A short-term treatment designed to help young children’s behavioural problems and support parent-child interactions to improve family functioning.
The Evidence Summaries presented on this site were drawn from the best available evidence of the program’s effectiveness from this review. It does not necessarily reflect all the evidence about the program. The research was selected and assessed for inclusion on the Menu and towards the evidence rating because it met selection criteria related to the specific topic area, study design, quality assessment and the outcomes of interest.
Overview
Evidence Rating
Pathway
- Early help
- Targeted and specialist
Australian Study
Risk of Bias
Cost
Target Age Group
About
Parent-Child Interaction Therapy (PCIT) is a short-term treatment designed to help young children aged 3 to 7 with an externalising behaviour problem. PCIT works with parents to build confidence and their ability to reduce children’s disruptive behaviours through behaviour management strategies and positive reinforcement. The program supports high-risk families with an in-home coaching or social support component. Trained therapists provide coaching sessions to parents as they observe parent-child interaction during play to help parents manage their child’s behaviour.
Aims
- Reduce child’s frequency and severity of negative attention-seeking behaviours
- Increase pro-social behaviours
- Increase security and safety attachment.
Impact
Evidence shows that PCIT was effective in improving child mental health/behaviour and parenting skills of high-risk families with a history of child maltreatment. No evidence was found for improving parent mental health. This trial tested a 12-week treatment of the PCIT program, which found equivalent or better outcomes compared to the lengthier version of PCIT in earlier trials.
| Outcome domain | Outcome measured | Positive effect | No effect | Negative effect |
|---|---|---|---|---|
| Child | Mental health/behaviour | Yes | Not found | Not found |
| Parent/caregiver | Mental health/functioning | Not found | Not found | Yes |
| Parent/caregiver | Parenting skills | Yes | Not found | Not found |
How to read the table:
When ‘Yes’ is indicated for one of the three directions of effect, this means there is evidence of ‘positive’, ‘no effect’ or ‘negative effect’. Evidence is mixed and inconclusive when ‘Yes’ is indicated for two or more directions of effect. Further information about direction of effect can be found on the Using the Menu page.
PCIT has an evidence rating of Supported.
This means that PCIT has evidence from one randomised controlled trial (RCT) or quasi-experiment (QE) demonstrating positive, short-term impact on at least one child and family outcome.
This assessment is based on one research output of RCT design. Another RCT (Thomas et al., 2011) and QE (Self-Brown et al., 2012) were identified but did not count towards the evidence due to concerns with study quality. PCIT has not received a Well-supported rating as it has not yet replicated its results in another RCT or QE with a different population or setting.
| Study design | Number of research outputs included |
|---|---|
| Systematic review with meta-analysis | Not identified or included |
| Randomised controlled trial | 1 |
| Quasi-experiment | Not identified or included |
The evidence has low concerns with risk of bias.
We can be confident about the results and quality of evidence from the included study.
The study was conducted in Australia and reported a small sample of Aboriginal children and families (1.4%).
Aboriginal knowledge and evidence is critical to recognise, document and share practices that lead to improved outcomes for Aboriginal children and families. The department is consulting with the Aboriginal community and stakeholders on how Aboriginal knowledge and evidence is defined and included on the Menu.
Location
- The RCT was conducted in Queensland, Australia.
Sample
- The 151 female caregivers (161 intervention, 91 control) and their children who participated in the trial were referred from child protection authorities, government and non-government health services. They were classified as having engaged in or are at high risk of child maltreatment and child behavioural problems.
- 74% of participants (112 participants) were born in Australia and 1.4% identified as Aboriginal.
Implementation
Delivery model and mode
- PCIT is delivered in-person to the parent and child together, or in a group format with other children, parents and/or families. The program can also be delivered using video-based teleconferencing technology to individual families in their home.
Target cohort
- Parents and families experiencing challenges with their child’s behaviour or parent-child relationship problems
- Foster parents or other caretakers
- Children aged 2 to 7.
