Parent-Child Interaction Therapy With Physically Abusive Parents: Efficacy for Reducing Future Abuse Reports.

Abstract

A randomized trial was conducted to test the efficacy and sufficiency of parent-child interaction therapy (PCIT) in preventing re-reports of physical abuse among abusive parents. Physically abusive parents (N=110) were randomly assigned to one of three intervention conditions: (a) PCIT, (b) PCIT plus individualized enhanced services, or (c) a standard community-based parenting group. Participants had multiple past child welfare reports, severe parent-to-child violence, low household income, and significant levels of depression, substance abuse, and antisocial behavior. At a median follow-up of 850 days, 19% of parents assigned to PCIT had a re-report for physical abuse compared with 49% of parents assigned to the standard community group. Additional enhanced services did not improve the efficacy of PCIT. The relative superiority of PCIT was mediated by greater reduction in negative parent-child interactions, consistent with the PCIT change model.

Parenting Programs to Prevent Corporal Punishment: A Systematic Review

“…Table 2 summarizes the selected intervention programs for this review. A detailed description of the instruments used in each study to evaluate program effects is beyond the scope of this revision, but, in general, the number of measures used in each program ranged from four (Santos & Williams, 2008) to eight (Chaffin et al, 2004). The most commonly used instruments were the following: (1) The Child Behavior Checklist-CBCL (Achenbach & Edelbrock, 1991) used in six of nine studies reviewed; (2) The Child Potential Inventory-CAP (Milner, 1994), used in four studies; and (3) The Beck Depression Inventory-BDI (Beck, Steer, & Brown, 1996); The Conflict Tactics Scale-CTS (Straus, Hamby, Finkelhor, Moore, & Runyan, 1998); and The Trauma Symptom Checklist for Children-TSCC (Briere, 1996), used in three studies each.…”

“…Still using the PCIT approach, Chaffin et al (2004) conducted a large study aimed at evaluating the efficacy of PCIT in reducing the reoccurrence of reports with 110 parents who had previously been reported to authorities as using corporal punishment. The study compared three types of intervention: (a) PCIT; (b) PCIT plus individualized enhanced services; and (c) a standard community-based parenting group.…”

“…With regards to the intervention procedures, three of nine studies used individual psychotherapy (Kolko, 1996;Kolko et al, 2011;Swenson et al, 2010); four used group psychotherapy (Kjellgren et al, 2013;Nicholson et al, 2002;Runyon et al, 2009;Santos & Williams, 2008); one used coaching (Borrego et al, 1999);and Chaffin et al (2004) used a motivational orientation in the initial phase, followed by coaching. Among the nine studies, four have used a RCT design with pre-test/post-test (Chaffin et al, 2004;Kolko, 1996;Nicholson et al, 2002;Swenson et al, 2010); and the remaining used a pre-test/post-test design on the treatment group only (without a comparison group).…”

“…Among the nine studies, four have used a RCT design with pre-test/post-test (Chaffin et al, 2004;Kolko, 1996;Nicholson et al, 2002;Swenson et al, 2010); and the remaining used a pre-test/post-test design on the treatment group only (without a comparison group). Six of nine studies have conducted follow-up evaluations, and the period between post-test and follow-up ranged from 1 month (Nicholson et al, 2002) to 2 years (Chaffin et al, 2004). Although there is no rule about the appropriate length of time for follow-up, as this depends on many factors (Weiner, Schinka, & Velicer, 2012), we argue that, in general, longer periods (about six months) would be more reliable to identify the intervention maintenance over time.…”

“…Among the methodologically robust interventions, considering the variable "externalizing behavior of the child", the effects varied from 0.54 (medium effect) to 2.17 (large effect), indicating not only the potential of the intervention to produce positive changes in the post-test, but that the programs seemed to be consolidated. The study with the highest value of effect size was by Chaffin et al (2004), suggesting that the intervention procedures used (motivational orientation associated with coaching) combined with solid methodology (large sample, RCT, follow-up of 28 months and the use of eight instruments for evaluation) were key elements in obtaining the positive effects.…”