Copyright October 2007 Sheila Eyberg Adaptations of Parent-Child Interaction Therapy to Different Needs, Different Groups UF PCIT Training Workshop October, 2007
Transcript
Slide 1
Copyright October 2007 Sheila Eyberg Adaptations of
Parent-Child Interaction Therapy to Different Needs, Different
Groups UF PCIT Training Workshop October, 2007
Slide 2
Copyright October 2007 Sheila Eyberg Active Skills Training
PCIT Proven Effective for Large Stuffed Bears
Slide 3
Copyright October 2007 Sheila Eyberg Weekly ECBI Intensity
Scores Normative mean Clinical cutoff Criterion to end treatment
Treatment Completers (n = 64) And All Children Who Complete
Treatment
Slide 4
Copyright October 2007 Sheila Eyberg PCIT is an Evidence-Based
Treatment for (strictly speaking) Young children (3 to 6)
Disruptive behavior disorders USA or Australian residents Without
severe mental impairment (e.g., autism) And their non-cognitively
delayed parents Designation based on two well-conducted RTCs
Schuhmann et al., 1998 (US study) Nixon et al., 2003 (Australian
study)
Slide 5
Copyright October 2007 Sheila Eyberg PCIT also named one of two
Well-Supported and Efficacious Treatments for Child Abuse
Designation based on a now classic study Chaffin, M., Silovsky, J.,
Funderburk, B. et al. (2004). Parent-child interaction therapy with
physically abusive parents: Efficacy for reducing future abuse
reports. Journal of Consulting and Clinical Psychology, 72, 500510.
U.S. Department of Justice - Office for Victims of Crimes
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Copyright October 2007 Sheila Eyberg But (strictly speaking)
the Chaffin Study Presented An Adaptation of PCIT for a Special
Population Child Abusing Parents Extended child age range up to 12
Age-appropriate CDI activities (e.g., crafts) Age-appropriate
back-ups to timeout chair (e.g., loss of privilege) Added group
modules at beginning and end Pre-PCIT motivational enhancement
group 6 session preparation for treatment involvement Follow-up
group meetings 4 sessions of loosely structured problem-solving
PCIT protocol was made time-limited (14 wks)
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Copyright October 2007 Sheila Eyberg Observed Parent Negative
Behaviors (Criticism, Sarcasm, Negative Touch) Chaffin et al.,
2004
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Copyright October 2007 Sheila Eyberg PCIT (Plus 6-week
Motivation Enhancement) with Abusive Parents Percent Re-Abuse
During 2.5 Years After Treatment Chaffin et al., 2004
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Copyright October 2007 Sheila Eyberg Exciting Results But If
you learn PCIT, will it work for child abuse treatment? Or must you
also use the motivation protocol? Economically important question
for agencies deciding whether to adopt a treatment Another question
the study spawns Does PCIT work for 12-year-olds? Unlikely
effective for treating conduct-disordered 12-year-olds Another
question Would the adaptations made for older children work well
with young disruptive children? Empirical question but
unlikely
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Copyright October 2007 Sheila Eyberg How Best to Develop a PCIT
Adaptation Test standard PCIT in the new population If it does not
work, an adaptation unlikely to work If it does work, then you can
examine if adaptation improves outcomes Problems with testing
adapted PCIT first If it does not work, you dont know if the
treatment or the adaptation was the problem If it does work, you
dont know if adaptation is needed It can waste expensive research
dollars and time First see if adaptation is needed
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Copyright October 2007 Sheila Eyberg A Pilot Study of PCIT for
Children with Comorbid ODD and Mental Retardation 3 - 6 years old
Oppositional defiant disorder DISC-IV-P and CBCL Mild or moderate
MR WPPSI-III Adaptive Behavior Scale Inclusion criteria Bagner
& Eyberg, 2007
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Copyright October 2007 Sheila Eyberg Children with Comorbid ODD
and Mental Retardation Major sensory impairments in child
(deafness, blindness) Childhood autism spectrum disorders Childhood
Autism Rating Scale Child history of psychosis Primary caregiver
not MR Wonderlic Personnel Test Families suspected of child abuse
Exclusion Criteria Bagner & Eyberg, 2007
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Copyright October 2007 Sheila Eyberg Sample Description Child
77 % male 67% Caucasian Mean age = 4.5 yrs Mean FSIQ = 59 (SD =
11.06) Family 73% two-parent families Mean age of mother = 36;
father = 38 Hollingshead SES = 41.30 (SD = 14.14) Bagner &
Eyberg, 2007
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Copyright October 2007 Sheila Eyberg Study Treatment
Characteristics Families randomized to PCIT (n = 15) or Waitlist
Control (n = 15) conditions Therapists Advanced graduate students
Weekly supervision Average of 12 weekly sessions CDI time limited
(6 sessions) PDI not time limited Completion criteria unchanged
Treatment Integrity 97% accuracy; 97% interrater reliability High
treatment satisfaction Therapy Attitude Inventory = 46.88 Bagner
& Eyberg, 2007
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Copyright October 2007 Sheila Eyberg Clinical cutoff Disruptive
Behavior Change in Children with Comorbid ODD and Mental
Retardation 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. n = 8 treatment
completers
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Copyright October 2007 Sheila Eyberg Mothers Do Skills During
Child-Led Play d = 1.43 p