Parent ChildParent ChildInteraction Interaction TherapyTherapy(PCIT)(PCIT)
The Future of School Psychology Task Force on
Family-School Partnerships
Kathryn Woods, Stephanie Bieltz, and Amanda Clinton
DefinitionDefinition
PCIT is a short-term, empirically validated intervention that is designed
for families with young children. This form of treatment may be used for
externalizing and internalizing problems and a broad range of behavioral,
emotional, and developmental problems exhibited in
childhood.
See PCIT Handout 1 for More Information
Rationale for a Multi-Tiered Rationale for a Multi-Tiered Approach to Family-School Approach to Family-School
PartnershipsPartnerships Family-school partnerships provide a context for families and educators to collaboratively identify and prioritize concerns across a continuum of opportunities and intensities
Prevention and intervention efforts and supports are delivered toward a universal and targeted audience
A multi-tiered approach enables families and educators to provide services based on a student’s responsiveness to previous preventions, interventions, and supports
See PCIT Handout 2 for More Information
Explanation for a Multi-Explanation for a Multi-Tiered Approach to Family-Tiered Approach to Family-
School PartnershipsSchool Partnerships Provides various levels of family-school supports based on a student’s identified need and responsiveness to previous efforts Universal – Family-school collaboration provided to support all students and families (e.g., 4 As, Parent-School Collaboration, Parent Involvement, Parent Education)
Targeted – Family-school collaboration provided to support identified students and families unresponsive to previous universal efforts (e.g., Parent Education and Intervention, Parent Consultation)
Intensive – Family-school collaboration provided to students and families unresponsive to previous targeted efforts (e.g., Parent Consultation [conjoint behavioral consultation] and Parent Intervention)
Tier 2: Targeted Group InterventionsSpecific preventions and remedial interventions
for targeted groups of families and students identified as “at risk” and unresponsive to the
first tier (e.g., Parent Training and Intervention, Parent Consultation)
The Multi-Tiered Approach to The Multi-Tiered Approach to Family-School PartnershipsFamily-School Partnerships
Tier 1 80-90%
Tier 31-7%
Tier 25-15%
Tier 1: Universal Interventions
Engaging all families as collaborative partners (e.g., 4 As,
Family-School Collaboration, Parent Involvement, Parent
Education)
Tier 3: Intensive, Individual InterventionsIndividualized supports for families and students unresponsive to the first two tiers (e.g., Parent
Consultation [conjoint behavioral consultation] and Family Intervention)
Rationale for Using Rationale for Using PCITPCIT
Early intervention is critical to prevent negative developmental trajectories and outcomes
Unlike other techniques used to improve child behavior, PCIT emphasizes a comprehensive treatment approach that is focused on increasing positive behavior, decreasing negative behavior, and improving the parent-child relationship (McDiarmid & Bagner, 2005)
Parent-child relationships are at the heart of many intervention efforts and intervention efforts that focus on improving this relationship enable families to interact with their children and achieve satisfying relationships and positive outcomes for children and their families for years to come (Epps & Jackson, 2000)
See Overview Module for More Information on
Partnering with Families
PCIT ResearchPCIT Research Research examining the effectiveness of PCIT has found: Statistically and clinically significant improvements in child disruptive behaviors and noncompliance
Treatment effects that generalize to home, daycare, preschool, early elementary classroom settings, and untreated siblings
Significant improvements in parent reported activity and stress levels, child internalizing problems, and self-esteem
High degree of participant satisfaction Clinically significant improvements maintained at one and two-year follow-up evaluations
See PCIT Implementation Guidelines for Factors that Influence the Effectiveness of PCIT
Treatment GoalsTreatment Goals
Goals for treatment include: An improvement in the quality of the parent-child relationship
An increase in parenting skills An increase in child prosocial behaviors
A decrease in child behavior problems A decrease in parenting stress
(Hembree-Kigin & McNeil, 1995)
Steps in PCITSteps in PCIT
Step 1: Pretreatment Assessment of Child and Family Functioning and Feedback
Step 2: Teaching Behavioral Play Therapy Skills
Step 3: Coaching Behavioral Play Therapy
Skills Step 4: Teaching Discipline Skills
Steps in PCIT cont. Steps in PCIT cont.
