• By Dartington SRU
  • Posted on Friday 25th May, 2012

PCIT: What next for the popular intervention?

In the third and final part of our series on the work and career of Sheila Eyberg, developer of the evidence-based treatment Parent-Child Interaction Therapy and Distinguished Professor at the University of Florida, we look to the future and ask: what next for PCIT?Two things, according to Eyberg. The first is a commitment to expanding the research base for PCIT. The second is developing effective ways of training new cohorts of PCIT clinicians. A new generation of research studiesA lot of research has been done on PCIT, but gaps remain. How long, for instance, does PCIT continue to have an effect? Current data suggest that positive effects can be detected up to six years after treatment, “but we need longer and more tightly controlled studies,” Eyberg said. Another focus for future research will be on retention and drop-out rates. A defining feature of the intervention is that families should be discharged only when the child’s behavior is back in a “normal” range. Those who drop out sooner do not receive the full treatment, and the concern is that PCIT won’t work for them. Although retention rates are generally reported to be high for PCIT, as with any intervention there are always families who stop turning up to sessions and disengage from the process. Eyberg said that understanding what factors influence drop-out is important for ensuring that those who need treatment, but struggle to remain engaged, get the help they deserve.Important as these research goals are for improving and validating PCIT, perhaps what sets Eyberg apart as a program developer is her additional commitment to developing innovative ways of training PCIT clinicians and reducing barriers to the implementation process. A new generation of PCIT cliniciansIn the early stages of PCIT’s development, graduate programs in clinical psychology were the primary vehicle for training PCIT therapists. But as the evidence base for the intervention became better established, graduate programs were deemed too limited to keep up with the increasing level of demand within the community. Since then, the training has become increasingly sophisticated. There have been two key developments. The first has been the deployment of modern communications technology to transform the training process, enabling trainers to consult with trainees from afar. Trainers can now provide immediate, live feedback to trainee therapists, without being physically present during the therapy session itself. This coaching relationship between trainer and trainee parallels the “bug-in-the-ear” device that PCIT therapists use to coach parents during therapy sessions. Another interesting development has been the formation of a learning collaborative in partnership with the National Center for Child Traumatic Stress (NCCTS). The goal of the collaborative is to foster clinical competence as well as organizational support and readiness in order to break down traditional barriers to the implementation of evidence-based programs in the community. The collaborative brings together trainee therapists, their supervisors, administrators, and senior agency leaders. Bringing all the parties into the same room ensures that everyone with a stake in the implementation process understands the basic workings and process of the intervention. It aims to foster a sense of community and mutual understanding that will help the implementation work more smoothly at each new site.The operation of the collaborative places strong emphasis on learning by doing, so-called “active learning.” The trainees participate in face-to-face sessions and consultation calls, and between sessions they practice their newly-developed skills. Throughout the training process, participants are encouraged to share learning so that everyone can benefit from others’ successes and failures. This innovative training model is subject to an ongoing evaluation. Preliminary findings have suggested that it results in a level of fidelity and treatment outcome that is comparable to those found in the strict conditions of randomized controlled trials. **********Reference:Niec, L.N., Eyberg, S., & Chase, R.M. (2012). Parent-Child Interaction Therapy: Implementing and Sustaining a Treatment Program for Families of Young Children with Disruptive Behavior Disorders. In A. Rubin (Ed.), Programs and Interventions for Maltreated Children and Families at Risk. New Jersey: John Wiley and Sons Inc.Links:Other stories in the series: PCIT: The birth of an innovationPCIT: The scientific method in actionPCIT: http://pcit.phhp.ufl.edu/

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