Program delivery
- PCIT is delivered in 2 treatment phases:
- The first phase focus on helping parents establish positive relationships with their child. Parents’ skills are observed to assess progress and feedback is provided immediately.
- The second phase equips parents with skills to reduce challenging children’s behaviours. Parents are observed and coached through a one-way mirror at treatment sessions. Parents learn to incorporate effective instructions and commands; for example, giving labelled praise after the child obeys and beginning a time-out procedure.
- Treatment is considered complete when the parent meets the pre-set mastery criteria for both phases of treatment and the child’s behaviour is within normal limits on a parent-report measure of disruptive behaviour at home.
- In the shortened Standard PCIT (tested in the included study), progression from the first to the second phase occurred after 6 to 8 coaching sessions, regardless of mastery criteria. Treatment concluded when a maximum of 12 coaching sessions had been conducted.
Duration and intensity
- PCIT can be completed within 12 to 20 sessions, however, treatment is not time limited. The average treatment program consists of 6 to 12 one-hour weekly sessions.
- PCIT can be delivered in a group format, including smaller groups of 3 to 4 families, in 90-minute sessions.
Manuals and guides
- The Parent-Child Interaction Therapy website has a program manual and materials to implement the program.
Additional information
The Parent-Child Interaction Therapy website has more information about PCIT.
Staffing
- Certified PCIT therapists should have a master’s degree or equivalent, in a mental health field.
- For practitioners who have completed the Therapist Certification and are interested in training others within their agency, prerequisites include being an independently licensed mental health provider, a psychology predoctoral intern, or a psychology postdoctoral fellow who has completed at least 4 PCIT cases to graduation criteria.
Training
- Basic training involves either 40-hours of face-to-face training with a PCIT Level 2 or Master Trainer; or 10 hours of online training from a program endorsed by PCIT International and 30 hours of face-to-face contact with a PCIT Level 2 or Master Trainer.
- Continuation training involves consultations at least twice per month, either via phone or web-conferencing with a Certified Master or Level 2 Trainer, usually in a group format of 6 to 8 practitioners; or in-person with a Certified Level One Trainer in an individual or group format.
- Training for Trainers courses are a minimum of 8 hours and require follow-up consultation including at least once monthly consultation (usually in group format of 6 to 8 Level One Trainer candidates) via phone or web-conferencing with a certified Master Trainer or Level 2 Trainer; and case experience in supervising a trainee while under consultation from a Certified Trainer.
To our knowledge, PCIT is available in New South Wales (NSW).
Karitane has pioneered PCIT efforts since 2005. In NSW, toddler clinics are available at Carramar and Camden. For families in rural or regional NSW, the program is available to families using video-based conferencing. This digital health delivery of PCIT was established in 2018 with support from NSW Health.
Cost
The cost of PCIT is approximately $4,500 USD, which includes the 40-hour workshop, a full year of consultation, ongoing video session review and protocol manuals. The cost varies for different levels of training for the Master Trainer and Level 2 Trainer. In Australia, PCIT is offered as a free health service to the community, with support from New South Wales Health.
References
Studies identified and included in the review
- Thomas R, Zimmer-Gembeck MJ (2012). Parent-child interaction therapy: an evidence-based treatment for child maltreatment. Child Maltreatment 17(3): 253-266.
Studies identified but not counted towards the evidence rating due to study quality
- Thomas R, Zimmer-Gembeck MJ (2011). Accumulating evidence for parent-child interaction therapy in the prevention of child maltreatment. Child Development 82(1): 177-192.
- Self-Brown S, Valente JR, Wild RC, Whitaker DJ, Galanter R, Dorsey S and Stanley J (2012). Utilizing benchmarking to study the effectiveness of parent-child interaction therapy implemented in a community setting. Journal of Child and Family Studies 21(6): 1041-1049.
Australian studies not included based on the Evidence Rating Scale
- Timmer, S. G., Zebell, N. M., Culver, M. A., & Urquiza, A. J. (2010). Efficacy of Adjunct In-Home Coaching to Improve Outcomes in Parent—Child Interaction Therapy. Research on Social Work Practice, 20(1), 36–45.