A naturalistic evaluation of parent-child interaction therapy (PCIT) and PCIT with trauma-directed interaction (PCIT with TDI) in Australian children exposed to abuse and neglect

Abstract

BackgroundTo optimize PCIT treatment with children exposed to abuse and neglect, PCIT with Trauma-Directed Interaction (PCIT with TDI) was created. ObjectiveThe current study was a quasi-experimental cohort study (PCIT and PCIT with TDI treatment groups) with pre/post-treatment comparisons. The study was conducted in a statutory child protection agency and was a naturalistic evaluation of the outcomes achieved by this service. The outcomes under investigation included caregiver and child posttraumatic stress symptoms, child behavior problems, parenting stress, caregiver mental health, child protection notifications, and placement permanency goals. Participants and settingChildren were included in the study if they were aged between 2 and 7 years, had behavioral difficulties or trauma symptoms and/or their caregivers were experiencing parenting stress. MethodsFamilies were allocated to treatment group by clinician availability/preference (i.e., preference allocation). Caregivers were asked to report on child posttraumatic symptoms and behavioral issues; and to self-report on posttraumatic stress, general stress, parenting stress, and depression and anxiety at prescribed points in treatment. FindingsSixty-eight children and their caregivers were treated with either PCIT (n = 22) or PCIT with TDI (n = 46). Statistically significant changes were observed for both treatment conditions for some of the outcomes of interest for both children (i.e., child behavioral problems, posttraumatic stress) and their caregivers (i.e., general stress, posttraumatic stress). There was no significant main effect of treatment on any of the outcomes of interest. ConclusionFuture research should include a randomized controlled trial to adequately determine the efficacy of PCIT versus PCIT with TDI with this population.