A Statewide Randomized Controlled Trial to Compare Three Models for Implementing Parent Child Interaction Therapy

ABSTRACT

Objective

This study (NIMH RO1 MH095750; ClinicalTrials.gov Identifier: NCT02543359) evaluated the effectiveness of three training models to implement a well-established evidence-based treatment, Parent-Child Interaction Therapy (PCIT).

Method

Fifty licensed outpatient clinics, including 100 clinicians, 50 supervisors, and 50 administrators were randomized to one of three training conditions: 1) Learning Collaborative (LC), 2) Cascading Model (CM) or 3) Distance Education (DE). Data to assess training and implementation outcomes were collected at 4 time points coinciding with the training period: baseline, 6- (mid), 12- (post), and 24-months (1-year follow-up).

Results

Multi-level hierarchical linear growth modeling was used to examine changes over time in training outcomes. Results indicate that clinicians in CM were more likely to complete training, reported high levels of training satisfaction and better learning experiences compared to the other training conditions. However, supervisors in the LC condition reported greater learning experiences, higher levels of knowledge, understanding of treatment, and satisfaction compared to supervisors in other conditions. Although clinicians and supervisors in the DE condition did not outperform their counterparts on any outcomes, their performance was comparable to both LC and CM in terms of PCIT use, supervisor perceived acceptability, feasibility, system support, and clinician satisfaction.

Conclusions

Through the use of a randomized controlled design and community implementation, this study contributes to the current understanding of the impact of training design on implementation of PCIT. Results also indicate that although in-person training methods may produce more positive clinician and supervisor outcomes, training is not a one-size-fits-all model, with DE producing comparable results on some variables.

Acknowledgments

We gratefully acknowledge the substantial contribution of the following steering committee members: Harriet Bicksler, Darlene Black, Kimberly Blair, Diana Borges, Brian Bumbarger, Amanda Clouse, Leigh Carlson-Hernandez, Judy Dogin, Susan Dougherty, Robert Gallen, Jim Gavin, Jennifer Geiger, Gordon Hodas, Jill Kachmar, Donna Mick, Doug Muetzel, Denise Namowicz, Connell O’Brien, Andrea Richardson, Ronnie Rubin, Sherry Shaffer, Doug Spencer, Michele Walsh and Priscilla Zorichak. This project also has benefitted by feedback provided by the following PCIT Experts: Rhea Chase, Beverly Funderburk, Sheila Eyberg, Cheryl McNeil, and Melanie Nelson. We gratefully acknowledge the support of Amanda Maise who carefully proofed and edited the manuscript. We also appreciate the time, commitment, and contribution of participating agency administrators, supervisors, and clinicians.

Disclosure Statement

The authors disclose support from federal grants and training contracts.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was funded by the National Institute of Mental Health (R01 MH095750; A Statewide Trial to Compare Three Training Models for Implementing an EBT; PI: Herschell) and guided by a statewide steering committee.