Can Parent-Child Interaction Therapy (PCIT) Remain Effective Where Parents Have A Mental Health Issue? An Audit of A Case Series in A Community Setting

ABSTRACT

Parent-Child Interaction Therapy (PCIT) is an evidence-based manualised parent training programme for parents of two to seven year old children with conduct problems and/or other complex needs that features in vivo (“live”) skills coaching of parents, with immediate feedback from a clinician through a discrete ear piece and one-way mirror.

This paper describes a clinical audit of a series of 35 families seen for PCIT in a community Child and Adolescent Mental Health Service (CAMHS) in New Zealand. The cohort was distinct from the extant PCIT literature in three ways – it included a disproportionately high rate of parental mental health issues, of children aged seven years or over, and it featured a relatively low attrition rate – a notoriously challenging area for parent training approaches.

Results indicated that despite the majority of mothers (74%) in the case series having a formal psychiatric diagnosis, and having previously unsuccessfully undertaken at least one parenting intervention (71%), average duration of treatment (17 sessions, range: 9–25) was within established international norms (12–20 sessions). The attrition rate (26%) was lower than is typical internationally for parent training approaches. There was a positive correlation between a child’s age and the number of sessions to graduation, albeit not statistically significant in this small study (r = 0.34, p = .10).

With minimal modification, PCIT remained an effective treatment in a real world setting for parents with mental health issues and their young children. Implications for clinical practice are discussed.

Acknowledgments

The authors would like to acknowledge the support of CAMHS staff. Tania Cargo (Ngāti Maru, Ngāti Manu, Ngāpuhi) provided training and supervision in PCIT. Peter Reed provided statistical support.

Disclosure Statement

Dr Melanie Woodfield is a Level 1 Trainer for Parent-Child Interaction Therapy, though is not specifically remunerated for this role.

Additional information

Funding

The audit activities described are part of a larger programme of research funded by a Foxley Fellowship for Dr Melanie Woodfield from the Health Research Council of New Zealand;