Effectiveness of community dissemination of parent–child interaction therapy.

Abstract

The Trauma Treatment Training Center (TTTC) at Cincinnati Children's Hospital examined the imple- mentation and effectiveness of Parent-Child Interaction Therapy (PCIT) in community agencies working with high-risk families through an awarded grant from the Substance Abuse and Mental Health Services Administration. The current study summarizes posttreatment data collected from community clinicians trained by the TTTC. Results include 53 posttreatment outcomes from 23 clinicians in 15 agencies in the United States. Significant improvement was seen on several measures regarding child behavior, child trauma symptoms, child dissociative characteristics, and caregiver stress. Community clinicians trained in PCIT during a five-day workshop did get effective results with even their first PCIT cases. It is only in the last generation that treatments for child mal- treatment establishing efficacy through randomized controlled studies have been developed and tested (Silverman et al., 2008). Trauma-Focused Cognitive Behavioral Therapy, the one well- established treatment for traumatized/maltreated children and their caregivers, includes a brief component about effective parenting, but further research in this area is warranted to help rebuild attachment relationships between maltreated children and their caregivers and to give parents the skills to deal with the emotional and behavioral dysregulations that often accompany child abuse and neglect. Parent-Child Interaction Therapy (PCIT), originally developed for families of children with disruptive behavior disor- ders, has shown potential to fill this gap in childhood trauma treatment by helping physically abusive parents transform their parenting practices and by offering a variety of skills to nonof- fending parents and caregivers (Chaffin et al., 2009). This study examined the dissemination and effectiveness of PCIT in commu- nity practices after clinicians, whose caseloads included substantial numbers of high-risk and maltreated children, were trained in a five-day workshop. PCIT is a dyadic treatment supported by more than 20 years of research and practice (Herschell, Calzada, Eyberg, & McNeil, 2002). It has demonstrated long-term maintenance of treatment gains of up to six years posttreatment (Hood & Eyberg, 2003). More than 100 randomized controlled trials support PCIT's effec- tiveness. Originally developed by Dr. Sheila Eyberg in the 1970s for young children with disruptive behavior disorders, PCIT has been successfully used with a variety of other populations, includ-