Viewing Parent-Child Interactions Through the Lens of Behaviorism

Population

Model

Behavioral assessment of child behavior

Parent report of child behavior

Reference

Preschool-aged children referred for conduct problems (United States) N = 10

PCIT

Compliance (CLP, PLP, & CU)

PCIT d = 1.8

Disruptive behavior (ECBI)

PCIT d = − 2.6

McNeil et al. 1991

Preschool-aged children referred for behavior problems (United States) N = 31

PCIT ^a

Compliance/deviant behaviors (CLP, PLP, & CU)

PCIT d = 1.8/− 0.64

Disruptive behavior (ECBI)

PCIT d = − 2.7

Eisenstadt et al. 1993

Preschool-aged children referred for disruptive behavior (United States) N = 64

PCIT WL

Compliance with mother ^b

Pre PCIT: 23 %

Post PCIT: 47 %

Compliance with father^b

Pre PCIT: 27 %

Post PCIT: 45 %

Mother rating of disruptive behavior (ECBI)

PCIT d = − 1.5

WL d = − 0.1

Father rating of disruptive behavior (ECBI)

PCIT d = − 1.2

WL d = − 0.2

Schuhmann et al. 1998

Preschool-aged children referred for behavior problems (Australia) N = 92

PCIT^c

ABB PCIT ^d

Compliance/deviant behaviors with mother (CLP, PLP, & CU)

PCIT d =0 .74/− 0.49

ABB PCIT d = 0.53/− 0.26 WL d = 0 .55/− 0.74

Mother rating of disruptive behavior (ECBI)

PCIT d = − 2.03

ABB PCIT d = − 1.68 WL d = − 1.21

Father rating of disruptive behavior (ECBI)

PCIT d = − 1.0 ABB PCIT d = − 1.1 WL d = − 0.5

Nixon et al. 2003

Young children referred for behavior problems (United States) N = 70; 72

PCIT

Not reported

Disruptive behavior (ECBI)

PCIT d = − 1.0 Exernalizing (CBCL) PCIT d = − 1.0 Internalizing (CBCL) PCIT d = − 1.0

Timmer et al. 2006

Preschool-aged children with diagnoses of both oppositional defiant disorder and mental retardation (United States) N = 30

PCIT

Compliance (PLP & CU)

PCIT d = 1.41 WL d = − .43

ECBI

PCIT d = − 2.0

WL d = − 0.9

Bagner and Eyberg 2007

Children referred to community providers for behavior problems. (United States) N = 154

PCIT

Not reported

ECBI

d = − 1.2

TSCYC post-traumatic stress total

d = − 0.7

TSCYC dissociation d = − 0.7

TSCYC anger

d = − 1.1

Pearl et al. 2012

Children referred for behavior problems (United States) N = 120

clinic and in-home PCIT

Not reported

ECBI

PCIT completers (clinic and in-home)

d = − 0.9

Lanier et al. 2011

PCIT parent-child interaction therapy, CLP child-led play, PLP parent-led play, CU clean up, d Cohen’s d, ECBI Eyberg Child Behavior Inventory, ABB PCIT abbreviated PCIT, WL wait list, TSCYC trauma symptom checklist for young children

^ahalf of sample received parent-directed interaction prior to child-directed interaction

^b d could not be calculated as SD was not reported

^cIn the version of PCIT used in this study parents were coached during five sessions of child-led play and seven sessions of parent-led play

^dIn the abbreviated version of PCIT used in this study five coaching sessions were alternated with 5 30 min telephone consultations

Table 1.2

Drop-out rates and parent outcomes in studies of parent-child interaction therapy (PCIT) with children with disruptive behavior

Population	Model	Drop-out rate	Behavioral assessment of parent behavior	Reference
Preschool-aged children referred for conduct problems (United States) N = 10	PCIT	0 %	Not reported	McNeil et al. 1991
Preschool-aged children referred for behavior problems (United States) N = 31	PCIT ^a	35 %	Not reported	Eisenstadt et al. 1993
Preschool-aged children referred for disruptive behavior (United States) N = 64	PCIT WL	PCIT: 41 % WL: 26 %	Mother % praise (CLP, PLP, & CU) PCIT d = 2.1 WL d = 0.4 Mother % criticism (CLP, PLP, & CU) PCIT d = − 1.1 WL d = − 0.5 Mother % behavioral description (CLP, PLP, & CU) PCIT d = 7.0 WL d = 0.9 Father % praise (CLP, PLP, & CU) PCIT d = 2.2 WL d = 0 Father % criticism (CLP, PLP, & CU) PCIT d = − 1.3 WL d = −0 .4 Father % behavioral description (CLP, PLP, & CU) PCIT d = 1.7 WL d = 0	Schuhmann et al. 1998
Preschool-aged children referred for behavior problems (Australia) N = 92	Strd PCIT Ab PCIT WL	Strd PCIT: 23 % Ab PCIT: 13 % WL: 6 %	Mother praise (CLP, PLP, & CU) Strd PCIT d = 2.0 Ab PCIT d = 1.2 WL d = 0.5 Mother criticism (CLP, PLP, & CU) Strd PCIT d = 1.1 Ab PCIT d =0 .6 WL d = 0.2	Nixon et al. 2003
Young children referred for behavior problems (United States) N = 70	PCIT	53 %	Not reported	Timmer et al. 2006
Preschool-aged children with diagnoses of both Oppositional Defiant Disorder and Mental Retardation (United States) N = 30	PCIT	PCIT: 33 % WL: 20 %	Praise + Reflection + Behavior Description (CLP) PCIT d = 1.9 WL d = 0.4 Question + Command + Criticism (CLP) PCIT d = − 2.7 WL d = − 0.8	Bagner and Eyberg 2007
Children referred to community providers for behavior problems. (United States) N = 154	PCIT	67 %	Praise + Reflection + Behavior Description (CLP) d = 2.9 ^b	Pearl et al. 2012
Children referred for behavior problems (United States) N = 120	PCIT In-Home PCIT	PCIT: 72 % In-Home PCIT: 66 %	Not reported	Lanier et al. 2011

PCIT parent-child interaction therapy, CLP child-led play, PLP parent-led play, CU clean up, d Cohen’s d, Strd PCIT standard PCIT, Ab PCIT abbreviated PCIT, WL wait list

^ahalf of sample received parent-directed interaction prior to child-directed interaction

^bdata on subsample of 21 parents

Child outcomes associated with PCIT in child welfare/child maltreatment populations are shown in Table 1.3. Parent outcomes and drop-out rates are shown in Table 1.4. As shown in Table 1.3, children with a history of maltreatment or at risk for maltreatment who participate in PCIT with either their foster parent (McNeil et al. 2005; Timmer et al. 2006) or primary caregiver (Chaffin et al. 2011; Chaffin et al. 2004; Galanter et al. 2012; Nieter et al. 2013; Thomas and Zimmer-Gembeck 2011, 2012) demonstrate significant improvement in disruptive behavior, anxiety, and depression. Somewhat surprisingly, given the primary focus on changing the parent’s behavior in studies where the parent had maltreated the child or was at risk of maltreating the child, only two of these six studies required the parent meet mastery criteria (Galanter et al. 2012). In the Chaffin et al. (2004) study, only 30 % of physically abusive parents participating in PCIT met mastery criteria.

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