Early Assessment and Intervention for Families Experiencing Homelessness: A randomized trial comparing two parenting programs

Abstract

Objective: As part of a larger community-based, service driven research project, the purpose of this study was to 1) document the clinical needs of sheltered children (i.e., externalizing behavior problems [EBP], trauma symptoms, and developmental status) and 2) examine the effectiveness of time-limited adaptations of Parent Child Interaction Therapy (PCIT) and Child Parent Psychotherapy (CPP). Method: One hundred and forty-four young children (Mage = 3.48, SD = 1.09; 56.9% male; 78.5% Black/African American) and their mothers were recruited from a women's homeless shelter and randomly assigned to a 12-week course of either PCIT or CPP delivered by shelter clinicians on site. Families completed pre and post intervention assessments including mother-reported measures of child EBP and trauma symptoms, and parenting stress. Observational data on maternal verbalizations during a child-led play session were also collected. Results: High rates of clinically elevated EBP (36%), trauma symptoms (47%), and developmental delays (35%) were found. Time-limited PCIT resulted in greater reductions in maternal negative verbalizations and parenting stress, and greater increases in maternal positive verbalizations relative to time-limited CPP. As it relates to child outcomes, both time-limited PCIT and CPP resulted in similar decreases in children's post-traumatic stress symptoms; however, only time-limited PCIT resulted in significant improvements in EBP. Conclusions: Young sheltered children evidenced high levels of EBP, trauma symptoms and developmental delays. Both time-limited PCIT and CPP offered effective trauma interventions. However, PCIT offered a more comprehensive intervention by more effectively targeting EBP and parenting. Implications of these findings for clinical practice are discussed.

Addressing Mental Health and Trauma-Related Needs of Sheltered Children and Families with Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT)

“…Thirty-seven youth (11.6%) reportedly did not experience a potentially traumatic event prior to entry to the homeless shelter.6 To address trauma-related symptoms in children below the age of 5, these children and their families were offered alternative intervention services which were more developmentally appropriate/validated for use in early childhood (e.g., Parent-Child Interaction Therapy;Eyberg et al, 2001). See(Graziano et al, 2020) for a description of services provided to children under the age of five.…”