Randomized trial of parent-child interaction therapy improves child-welfare parents' behavior, self-regulation, and self-perceptions.

Abstract

We conducted a large (N = 204) randomized, clinical trial to test the efficacy of parent-child interaction therapy (PCIT) on observed parenting, two key drivers of maladaptive parenting-self-regulation and social cognitions, and child behavior outcomes in a sample of child welfare-involved families. Participants were randomly assigned to standard PCIT (n = 120) or services-as-usual (SAU; n = 84). The sample was characterized by low household income, significant exposures to adverse childhood experiences, and substance abuse. Intention-to-treat analyses were conducted on multiply imputed data followed by secondary per-protocol analyses. Significant PCIT effects emerged on (a) increased positive parenting, reduced negative parenting and disruptive child behavior (small-to-medium intention-to-treat effects and medium-to-large per-protocol effects); (b) gains in parent inhibitory control on the stop-signal task (small-to-medium effects); (c) gains in parent-reported emotion regulation and (d) positive, affirming self-perceptions (small-to-medium effects), relative to the SAU control group. PCIT's effects on gains in parent emotion regulation were mediated by reductions in observed negative parenting. No differences in rates of parent commands or child compliance were observed across conditions. Harsh child attributions moderated treatment impact on parenting skills acquisition. PCIT parents who held harsher attributions displayed greater gains in use of labeled praises and declines in negative talk/criticism with their child, than control group parents. This randomized trial presents the first evidence that PCIT improves inhibitory control and emotion regulation in a child welfare parents and replicates other published trials documenting intervention gains in positive parenting and child behavior in child welfare families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).