Parent-Child Interaction Therapy (PCIT) Singapore

 

Parent-child interaction therapy (PCIT) is an effective, evidence-based parenting intervention for children aged 2-7 years old and their caregivers. 

PCIT Research

Research Information

PCIT was developed by Dr Sheila Eyberg in the 1970s as an intervention for children diagnosed with Disruptive Behaviour Disorders (e.g. Oppositional Defiant Disorder, Conduct Disorder and ADHD). She drew on concepts of best parenting style, attachment theory, social learning theory and behaviour modifications to create this unique therapy.  

 

Over the past 40 years, the effectiveness of PCIT has been supported by a growing body of research which consisted of single-subject studies, program evaluations and randomized controlled trials. With over 300 papers published, there is clear research evidence that PCIT is an effective and efficacious treatment program. PCIT has been shown to have good effectiveness, long-term efficacy and generalizability.

Effectiveness

To examine the effectiveness of PCIT on addressing child problem behaviours, we make reference to Thomas et al’s (2017) meta-analysis of PCIT. In the paper, his team reviewed 23 PCIT studies which consisted of 1144 participants to examine the results of PCIT versus control groups who received other form of therapy or no therapy. Measures examined included child externalizing behaviours, parental stress and parent-child interactions. 

 

This statistical analysis which combined the results of the many studies found that PCIT was superior to control groups for reducing child externalizing behaviours. PCIT also significantly reduced parent-related stress and child-related stress.  

 

Another meta-analysis of 12 PCIT studies by Ward et al (2016) demonstrated that PCIT had a large effect size on improved behaviour problems in children with disruptive behaviour disorder when they examined pre-treatment and post-treatment behaviour outcomes across treatment and control groups. 

Long Term Efficacy

In the area of long-term gains, the first follow-up research by Eyberg et al (2001) found that 2 years after PCIT, mothers still reported a maintenance of reduced problem behaviours in their child and lowered parenting stress. Subsequent outcomes studies demonstrated maintenance of treatment gains up to 6 years (Hood & Eyberg, 2003).

Generalization

PCIT shows good generalizability in children who have undergone the program and its application to various life situations. 

 

1. To school setting 

For children who display problem behaviours both at home and school, research has showed that gains made at home via PCIT treatment was generalized to the school setting despite no direct classroom intervention (McNeil et al, 1991). 

 

‚Äč2. To siblings 

In a study of treatment generalization to siblings, Brestan et al (1997) found that after undergoing PCIT with a target child, mothers reported siblings’ behaviour as less distressing or difficult to manage and fathers also reported reduced frequency of problem behaviour in siblings. 

 

PCIT has the potential to impact all children in the family - it can serve as a remedial treatment for a child who displays problem behaviour as well as a preventive intervention for children who may display occasional mild behaviour problems. Parents are thus equipped with a skill that can have far reaching effects on the whole family.

Effectiveness with Various Population Groups

Over the past decade, the effectiveness of PCIT has been tested with various population groups. 

 

When applied to families with history of maltreatment, PCIT resulted in improved parent-child interaction, higher use of positive parenting behaviour and reduction in re-reports of physical abuse (Chaffin et al, 2004).  

 

PCIT has been listed as one of the three best practice for working with children with a history of maltreatment by Kaufman Best Practices Project final report (2004) and it is recognized by the National Child Traumatic Stress Network as a trauma informed treatment for young children. 

 

When applied to treatment of children diagnosed with autism, PCIT resulted in increased compliance and reduced problem behaviours (Agazzi et al, 2013). 

 

At the end of 2018, the Handbook of Parent-Child Interaction Therapy: Innovations and Applications for Research and Practice was published which documented adaptations of PCIT to successfully treat children with depression, anxiety, behavioural inhibitions and developmental delay.

PCIT Around the World

PCIT is currently being practiced internationally in 17 countries. Closer to home, countries practicing PCIT include Hong Kong, Indonesia, Japan, South Korea and Taiwan. Hong Kong has published two research papers which showed the efficacy of PCIT on the Chinese population (Leung et al, 2015; Leung et al, 2017).  PCIT is thus proving itself to be a therapy that transcends geographical locations and cultures.

Other Links

For the full list of research papers done on PCIT, please click here (http://www.pcit.org/pcit-research.html)

 

For more information on PCIT and child welfare, please refer to a good review of the literature here (http://www.pcit.org/uploads/6/3/6/1/63612365/pcit_overview_child_welfare.pdf)

References: 

1. Agazzi, H., Tan, R., Tan, S. Y. (2013). A case study of parent-child interaction therapy for treatment of autism spectrum disorder. Clinical Case Studies, 12, 428-442. 

2. Brestan, E. V., Eyberg, S. M., Boggs, S. R., & Algina, J. (1997). Parent-child interaction therapy: Parents’ perceptions of untreated siblings. Child and Family Behaviour Therapy, 19, 13-28.

3. 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, 500-510. 

4. 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 behaviour problem children: One and two year maintenance of treatment effects in the family. Child and Family Behaviour Therapy, 23, 1-20.

5. Hood, K., & Eyberg, S. M. (2003). Outcomes of parent-child interaction therapy: Mothers’ reports on maintenance three to six years after treatment. Journal of Clinical Child and Adolescent Psychology, 32, 419-429. 

6. Leung, C., Tsang, S., Sin, T. C., & Choi, S. Y. (2015). The efficacy of parent–child interaction therapy with Chinese families: Randomized controlled trial. Research on Social Work Practice, 25, 117-128. 

7. Leung, C., Tsang, S., Ng, G. S. H., & Choi, S. Y. (2017). Efficacy of parent–child interaction therapy with Chinese ADHD children: Randomized controlled trial. Research on Social Work Practice, 27, 36-47. 

8. McNeil, C. B., Eyberg, S., Eisenstadt, T. H., Newcomb, K., & Funderburk, B. (1991). Parent-child interaction therapy with behaviour problem children: Generalization of treatment effects to the school setting. Journal of Clinical Child Psychology, 20, 140-151. 

9. Niec, L. N. (2018). Handbook of Parent-child interaction therapy Innovations and application for research and practice. MI: Springer. 

10. Thomas, R., Abell, B., Webb, H. J., Avdagic, E., & Zimmer-Gembeck, M. J. (2017). Parent-child interaction therapy: A meta-analysis. Pediatrics, 140, 1-17.

11. Ward, M. A. Theule, J., & Cheung, K. (2016). Parent-child interaction therapy for child disruptive behaviour disorders: A meta-analysis. Child Youth Care Forum, 45, 675-690.