Understanding New Zealand therapist experiences of Parent-Child Interaction Therapy (PCIT) training and implementation, and how these compare internationally

Abstract

Embedding effective parent training programmes for the treatment of childhood conduct problems into routine clinical practice does not happen spontaneously. Despite the known influence of contextual factors on implementation success, and the centrality of the therapist as a key implementation stakeholder, studies into the therapist experience of receiving training in, and implementing evidence-based manualised parent training programmes are relatively rare. This study sought to understand the training and post-training implementation experiences of Parent-Child Interaction Therapy (PCIT) therapists in New Zealand, and to compare and contrast these with existing research into the experiences of PCIT trainees in the Netherlands (i.e., Niec et al., 2018) Fifty-six therapists (a response rate of 67%) completed an anonymous online survey of their experiences of training in, and subsequently implementing Parent-Child Interaction Therapy (PCIT) in New Zealand. Qualitative and quantitative analyses indicated that therapists experienced barriers to implementation, both internal (“burdened”) and external (“blocked”) yet typically persisted with implementation efforts. Therapist (and other stakeholder) attitudes towards the use of time out with young children was a common barrier to implementation. Therapists described drawing from other - at times incompatible – treatment approaches for children with conduct problems, and in some cases reported using only components of the manualised PCIT protocol. Direct international comparison of New Zealand and Dutch PCIT therapists’ responses demonstrated remarkably similar (and positive) attitudes towards PCIT, and the experience of similar barriers internationally. Implications for implementation success are discussed.