Abstract
Parent management training programs have proven the most effective way to treat child behavior problems. This study reports on an effectiveness trial of a community-based implementation of Parent–Child Interaction Therapy (PCIT) in comparison with the Dutch-developed Family Creative Therapy (FCT). Forty-five children (58 % boys) aged between 32 and 102 months (M = 67.7, SD = 15.9) were referred for treatment, and they and their parent(s) were randomly assigned to PCIT or FCT. Treatment effectiveness was measured primarily by the degree of improvement on child behavior problems, using the Eyberg Child Behavior Inventory. Secondary outcomes included parent and teacher report data and independent observations of parenting skills and child behavior. During the trial, randomization was violated by treatment crossovers (from FCT to PCIT). Intention-to-treat analyzes revealed no significant differences in the primary outcome at 6-month follow-up, but interpretation was hampered by the crossovers. Subsequent treatment-received analyzes revealed significant interaction effects between time and treatment condition, with greater improvements in child behavior and parenting skills for PCIT families compared to FCT families. Analyzes on families that fully completed the PCIT protocol also showed higher treatment maintenance at follow-up. The treatment-received analyzes indicated promising results for the effectiveness of PCIT in treating young children’s disruptive behavior problems in a high-risk population. However, caution in generalizing the conclusions is needed in view of the design difficulties in this study. Suggestions are made for enhancing treatment delivery in daily practice, and clinical implications are noted.
Highlights
Disruptive behavior disorders are highly prevalent among young children (Lavigne et al 2009) and have been identified as the most common reason for referral to mental health services in that population (Loeber et al 2000)
This study reports on an effectiveness trial of a community-based implementation of Parent–Child Interaction Therapy (PCIT) in comparison with the Dutch-developed Family Creative Therapy (FCT)
A structured clinical interview, the Anxiety Disorders Interview Schedule (ADIS) (Silverman and Albano 1996), was administered to the mother to assess the presence of clinically significant levels of attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms, based on diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association 2000)
Summary
Disruptive behavior disorders are highly prevalent among young children (Lavigne et al 2009) and have been identified as the most common reason for referral to mental health services in that population (Loeber et al 2000). J Child Fam Stud (2016) 25:1605–1622 abuse (McCord et al 2001) Such negative outcomes result in higher costs for educational, mental health, law enforcement, and social services—estimated at ten times higher for children with disruptive behavior disorders than for children without problems (Lee et al 2012; Scott et al 2001). Given the high prevalence and persistence of serious behavioral problems and the costly trajectories of the children involved, this population is a source of considerable public health concern. To reduce the risks of negative developmental outcomes and high public costs, early intervention is essential for young children with disruptive behavior problems
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