Step 5: Coaching Discipline Skills Step 6: Posttreatment Assessment of Child and Family Functioning and Feedback
Step 7: Boosters
(Information on steps and session content gathered from Hembree-Kigin & McNeil, 1995)
Session #1 - IntakeSession #1 - Intake Average Length: 1-2 Sessions Process:
Information is gathered on concerns, developmental history, family functioning, and family stressors
Formal testing is conducted which will serve as a baseline measure of a child’s behavior and parenting skills
Therapist observes and may videotape how the parent and child interact with one another
Feedback on these interactions will be provided during the next session
See PCIT Implementation Guidelines for More Information on PCIT Sessions
Session #1 – IntakeSession #1 – Intake Process cont.:
Information is also collected regarding the family’s experience using time-out
Time-out is described in later sessions so it is important to inform the family that the time-out that will be described is different from the one that may have been used unsuccessfully in the past
Feedback regarding assessment results and treatment planning is provided
Preliminary feedback on observations is discussed along with results from formal testing
Parents are asked why they believe their child is experiencing problems
Therapist tries to reduce any feelings of guilt the parents may have for their child’s behavior problems while also encouraging them to take responsibility for successfully resolving them
Available ResourcesAvailable Resources Assessment tools that may be used during intake: Parent Report Measures:
Child Behavior Checklist – Parent Form Eyberg Child Behavior Inventory Parenting Stress Index Social Skills Rating System Conners Parent Rating Scale – Revised Vineland Adaptive Behavior Scales Childhood Autism Rating Scale Minnesota Multiphasic Personality Inventory – 2
Beck Depression Inventory See PCIT Handout 3 for References
Available Resources Available Resources cont.cont.
Assessment tools that may be used during intake: Teacher Report Measures:
Sutter-Eyberg Student Behavior Inventory Child Behavior Checklist Social Skills Rating System Conners Teacher Rating Scale
Child Report Measures: Harter Pictoral Scale of Perceived Competence and Social Acceptance for Young Children
Peabody Picture Vocabulary Test – Revised
See PCIT Handout 3 for References
Session #2 – Session #2 – Teaching BehavioralTeaching Behavioral
Play Therapy Play Therapy Average Length: 1 Session Process:
Goals of behavioral play therapy are described Rationale for the use of brief daily home “play therapy” sessions is presented
“Do” and “Don’t” skills of behavioral play therapy are described
Use of strategic attention and selective ignoring are discussed
All skills are modeled together Parents are coached as they role-play skills
Logistics of play therapy at home are discussed
Session #2 – Session #2 – Teaching Behavioral Teaching Behavioral
Play TherapyPlay Therapy Goals of Behavioral Play Therapy
Goals based on presenting concerns Important to convey that playtime is a therapeutic intervention and not “just playing” with the child
Daily Home Play Therapy Practice To be done for at least 5 minutes everyday with the child leading the activity
Play therapy should not be viewed as a privilege that the child can earn or lose
Playtime is often more important on days when the child has misbehaved
Session #2 –Session #2 – Teaching Behavioral Teaching Behavioral
Play TherapyPlay Therapy “Do” Skills (DRIP)
Describe appropriate behavior Reflect appropriate verbalizations Imitate appropriate play Praise prosocial behavior
“Don’t” Skills Give commands or make requests Ask questions Criticize or correct in a negative way
Session #2 – Session #2 – Teaching Behavioral Teaching Behavioral
Play TherapyPlay Therapy Using Strategic Attention
Involves using the “Do” skills of behavioral play therapy Used to reward the behaviors adults would like to see the child display more often
First, identify the behaviors or qualities that the parent sees as desirable and prosocial even if infrequent at first
Parents may want to think of the behaviors they would like to see their child display as opposed to their inappropriate behaviors
Once behaviors are identified, parents are to lookout for targeted behavior
