Parent-Child Interaction Therapy: An Evidenced Based Intervention for Children With a Trauma History
Robin Gurwitch, PhD of Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
Parent-Child Interaction Therapy (PCIT) is an evidenced based treatment for young children with significant behavior problems. Recently, the Kauffman Best Practices Report cited PCIT as one of the three best treatments in the field of child abuse and neglect. Although originally developed to address externalizing problems in young children, PCIT is now being successfully used with children in foster care, adoptive and stepfamilies, and co-occurring problems like children from homes characterized by domestic violence and/ or substance abuse. Behavior problems, the leading reason for child referrals to mental health services, often occur in children from these high-risk populations. The combination of behavior problems and child history impacts children’s safety, physical health, and mental health; the majority of children become involved in the child welfare system. As children enter the system, they often experience additional trauma with multiple moves, as the presenting behavior problems are listed as the top reason for failed placements. Reunification may also fail as parents are ill-equipped to manage the behavioral difficulties of their children. PCIT is a relatively short-term intervention (average of 14 sessions) that involves the caregivers and the child. It consists of two phases. The first phase focuses on enhancing the parent-child relationship with other goals including: improved self-esteem, increased frustration tolerance, improved attention and concentration, and improved anger management.
The second phase of PCIT addresses the implementation of a positive and effective discipline program such that minding increases while non-compliant behaviors are significantly reduced. With several decades of empirical research, PCIT has been shown to maintain gains made for over six years (longest study to date), generalize to the school setting, and generalize to untreated siblings. Measures of parenting stress, maternal depression, and child behavior problems are shown to move from the clinically significant range to the normal range by the end of treatment. In a landmark study involving PCIT with children and parents with an adjudicated history of child maltreatment, outcomes showed improved survival rates in families receiving PCIT-alone when compared with standard of care, family preservation services, and wrap-around services plus including PCIT. This workshop will provide an overview of PCIT and its use with children with trauma history. Through didactics, video-clips, and brief experiential exercises, participants will learn how PCIT can be effectively implemented to improve the outcomes in the lives of these children. The workshop will also include issues related to successful implementation of this treatment.
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