A Case Study of Parent–Child Interaction Therapy

Abstract

The authors present a case study of “Katie,” a 4-year-old girl diagnosed with oppositional defiant disorder (ODD). Treatment was conducted with Katie and her family using Parent–Child Interaction Therapy (PCIT). However, client-centered adaptations were made to improve the feasibility of the treatment and its ecological validity in a community setting. Katie demonstrated marked reduction in ODD symptoms during treatment and no longer met criteria for ODD at discharge and throughout follow-up periods. A hybrid model was utilized whereby PCIT components were delivered in both clinic and in-home settings. Client-centered adaptations and the benefits of treatment in the in-home setting are discussed. The authors contend that use of appropriate client-centered clinical flexibility, when implementing a manualized, empirically supported, and evidence-based treatment, can assist in bridging the “science–practice gap” allowing for appropriate flexibility and individualization, while also promoting the use of empirically supported and validated treatment approaches.

Keywords

parent–child interaction therapy adaptations clinical flexibility in-home therapy

Get full access to this article

View all access options for this article.

References

Achenbach

T. M.

Rescorla

L. A.

(2000). Manual for the ASEBA preschool forms & profiles. Burlington: University of Vermont, Research Center for Children, Youth, & Families.

Addis

M. E.

Krasnow

A. D.

(2000). A national survey of practicing psychologists’ attitudes toward psychotherapy treatment manuals. Journal of Consulting and Clinical Psychology, 68, 331-339.

Agazzi

Tan

S. Y.

(2013). A case study of parent-child interaction therapy for the treatment of autism spectrum disorder. Clinical Case Studies, 12, 428-442.

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Bagner

D. M.

Eyberg

S. M.

(2007). Parent-child interaction therapy for disruptive behavior in children with mental retardation: A randomized controlled trial. Journal of Clinical Child & Adolescent Psychology, 36, 418-429.

Barkley

R. A.

(1997). Defiant children. New York, NY: Guilford Press.

Baumrind

(1967). Child care practices anteceding three patterns of preschool behavior. Genetic Psychology Monographs, 75, 43-88.

Baumrind

(1991). The influence of parenting style on adolescent competence and substance use. Journal of Early Adolescence, 11, 56-95.

Bell

S. K.

Eyberg

S. M.

(2002). Parent-child interaction therapy: A dyadic intervention for the treatment of young children with conduct problems. Innovations in Clinical Practice: A Source Book, 20, 57-74.

10.

Brestan

E. V.

Eyberg

S. M.

(1998). Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5,272 kids. Journal of Clinical Child Psychology, 27, 180-189.

11.

Burlingame

Wells

Lambert

Cox

J. C.

(2004). Youth Outcome Questionnaire (Y-OQ). In Maruish

M. E.

(Ed.), The use of psychological testing for treatment planning and outcomes assessment (Vol. 2, pp. 235-273). Mahwah, NJ: Lawrence Erlbaum.

12.

Chu

B. C.

Kendall

P. C.

(2009). Therapist responsiveness to child engagement: Flexibility within manual-based CBT for anxious youth. Journal of Clinical Psychology, 65, 736-754.

13.

Connor-Smith

J. K.

Weisz

J. R.

(2003). Applying treatment outcome research in clinical practice: Techniques for adapting interventions to the real world. Child and Adolescent Mental Health, 8, 3-10.

14.

Eisen

A. R.

Silverman

W. K.

(1998). Prescriptive treatment for generalized anxiety disorder in children. Behavior Therapy, 29, 105-121.

15.

Eyberg

(1999). Parent child interaction therapy: Integrity checklists and session materials. University of Florida. Retrieved from http://pcit.phhp.ufl.edu/Presentations/PCIT%20Integrity%20Checklists%20and%20Materials%204-13-06.pdf

16.

Eyberg

Pincus

(1999). Eyberg Child Behavior Inventory & Sutter-Eyberg Student Behavior Inventory-Revised: Professional manual. Odessa, FL: Psychological Assessment Resources.

17.

Guevara

J. P.

Mandell

D. S.

Rostain

A. L.

Zhao

Hadley

T. R.

(2003). National estimates of health services expenditures for children with behavioral disorders: An analysis of the medical expenditure panel survey. Pediatrics, 112, e440-e446.

18.

Herschell

A. D.

Calzada

E. J.

Eyberg

S. M.

McNeil

C. B.

(2002). Parent-child interaction therapy: New directions in research. Cognitive and Behavioral Practice, 9, 9-16.

19.

Jacobson

N. S.

Schmaling

K. B.

Holtzworth-Munroe

Katt

J. L.

Wood

L. F.

Follette

V. M.

(1989). Research-structured vs. clinically flexible versions of social learning-based marital therapy. Behaviour Research and Therapy, 27, 173-180.