“Catch the child being good” Parents are encouraged to use strategic attention and praise appropriate behavior as much as possible throughout the day
Session #2 – Session #2 – Teaching Behavioral Teaching Behavioral
Play TherapyPlay Therapy Using Selective Ignoring
Parents are to identify behaviors or qualities they would like to see diminished
In order for ignoring to be effective the child must be doing the problem behavior to get a reaction or attention from the parent
Therapist then helps the parents analyze whether or not their attention rewards the child for engaging in each of the behaviors and whether the removal of attention should be expected to impact the behavior
Important for parents to understand that a behavior that is ignored will get worse before it gets better
Parents should determine if they can tolerate having the behavior get worse before it gets better
Parents must also understand that once they begin to ignore a behavior they must continue to ignore the behavior until it stops occurring
Session #2 – Session #2 – Teaching Behavioral Teaching Behavioral
Play TherapyPlay Therapy Modeling Skills Together
The therapist may model the skills with the parent pretending to be the child or show a videotaped segment of a parent with a child who presented with similar problems
After demonstrating the combined skills the parent performs a role-play
The therapist should encourage parents to perform the “Do” skills and may suggest specific phrases for the parent to repeat
Purpose is to show the parent how it feels to do the skills and what it is like to have someone providing frequent feedback on their performance
Session #2 – Session #2 – Teaching Behavioral Teaching Behavioral
Play TherapyPlay Therapy Considerations:
Behavioral play therapy is particularly helpful for one-parent families
These parents may often feel stressed and overburdened and this playtime provides them with positive interactions and time with their children
Two-parent families should consider alternating days in which each parent engages in play therapy with the child
Parents can also do play therapy at home with all of their children between the age of 2 and 7
Before leaving the session, parents should know when and where they will conduct play therapy in their home
Should be done in a place that is quiet, private, and free of distractions and should occur at about the same time everyday
Parents are reminded to practice for 5 minutes a day and are given a recording sheet to note whether or not they practiced and any difficulties or problems that came up during playtime
Session #3 – Session #3 – Coaching Behavioral Coaching Behavioral Play Therapy SkillsPlay Therapy Skills
Average Length: 2 – 4 Sessions Process:
Check-in and review homework Recording of play therapy skills Coaching of play therapy skills Feedback on progress and homework assignment
Individual time with child (optional)
Session #3 –Session #3 – Coaching Behavioral Coaching Behavioral Play Therapy SkillsPlay Therapy Skills
Observing Behavioral Play Therapy Skills The parent and child play together for five minutes and the therapist records the parent’s progress on a chart that is updated on a weekly basis
Progress is compared to mastery criteria
Criteria is based on concept of overlearning principles taught by therapists
Session #3 – Session #3 – Coaching Behavioral Coaching Behavioral Play Therapy SkillsPlay Therapy Skills
Coaching the “Do” and “Don’t” Skills: Tips for Therapists Make coaching brief and precise
Should take the form of labeled praise, gentle correction, directives, and observations
Coach after nearly every parent verbalization Give more praise than correction Coach easier skills first Incorporate observations into feedback Make use of humor Move from more directive to less directive coaching
Session #3 – Session #3 – Coaching Behavioral Coaching Behavioral Play Therapy SkillsPlay Therapy Skills
Qualitative Aspects of Parent-Child Interactions
Physical closeness and touching Eye contact, facial expressions, vocal qualities
Turn-taking, sharing, polite manners Developmentally sensitive teaching Task persistence
Session #4 – Session #4 – Teaching Discipline Skills Teaching Discipline Skills
Average Length: 1 Session Process:
