Guide to Effective Programs
for Children and Youth

Parent-Child Interaction Therapy (PCIT)

OVERVIEW

Parent-Child Interaction Therapy (PCIT) is a program designed to prevent physical child abuse among families with a history of previous physical abuse or child neglect. In the program, parents and children are treated together in therapy sessions. Sessions focus on enhancing parent-child relationships by dealing with negative behaviors appropriately and reinforcing positive parent-child interaction. An evaluation of PCIT found that it was effective in reducing repeat cases of physical abuse. The PCIT program also reduced parental depression and negative parenting behaviors.

DESCRIPTION OF PROGRAM

Target population: Parents with children ages 2-12 with prior abuse reports who are at-risk for engaging in future physical child abuse.

Parent-Child Interaction Therapy (PCIT) was initially developed for young children who were exhibiting externalizing behavior disorders. This therapy style was modified to be used with physically abusive families and for children up to 12 years old. The PCIT program consists of 3 different modules and focuses directly on parent’s behaviors and interactions with their children. The first focuses on increasing the parent’s motivation to complete the treatment through testimonials from previous graduates of the program and understanding of the negative effects of abuse. The second module consists of training sessions in which parents are instructed about how to handle specific situations with their children. During this module, parents and children or therapists and children role-play various daily interactions and therapists teach skills and techniques to use in these interactions. The third and final module is a series of four follow-up sessions which are intended to answer any questions that parents may have about the program and help solve any issues that have come up since the previous sessions. In an evaluation of the PCIT program, researchers estimate that the program costs between $2,208-3,638 for each parent/child pair that completes the program.

EVALUATION(S) OF PROGRAM

Chaffin, M., Silovsky, J. F., Funderburk, B., Valle, L. A., Breston, E. V., Balachova, T., Shultz, S., & Bonner, B. L. (2003). Physical abuse treatment outcome project: Application of parent-child interaction therapy (PCIT) to physically abusive parents (Grant No. 90CA1633). Oklahoma City, OK: University of Oklahoma Health Sciences Center, Center on Child Abuse and Neglect.

Evaluated population: 100 parent/child pairs who were referred to the investigators by a county child welfare office in Oklahoma. Parents had a recent confirmed report of physical child abuse. Parents in the study had, on average, 2 previous reports of abuse, with 39% of parents reportedly engaging in severely abusive behavior. 65% of parents in the study were female, and 62% of children were male. The average age of parents in the study was 32, and the average age of children was 8. 62% of households were living below the federal poverty line, and 64% of households were receiving some sort of public assistance. Additionally, 39% of the parents met guidelines for an antisocial personality disorder, 33% met criteria for a substance abuse disorder, and 20% were classified as significantly depressed.

Approach: To qualify for the study, the parent/child pairs had to meet 5 eligibility criteria: 1) both parent and child had to be available for participation throughout the study; 2) parents had to score above a mean intelligence score of 70; 3) children were between the ages of 4 and 12; 4) parents were not identified as sexual abusers; and 5) both parent and child appeared able to participate in the intervention. All of these criteria were assessed at an initial interview. After the interview, parent/child pairs were randomly assigned to one of three conditions. The first condition was a PCIT intervention which followed the design described in the previous section. The second condition (EPCIT) was a modified PCIT treatment in which parents received additional services to specifically address parental depression, current substance abuse, and family problems. The control condition consisted of a community group (CG) in which parents were referred to a long-standing community service center which conducted a parenting program in a series of 40 sessions.

Results: Parents in the PCIT treatment condition were less likely to be re-reported for physical abuse (19%) than parents in the CG control condition (49%) over a period of 850 days following the conclusion of the intervention. Parents in the EPCIT treatment condition scored lower than parents in the community group control condition on the Beck Depression Inventory. Likewise, parents in the PCIT condition scored somewhat lower on the Beck Depression Inventory than parents in the community group condition, but this difference only approached significance. Parents in the EPCIT and PCIT treatment conditions scored lower than parents in the CG control condition on a measure of negative parenting behaviors. No differences between groups were found on measures of parenting attitudes, parent-reported child behavior problems, parental distress, parental loneliness, positive parent behaviors, and child neglect. The authors estimate that the incremental cost required to avert one repeat report of physical abuse would be between $371 and $1,326, compared with the control group treatment approach.

SOURCES FOR MORE INFORMATION

References

Website: http://pcit.phhp.ufl.edu/

Program categorized in this guide according to the following:

Evaluated participant ages: 4-12 years / Program age ranges in the Guide: early childhood; middle childhood

Program components: counseling/therapy; clinic or provider based; parent or family component

Measured outcomes: social and emotional health, physical health, behavioral problems

Program information last updated 7/24/07