20.

Jacobson

N. S.

Truax

(1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.

21.

Kazdin

A. E.

(1987). Treatment of antisocial behaviour in children: Current status and future directions. Psychological Bulletin, 102, 187-203.

22.

Kazdin

A. E.

(1995). Child, parent and family dysfunction as predictors of outcome in cognitive-behavioral treatment of antisocial children. Behaviour Research and Therapy, 33, 271-281.

23.

Keenan

Wakschlag

L. S.

(2002). Can a valid diagnosis of disruptive behavior disorder be made in preschool children? American Journal of Psychiatry, 159, 351-358.

24.

Kendall

P. C.

Beidas

R. S.

(2007). Smoothing the trail for dissemination of evidence-based practices for youth: Flexibility within fidelity. Professional Psychology: Research and Practice, 38, 13-20.

25.

Kendall

P. C.

Chu

B. C.

(2000). Retrospective self-reports of therapist flexibility in a manual-based treatment for youths with anxiety disorders. Journal of Clinical Child Psychology, 29, 209-220.

26.

Kendall

P. C.

Gosch

Furr

J. M.

Sood

(2008). Flexibility within fidelity. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 987-993.

27.

Kimonis

E. R.

Armstrong

(2012). Adapting parent-child interaction therapy to treat severe conduct problems with callous-unemotional traits: A case study. Clinical Case Studies, 11, 234-252.

28.

Lavigne

J. V.

Arend

Rosenbaum

Binns

H. J.

Christoffel

K. K.

Burns

Smith

(1998). Mental health service use among young children receiving pediatric primary care. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 1175-1183.

29.

Loeber

Burke

J. D.

Lahey

B. B.

Winters

Zera

(2000). Oppositional defiant and conduct disorder: A review of the past 10 years, part I. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 1468-1484.

30.

Masse

J. J.

McNeil

C. B.

(2008). In-home parent-child interaction therapy: Clinical considerations. Child & Family Behavior Therapy, 30, 127-135.

31.

Mazzucchelli

T. G.

Sanders

M. R.

(2010). Facilitating practitioner flexibility within an empirically supported intervention: Lessons from a system of parenting support. Clinical Psychology: Science and Practice, 17, 238-252.

32.

McHugh

R. K.

Murray

H. W.

Barlow

D. H.

(2009). Balancing fidelity and adaptation in the dissemination of empirically-supported treatments: The promise of transdiagnostic interventions. Behaviour Research and Therapy, 47, 946-953.

33.

Neary

E. M.

Eyberg

S. M.

(2002). Management of disruptive behavior in young children. Infants & Young Children, 14, 53-67.

34.

Nock

M. K.

Kazdin

A. E.

Hiripi

Kessler

R. C.

(2007). Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: Results from the National Comorbidity Survey Replication. Journal of Child Psychology and Psychiatry, 48, 703-713.

35.

O’Brien

(1996). Child-rearing difficulties reported by parents of infants and toddlers. Journal of Pediatric Psychology, 21, 433-446.

36.

Pearl

E. S.

(2008). Parent-child interaction therapy with an immigrant family exposed to domestic violence. Clinical Case Studies, 7, 25-41.

37.

Persons

J. B.

(1991). Psychotherapy outcome studies do not accurately represent current models of psychotherapy: A proposed remedy. American Psychologist, 46, 99-106.

38.

Rich

B. A.

Eyberg

S. M.

(2001). Accuracy of assessment: The discriminative and predictive power of the Eyberg Child Behavior Inventory. Ambulatory Child Health, 7, 249-257.

39.

Schuhmann

Foote

Eyberg

Boggs

Algina

(1998). Efficacy of parent-child interaction therapy: Interim report of a randomized trial with short-term maintenance. Journal of Clinical Child Psychology, 27, 34-45.

40.

Silverman

W. K.

Albano

A. M.

(1996). Anxiety Disorders Interview Schedule for DSM-IV.: Parent Interview Schedule (Vol. 1). London, England: Oxford University Press.

41.

Timmer

S. G.

Urquiza

A. J.

Zebell

N. M.

McGrath

J. M.

(2005). Parent-child interaction therapy: Application to maltreating parent-child dyads. Child Abuse & Neglect, 29, 825-842.

42.

Ware

L. M.

McNeil

C. B.

Masse

Stevens

(2008). Efficacy of in-home parent-child interaction therapy. Child & Family Behavior Therapy, 30, 99-126.

43.

Webster-Stratton

Taylor

(2001). Nipping early risk factors in the bud: Preventing substance abuse, delinquency, and violence in adolescence through interventions targeted at young children (0-8 years). Prevention Science, 2, 165-192.