Explain use of compliance exercises Discuss how to give effective directions Discuss how to determine if child has obeyed Discuss consequences for obeying Discuss consequences for disobeying Present backups for time-out Coach parents as they role-play discipline skills
Session #4 – Session #4 – Teaching Discipline SkillsTeaching Discipline Skills Importance of Compliance Exercises
Parents are informed of the importance of consistency, predictability, and follow-through
Parents are taught to view all misbehavior as falling into two categories: noncompliance and disruptiveness
Noncompliance – refusing to do what one is told
Disruptiveness – doing things that one is told not to do
Session #4 – Session #4 – Teaching Discipline SkillsTeaching Discipline Skills
Importance of Compliance Exercises cont. Best way to teach compliance is through practice
By receiving a great deal of enthusiastic praise for small accomplishments, the child views minding in a more positive light and the habit of defying simple requests is weakened
Once compliance is improved within these exercises parents are coached in more real-life situations such as getting their child to come in from outside
Session #4 – Session #4 – Teaching Discipline SkillsTeaching Discipline Skills
Determining Compliance: Even with well-stated commands it is sometimes difficult to determine if a child has obeyed
The following situations should be discussed with the parent to determine if the child complied with the parent’s direction
Doing something slightly different from the parent’s request
Dawdling “Playing Deaf” Partially complying Minding with a bad attitude Undoing
Session #4 – Session #4 – Teaching Discipline SkillsTeaching Discipline Skills
Consequences for Obeying Parents are taught to praise their child as specifically as possible when their child complies with a request
Labeled praise such as: “Thanks for minding,” “I like it when you do what I ask,” or “Good following instructions!”
When enthusiastic labeled praises are given for listening children begin to view compliance in a more positive light
In addition to labeled praise, the parent should mention that they are happy that the child did not have to go to time-out
Session #4 – Session #4 – Teaching Discipline SkillsTeaching Discipline Skills
Consequences for Disobeying If a child does not follow a parent’s command, parents are instructed to not repeat the command, but make a “two-choices statement”
Parents hold up two fingers and says in a neutral tone of voice, “You have two choices. You can put Mr. Potato Head back in the box or go to time-out.”
It is critical that a parent never provides a two-choices statement without being prepared to follow through with time-out
After giving the statement, parents are taught to watch closely to determine whether their child has complied
If so, enthusiastic praise is given If not, the parent should proceed with time-out
Session #4 – Session #4 – Teaching Discipline SkillsTeaching Discipline Skills
Time-Out Parent should escort child to time-out and then explain that the child is to sit in the chair until they can get off
The time-out chair should be in a specific, “boring” location that is free from distractions or attention from others
Time-out is over after the child has spent three minutes in time-out chair
More time may be added if child misbehaves in time-out chair
Session #4 – Session #4 – Teaching Discipline SkillsTeaching Discipline Skills
Backups for time-out Isolation in another room Restriction of privileges
Ways to handle time-out escape Stand by time-out chair Place hand on child’s shoulder as they sit in time-out
Repeatedly place child back in time-out chair Add additional time for time-out escapes Explain to child that time-out does not begin until they sit appropriately
Parents role-play discipline skills Time-out procedures are reviewed Parents should not use time-out until after the next session with additional coaching by the therapist
Session #5 –Session #5 – Coaching Discipline Coaching Discipline
SkillsSkills Average Length: 4-6 Sessions Process:
Rehearse time-out with family Coach discipline skills Combine play therapy and discipline skills
Coach time-out
Session #5 – Session #5 – Coaching Discipline SkillsCoaching Discipline Skills Guidelines for Coaching Discipline Skills Give one instruction at a time Use positively stated instructions Coach both verbal and nonverbal communication
