaluating interventions for difficult foster children, as aggressive and defiant foster children are more likely to have multiple out-of-home placements. Research has indicated that foster children who experience multiple placements are likely to experience greater academic difficulties and exhibit more behavioral problems as compared to children with stable placements. Recently, team of researchers evaluated PCIT with a 41-year-old married foster-adoptive mother and her 4-year-old foster son (Timmer, et al., 2006). At the end of treatment, both parenting stress and the child’s behavior problems had decreased, and the foster placement was saved. The authors note that changing how a child interacts with a caregiver is a difficult and a rare undertaking. However, because persistence of child behavior problems often results in placement loss, it is important for social workers, social service administrators and mental health professionals to assist both foster parents and the children for whom they care.
Overview on PCIT was obtained from the Child Study Laboratory at the University of Florida. For more information, see: http://pcit.phhp.ufl.edu/
Chaffin, M., Silovsky, J. F., Funderburk, B., Valle, L. A., Brestan, E. V., Balachova, T., Jackson, S., Lensgraf, J., &
Bonner, B. L. (2004). Parent-Child Interaction Therapy with physically abusive parents: Efficacy for reducing future abuse reports. Journal of Consulting and Clinical Psychology, 72(3).
Timmer, S. G., Uruiza, A. J., Herschell, A. D., McGrath, J. M., Zebell, N. M., Porter, A. L., & Vargas, E. C. (2006). Parent-Child Interaction Therapy: Application of an empirically supported treatment to maltreated children in foster care. Child Welfare, 85, 919-939.
