Home-Based Parent-Child Interaction Therapy to Prevent Child Maltreatment: A Randomized Controlled Trial.

Mariëlle E Abrahamse,Vionna M W Tsang,Ramón J L Lindauer

doi:10.3390/ijerph18168244

Abstract

High treatment attrition and limited reach of mental health services for at-risk families remains an important problem in order to effectively address the global concern of child maltreatment and child disruptive behavior problems. This study evaluated the effectiveness of a home-based and time-limited adaptation of Parent–Child Interaction Therapy (PCIT). Twenty families with children (70% boys) aged between three and seven years were randomly assigned to an immediate treatment group (IT, n = 10) or a waitlist control group (WL, n = 10). After receiving treatment and compared to mothers in the WL group, mothers in the IT group reported fewer child behavior problems and more improved parenting skills. Although initial analyses revealed no significant differences, additional analyses showed a significant decrease in the primary outcome of the study, namely child abuse potential, between the baseline and follow-up assessment for the total treated sample. A low treatment attrition rate (15%) was found, indicating higher accessibility of treatment for families. Findings suggest that the brief home-based PCIT is a potentially effective intervention to prevent child maltreatment and disruptive behavior problems in at-risk families. Results also reinforce the importance of addressing the specific needs of these families to increase treatment effectiveness.

Highlights

Our goal was to evaluate the effectiveness of Parent–Child Interaction Therapy (PCIT)-Home, a homebased and time-limited version of PCIT, by conducting a randomized controlled trial using a waitlist control condition in an at-risk family population who were referred to a Dutch community mental health center
These results suggest the added value of PCIT-Home compared to the waitlist control (WL) group; no treatment
Our current study shows promising findings in the field of the prevention of child maltreatment by creating higher accessibility of treatment through providing a brief and home-based version of PCIT for at-risk families who may not have access otherwise

Summary

Introduction

It is not a surprise that child maltreatment can lead to a range of consequences such as an increased risk for negative development including physical and mental health problems [2]. In the Netherlands, a national prevalence study showed that the rates of child maltreatment for children aged 0 to 17 years were estimated to be 3.4% [3]. Given the prevalence and high impact on child development, early prevention of child maltreatment is of outmost importance. The best efforts of child protection services and increased government attention as well as expenditures in many countries have led to more knowledge about the signs, prevention, and interventions focusing on child maltreatment [4]. There are some factors impeding the effective prevention and intervention of child maltreatment. Premature treatment attrition remains a significant problem in prevention and intervention such as parent training programs [7,8]

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Discussion

Conclusion