Praise parental compliance Offer support and reassurance Use relaxation training strategies
Session #6 – Session #6 – Posttreatment Assessment Posttreatment Assessment
of of Child and FamilyChild and Family
Average Length: 1 – 2 Sessions Process:
Therapist and family review therapy progress
Discuss strategies for addressing any remaining problems
Decide on a schedule for maintenance or “booster” sessions
Session #6 – Session #6 – Posttreatment Assessment Posttreatment Assessment
of of Child and FamilyChild and Family
Measures that were administered before treatment are repeated Changes on formal measures and videotaped interactions of the family from pretreatment to posttreatment are reviewed
Problem-solving skills are reviewed with the parents so that they can apply their new parenting strategies to a variety of problems that may come up Parents are asked to identify at least one remaining concern and formulate a plan to address this concern
CASE EXAMPLE
BackgroundBackground
Tommy is a 5-year, 3 month-old English-speaking African-American male who demonstrates behavioral difficulties including talking back to adults, ignoring directions, and hitting other children when frustrated
He is the child of an older single mother and has two siblings in their early twenties
Step 1 – Step 1 – Pretreatment AssessmentPretreatment Assessment
Interview: Mrs. Smith, Tommy, and Tommy’s siblings attend the session
First, the limits of confidentiality are explained to the family
During a semi-structured interview, Mrs. Smith describes Tommy’s developmental history, which is significant for slight language delays. She shares that the family is under considerable stress given her long work days, the absence of Tommy’s father, and the need to rely on her adult children to care for Tommy after preschool
Step 1 – Step 1 – Pretreatment Assessment, Pretreatment Assessment,
cont.cont. Interview, cont.:
During the interview, Tommy is permitted to play with toys in the room. He is observed by the therapist to select plastic dinosaurs which he has ‘run’ in the air and often strikes against one another with loud crashing sounds
As Tommy becomes increasingly louder and more active, Mrs. Smith responds to his behavior by yelling, “Stop!” Similar techniques are employed by Tommy’s elder sister, while his brother ignores Tommy
The therapist is careful to encourage Mrs. Smith to feel comfortable managing her son’s behavior as best she can and does not intervene
Step 2 – Formal Step 2 – Formal AssessmentAssessment
Formal Assessment: Tommy is observed for a few minutes while the therapist speaks to his mother about the questionnaires she will complete
Next, formal assessment is conducted Tommy is administered the Peabody Picture Vocabulary Test due to reported concerns about his language development
While Tommy is being evaluated, Mrs. Smith responds to the items on a series of behavioral checklists, including the Child Behavior Checklist – Parent Form, Eyberg Child Behavior Inventory, and Parenting Stress Index, in order to establish baseline information
Step 2 – Step 2 – Teaching Behavioral Teaching Behavioral
Play TherapyPlay Therapy Teaching Play Therapy:
Mrs. Smith receives information about the goals of play therapy
Mrs. Smith learns that the interventions are designed to improve her relationship with her son while reducing Tommy’s aggression and anger and increasing his self-esteem
Daily home therapy is explained to her as being done for at least 5 minutes each day and that the child should lead the activity
She expresses understanding, along with doubts, that this 5 minute play activity must take place even on days when Tommy has been non-compliant because it can break the negative cycle of behavioral non-compliance
Step 2 – Step 2 – Teaching Behavioral Teaching Behavioral Play Therapy, cont.Play Therapy, cont.
Teaching Play Therapy, cont.: The therapist explains the acronym “DRIP” to Mrs. Smith.
Mrs. Smith practices with the therapist, starting out by saying, “You play with the dolls.” The therapist reminds her it is important to describe, reflect, imitate, and praise. Mrs. Smith then says, as the therapist picks up a car and starts to play with it, “You picked a red car and you are driving it along the street.”
Step 2 – Step 2 – Teaching Behavioral Teaching Behavioral Play Therapy, cont.Play Therapy, cont.
