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Parent-Child Interaction Therapy
In response to your interest in intensive parent-training efforts, might I
suggest you review some of the recent research, training, and dissemination
efforts related to Parent-Child Interaction Therapy (PCIT). This program,
developed by Sheila Eyberg, was initially developed for parents with young
children who have some type of behavior disturbance. Dr. Eyberg has
developed an outstanding program aimed at developing an empirically
supported treatment for this population (a literature search on her name
will yield many references; although I might suggest two publications as
excellent overviews:
Hembree-Kigin, TL., & McNeil, C.B. (1995) Parent-Child Interaction Therapy,
New York: Plenum
Herschell, A., Lumley, E.A., & McNeil, C.B. (2000). Parent-Child
Interaction Therapy. L. VandeCreek &T. L. Kackson (Eds.), Innovations in
Clinical Practice: A sourcebook,(18), 103-120, Sarasota, FL: Professional
Resource Press).
Further, I might suggest a recent publication (Herschell, A. D., Calzada,
E. J., Eyberg, S. M., & McNeil, C. B. (2002). Parent-Child Interaction
Therapy: New directions in research. Cognitive and Behavioral Practice, 9)
which is an excellent review of the empirical support for PCIT.
Essentially, PCIT is an intensive parent-child dyadic intervention which
addresses many core problems with high-risk families. It uses a
'bug-in-the-ear' device to prompt (or 'coach') parents while they interact
with their children. During a 14-20 week course of treatment, parents (and
children ages 2-8) gain knowledge and (most importantly) master skills in
the fundamental elements of a positive parent-child relationship.
Treatment is focused in two parts, a relationship enhancement portion
(Child-Directed Interaction) and a discipline portion (Parent-Directed
Interaction). There are several individuals who are doing PCIT research
with the populations for which it was initially developed. If this is your
interest, I might suggest starting contacts with Sheila Eyberg (University
of Florida) or Cheryl McNeil (West Virginia University)
During the last 6-8 years, there has been a strong movement of applying
PCIT to physically abusive and neglect parent-child dyads (or similar types
of families, such as: foster parents, child welfare/reunification
families). I would suggest reviewing an article I wrote a few years ago
(Urquiza, A.J., & McNeil, C.B. (1996). Parent-child interaction therapy:
An intensive dyadic intervention for physically abusive families. Child
Maltreatment, 1(2), 132-141) for a discussion of the application of PCIT to
these populations. There are several groups of people that are researching
the application of PCIT to maltreating parent-child dyads (we are doing
this research at UC Davis Medical Center; as are Mark Chaffin/Oklahoma
Health Sciences; and Joaquin Borrego/Texas Tech University). It is my
opinion (although I do not yet have data to support this) that for
non-abusive parent-child relationships (the population for which PCIT was
initially developed), I think that the discipline element is most
important. Conversely, for maltreating populations, I think that the
relationship enhancement element is most important (I might suggest
reviewing Joel Milner's chapter on social attributions and child
maltreatment for a good description on some of the ways in which physically
abusive parent-child dyads need to change:
Milner, Joel S. (46th Annual Nebraska Symposium on Motivation, Lincoln, NE,
US.) Social information processing and child physical abuse: Theory and
research. In: David J. Hansen, Ed. Nebraska Symposium on Motivation Vol.
46, 1998: Motivation and child maltreatment. University of Nebraska Press:
Lincoln, NE, US, 2000. p. 39-84 of xv, 286pp)
While there are several parenting approaches to high-risk families, I would
make the strong recommendation for a strategy which provides the
opportunity for parents and children to not only acquire information and
skill, but to practice skill development to the point of mastery. I think
that the use of 'coaching' parents to skill mastery is a unique element of
PCIT which is essential with difficult and high-risk parents (i.e., the
physically abusive and neglectful parents we are discussing here). Without
this element, I would be concerned that any intervention would be
informational, but not useful in changing and sustaining change in abusive
and maladaptive parent-child behaviors.
The empirical research examining the application of PCIT is forthcoming
primarily from our program and from Mark Chaffin in Oklahoma (Dr. Chaffin
is researching the application with a latency age and adolescent age child
population). Our data show a positive effect in several areas/domains with
physically abusive parents, foster parents (and their physically abused
foster children), and non-abused pediatrician-referred outpatient
parent-child dyads. Until then, there are only some single case studies
(See Borrego, Jr., J., Urquiza, A.J., Rasmussen, R.A., & Zebell, N. (1999).
Parent-Child Interaction Therapy with a Family at High-Risk for Physical
Abuse, Child Maltreatment, 4(4), 331-342).
Finally, during the last two years we have been funded to develop a PCIT
training curriculum and train 20 community mental health agencies through
the state of California in developing PCIT programs. Utilizing a TOT
model, we train a set of staff (mental health providers) at each agency to
be PCIT therapists, then some of these staff progress to be PCIT clinical
supervisors and PCIT Trainers (i.e., TOT = Trainer of Trainers). Our
preliminary data show that we have been very successful in training staff
and in establishing PCIT agencies.
I hope this helps.
Anthony---
Anthony J. Urquiza, Ph.D.
Director
Mental Health Services and Clinical Research
CAARE Diagnostic and Treatment Center
University of California at Davis, Medical Center
3300 Stockton Blvd.
Sacramento, CA 95818
(916) 734-7608 voicemail
(916) 734-4150 fax
"Hollows, Anne E"
<A.E.Hollows@shu.ac.uk> To: Child Maltreatment Researchers
Sent by: <CHILD-MALTREATMENT-RESEARCH-L@cornell.edu>
owner-CHILD-MALTREATMENT-RESEARCH-L@c cc:
ornell.edu Subject:
03/06/02 07:08 AM
Please respond to
CHILD-MALTREATMENT-RESEARCH-L
List members were recently very helpful in directing me to sources of
information on family support and family preservation, in connection with
my current research on the development of evidence based
strategies for family suport and preservation.
I would now be grateful for specific information on what works, for which
parents, in terms of parent training. I am interested in discrete
curricula as well as the role of parent training in integrated packages of
family support/preservation. As with many places, the major focus
is around neglect and susbtance using parents. there is aprticular interest
locally n the Webester Startton approach and in a programme
called Michigan Family Regeneration - I have web references for the former
but am struggling to locate data on the latter.
Many thanks in anticipation
Dr Anne Hollows
Principal Lecturer in Social Work
School of Health and Social Care
Sheffield Hallam University
33 Collegiate Crescent
Sheffield S10 2BP
Tel +44(0)114 2252369
Email: a.e.hollows@shu.ac.uk