A Pilot Study Examining Trainee Treatment Session Fidelity when Parent–Child Interaction Therapy (PCIT) Is Implemented in Community Settings

Abstract

Research supports the impact of empirically based treatments, such as Parent-Child Interaction Therapy (PCIT), on producing positive treatment outcomes for clients. However, achieving outcomes in community settings that are similar to those found in research settings can be challenging, and little research has been conducted on how to best train community providers to implement PCIT with fidelity. This study assessed trainee implementation fidelity to the PCIT protocol in community settings. Session fidelity was reviewed for trainees using pre-established session integrity checklists and post hoc video review of key sessions. Analyses revealed that trainees maintained strong overall session fidelity, although fidelity percentages varied by session type and treatment phase. Results also highlight those session content items that are frequently left out by trainees during implementation. Implications of these findings, limitations, and future directions for research and PCIT workshops and consultation are discussed.

A mixed-methods study of system-level sustainability of evidence-based practices in 12 large-scale implementation initiatives

“…Outcomes monitoring is broadly accepted to promote understanding of system functioning and continuous quality improvement [ 40 ]. Pilot examinations of PCIT fidelity in community systems suggest higher rates than other interventions [ 10 , 41 , 42 ]. Nonetheless, the most recent state mental health director’s report (from 2012) indicates no change in the number of states monitoring quality over the past decade [ 39 ]; only half had integrated systems for monitoring client outcomes or other data.…”

“…Nonetheless, the most recent state mental health director’s report (from 2012) indicates no change in the number of states monitoring quality over the past decade [ 39 ]; only half had integrated systems for monitoring client outcomes or other data. As most trainers emphasise maintaining high fidelity to PCIT, future research should examine the impact of PCIT fidelity on patient outcomes within community implementations [ 41 , 42 ].…”

Changes in provider Fidelity after introducing a new model of intervention

“…Therefore, although not specifically assessed in this study, the ongoing support coaches received through ABC supervision and fidelityfocused feedback may have helped them to feel confident and competent in delivering the ABC-T model. In general, researchers have noted that providing clearly delineated fidelity requirements that are predictable and consistent is an important step as individuals are learning complex evidence-based interventions (e.g., Travis and Brestan-Knight 2013). Therefore, ongoing supervision, post-training, could allow trainees delivering an evidence-based intervention the opportunity to problem-solve potential barriers to delivering an intervention with fidelity, including the chance to practice new or challenging techniques, with the goal of honing provider skill and confidence during the learning of a complex intervention.…”

“…Additionally, the ability to measure change in fidelity over time can be used to track changes in fidelity that may arise as providers learn new skills or aspects of an intervention. Ultimately, these data then can be used to support providers in supervision or consultation, either during the training period, or after providers are certified in the model (Costello et al 2019;Travis and Brestan-Knight 2013). Given strong intervention fidelity is clearly linked with positive outcomes (Dusenbury et al 2003), it appears critical that intervention developers gain a rich understanding of these data.…”

Communication Interventions for Families of Pre-School Deaf Children in the UK

“…However, a randomized control study using the second edition of the programme demonstrated that, after intervention, children had larger lexicons overall and used more multiword utterances and early morphemes (Girolametto et al, 1996). In the US the term "Parent Child Interaction Therapy" (PCIT) is used to describe parenttraining programmes for parents whose children have conduct problems (Travis and Brestan-Knight, 2013). In the UK the term is usually used to describe programmes that follow a selection of the principles from the Hanen programme.…”