Teaching Play Therapy, cont.: When Mrs. Smith demonstrates a solid grasp of the use of “DRIP” techniques through role plays with the therapist, she and the therapist make plans for follow-up play sessions at home
Mrs. Smith decides that the most convenient place and time to practice behavioral play therapy will be just after dinner each day. She plans to play with Tommy in his room, since it is a relatively quiet location
Step 3 – Step 3 – Coaching Behavioral Coaching Behavioral
Play TherapyPlay Therapy
Coaching Play Therapy: Mrs. Smith shares her record of play therapy sessions
She demonstrates that she engaged in play therapy 5 of the 7 days between sessions
Her efforts and consistency are praised by the therapist
Step 3 – Step 3 – Coaching Behavioral Coaching Behavioral
Play TherapyPlay Therapy Coaching Play Therapy, cont.:
Next, Mrs. Smith and Tommy play together for 5 minutes in a therapy room while the therapist observes behind a one-way mirror
Mrs. Smith is reminded to praise Tommy when he shares his toy with her and to avoid asking questions and giving commands
Step 3 – Step 3 – Coaching Behavioral Coaching Behavioral Play Therapy, cont.Play Therapy, cont.
Coaching Play Therapy, cont.: Mrs. Smith shares her record of play therapy sessions indicating that she engaged in play therapy 6 of the 7 days between sessions
During this 2nd session, focused on coaching behavioral play therapy, Mrs. Smith is encouraged to ignore behaviors that continue to be of concern to her. Specifically, when Tommy grabs toys away from her or bangs them together, she attends to another toy and does not say anything
As soon as Tommy realizes that his mother is not attending to his acting out, he offers to share with her. Mrs. Smith reflects on this behavior and praises him
Step 3 – Step 3 – Coaching BehavioralCoaching Behavioral Play Therapy, cont. Play Therapy, cont.
Coaching Play Therapy, cont.: Mrs. Smith shares that she engaged in play therapy 4 of the 7 days between sessions
During this session, qualitative aspects of PCIT are the focus
Mrs. Smith is encouraged to make eye contact with Tommy and sit close to him or give him a hug when he engages in appropriate behaviors, especially when he persists on a task that is difficult for him
Tommy responded to attention from his mother by continuing to engage in appropriate behaviors
Step 4 – Step 4 – Teaching Discipline Teaching Discipline
SkillsSkills Teaching Discipline:
This session explains to Mrs. Smith how to effectively implement consequences for Tommy’s inappropriate behavior
The therapist focuses on increasing Tommy’s compliance during play by helping Mrs. Smith give effective directions to Tommy
When they are not followed, Mrs. Smith identifies and responds to non-compliant behavior
Step 4 – Step 4 – Teaching Discipline Teaching Discipline
SkillsSkills Teaching Discipline, cont.:
Mrs. Smith gives Tommy two choices, to follow her command or go to time-out
Mrs. Smith practices giving direct commands and the use of time-out in the therapist’s office
Step 5 – Step 5 – Coaching Discipline Coaching Discipline
SkillsSkills Coaching Discipline:
Mrs. Smith is taught to increase Tommy’s compliance with her requests by setting small goals toward a skill that she knows Tommy can learn
Mrs. Smith picks building a house with blocks, since she knows Tommy can do it. She begins by giving Tommy a single simple instruction, “Tommy, put the red blocks at the bottom of the house”
When he does so, she smiles broadly, gives him a pat on the back and says, “Good listening! You put the red blocks at the bottom of the house”
Step 5 – Step 5 – Coaching Discipline Coaching Discipline
SkillsSkills Coaching Discipline, cont.:
Mrs. Smith continues to give commands in simple language
When Tommy is noncompliant, Mrs. Smith holds up two fingers and calmly but firmly says, “Tommy, you have two choices. You can put the roof on the house or go to time-out”
Tommy stands with his arms folded looking at his mother then throws a block
Mrs. Smith gets up and escorts Tommy to time-out. He will not go with her so she gently picks him up and sets him in the pre-determined time-out area for 3 minutes
Step 5 – Step 5 – Coaching Discipline Coaching Discipline
SkillsSkills Coaching Discipline, cont.:
When time-out is over, Mrs. Smith repeats the original command in which Tommy was noncompliant
Mrs. Smith says, “Tommy, put the cardboard on top for a roof.” Tommy does nothing
Mrs. Smith holds up two fingers and says, “Tommy, you have two choices. You can put the chimney on the roof on the house or go to time-out.”
