A Motivational Intervention Can Improve Retention in PCIT for Low-Motivation Child Welfare Clients

Abstract

A motivational orientation intervention designed to improve parenting program retention was field tested versus standard orientation across two parenting programs, Parent-Child Interaction Therapy (PCIT) and a standard didactic parent training group. Both interventions were implemented within a frontline child welfare parenting center by center staff. Participants had an average of six prior child welfare referrals, primarily for neglect. A double-randomized design was used to test main and interaction effects. The motivational intervention improved retention only when combined with PCIT (cumulative survival = 85% vs. around 61% for the three other design cells). Benefits were robust across demographic characteristics and participation barriers but were concentrated among participants whose initial level of motivation was low to moderate. There were negative effects for participants with relatively high initial motivation. The findings suggest that using a motivational intervention combined with PCIT can improve retention when used selectively with relatively low to moderately motivated child welfare clients.

Treatment Outcomes for At-Risk Young Children With Behavior Problems: Toward a New Definition of Success

“…This definition consisted of two components: (a) treatment duration and (b) a RCI for the primary outcome measure of child behavior problems. Results indicated a significantly lower attrition rate than generally reported in PCT programs for low-income families (Nicholson et al, 2002;Chaffin et al, 2009). By engaging caregivers in their home environment, PYC may have helped circumvent the typical contextual barriers for lowincome families, resulting in this decreased attrition rate.…”

“…As a result of these differing definitions, reports of child and family attrition percentages are highly variable. For example, attrition rates vary from as low as 10% (Nicholson et al, 2002) to as high as over 70% (Carrasco & Fox, 2012;Chaffin et al, 2009). At other times attrition rates are not even reported.…”

IMPRoving Outcomes for children exposed to domestic ViolencE (IMPROVE): an evidence synthesis

“…212 Research indicates that this type of preparatory work may enhance rates of uptake and engagement in child mental health and child welfare interventions, [283][284][285][286] and it would be worth considering how these techniques can be extended to this field of work, especially as this already seems to be a feature of one widely implemented UK intervention. We note that an ongoing trial is examining the impact of a 6-week preparatory programme for parents as an adjunct to trauma-focused CBT, 62 which aims to increase parents' insightfulness and orient them to their children's needs before they take part in the full therapeutic programme.…”

The development and evaluation of a natural helpers' training program to increase the engagement of urban, Latina/o families in parent-child interaction therapy

“…Adaptations to PCIT have been made to increase parental engagement once parents are referred to treatment (Chaffin et al, 2004;Chaffin et al, 2009;McCabe & Yeh, 2009), but no known efforts have addressed strategies to improve recruitment of high-risk families into the program. Consequently, the engagement strategies that have been researched only help families who are already referred to treatment, but do not reach families who have not yet initiated services.…”