Tommy hesitates, and then puts the chimney on the roof of the house, which causes it to collapse
Mrs. Smith praises Tommy for showing he was listening by putting chimney on the house
Step 5 – Step 5 – Coaching Discipline Coaching Discipline
SkillsSkills Coaching Discipline, cont.:
Mrs. Smith and Tommy play in an appropriate manner without further events during this session
Tommy obeys commands that his mother makes in an appropriate fashion and time-out is not required
Step 6 – Step 6 – Posttreatment Posttreatment AssessmentAssessment
Posttreatment Assessment: The measures utilized in the initial assessment are re-administered in order to provide comparative results to Mrs. Smith
Results indicate that Tommy demonstrates significantly less aggression during play and more appropriate methods for seeking his mother’s attention. Areas of progress are discussed and comparison scenes on videotape are shown to demonstrate Tommy’s improvements
Tommy’s remaining difficulties of a short attention span and limited coping skills for challenges are discussed
Mrs. Smith indicates a willingness to continue to work on gradually increasing Tommy’s play sessions to help with his attention span. She also discusses ways in which she can provide additional praise that might influence greater coping during play therapy sessions at home
Step 6 – Step 6 – Posttreatment Posttreatment AssessmentAssessment
Posttreatment Assessment, cont.: Maintenance sessions are scheduled once a month with Mrs. Smith and Tommy
At each session, the therapist and Mrs. Smith discuss present concerns and ways to address them
Mrs. Smith and Tommy spend time interacting with one another while the therapist provides feedback and reinforcement as needed
A future booster session is scheduled for 3 months after their last meeting
Future DirectionsFuture Directions
Determine what specific context or individual variables lead to greater treatment effectiveness
Identify groups most likely to benefit from treatment to ensure that services are provided to those who will most likely benefit
Identify groups who have shown to be less responsive to treatment to identify groups in need of further study and how to modify PCIT procedures to better serve these groups
Examine effects in real-world clinics without intense supervision to improve treatment protocols and dissemination
Examine outcomes for families that do not complete training
(Herschell, Calzada, Eyberg, McNeil, 2002)
Future DirectionsFuture Directions
Examine the range of comorbid disorders (e.g. internalizing disorders, chronic pediatric illness, developmental disorders) that may be affected by PCIT
Explore the extent to which PCIT can be adapted Investigate effectiveness of PCIT among diverse populations in terms of ethnicity and cultural factors
Determine ways in which treatment should be tailored to maximize gains in minority groups
Examine what therapist behaviors contribute to improved treatment outcomes
(Herschell, Calzada, Eyberg, McNeil, 2002)
Future DirectionsFuture Directions
Identify families at-risk for drop out and factors that may promote their adherence to treatment
Determine the level of training necessary to produce therapeutic gains
Evaluate alternate ways to deliver treatment to ensure accurate implementation so critical treatment components are not altered
Examine long-term maintenance of treatment effects
Predictors of long-term treatment outcomes
(Herschell, Calzada, Eyberg, McNeil, 2002)
ReferencesReferencesBates, S. L. (2005). Evidence-based family-school interventions with
preschool children. School Psychology Quarterly, 20, 352-370.
Epps, S. & Jackson, B. (2000). Empowered families, successful children: Early intervention programs that work. American Psychological Association.
Hembree-Kigin, T.L. & McNeil, C.B. (1995). Parent-Child Interaction Therapy. New York: Plenum Press.
Herschell, A. D., Calzada, E. J., Eyberg, S. M., & McNeil, C. B. (2002). Parent child interaction therapy: New directions in research. Cognitive and Behavioral Practice, 9, 9-16.
Jacob-Timm, S. & Hartshorne, T. S. (1998). Ethics and law for school psychologists (3rd ed.). New York: Wiley & Sons.
McDiarmid, M. D. & Bagner, D. M. (2005). Parent-child interaction therapy for children with disruptive behavior and developmental disabilities. Education and Treatment of Children, 28, 130-141.