Enhancing Foster Parent Training with Parent-Child Interaction Therapy: Evidence from a Randomized Field Experiment

Abstract

Objective Research indicates that foster parents often do not receive sufficient training and support to help them meet the demands of caring for foster children with emotional and behavioral disturbances. Parent-Child Interaction Therapy (PCIT) is a clinically efficacious intervention for child externalizing problems, and it also has been shown to mitigate parenting stress and enhance parenting attitudes and behaviors. However, PCIT is seldom available to foster families, and it rarely has been tested under intervention conditions that are generalizable to community-based child welfare service contexts. To address this gap, PCIT was adapted and implemented in a field experiment using 2 novel approaches—group-based training and telephone consultation—both of which have the potential to be integrated into usual care. Method This study analyzes 129 foster-parent-child dyads who were randomly assigned to 1 of 3 conditions: (a) waitlist control, (b) brief PCIT, and (c) extended PCIT. Self-report and observational data were gathered at multiple time points up to 14 weeks post baseline. Results Findings from mixed-model, repeated measures analyses indicated that the brief and extended PCIT interventions were associated with a significant decrease in self-reported parenting stress. Results from mixed-effects generalized linear models showed that the interventions also led to significant improvements in observed indicators of positive and negative parenting. The brief course of PCIT was as efficacious as the extended PCIT intervention. Conclusions The findings suggest that usual training and support services can be improved upon by introducing foster parents to experiential, interactive PCIT training.

Parent–Child Interaction Therapy: current perspectives

“… 28 Each of these studies noted similar decreases in child behavior problems and increases in positive parenting skills. It is interesting to note that several studies have also shown PCIT to be effective with nonparental caregivers such as foster parents 29 , 30 and participants in a kinship care program. 31 …”

“…Notably, when researchers compared the use of individual PCIT to group PCIT, significant improvements were noted in child conduct problems, parenting stress, and children’s adaptive functioning in both formats. 83 Such groups have included families of predominantly low socioeconomic backgrounds in a community-based setting, 82 women in a correctional facility, 26 , 29 and families with a history of child abuse or at risk of child maltreatment. 28 in addition to such lack of outcome differences between formats, a group treatment context may be more cost effective and foster a supportive community between participants.…”

The effectiveness of Video-feedback Intervention to promote Positive Parenting for Foster Care (VIPP-FC): study protocol for a randomized controlled trial

“…Several randomized controlled trials have been conducted in the USA to meet the need for parental sensitivity-focused, evidence-based prevention and intervention programs for this high-risk population. Examples of effective interventions for foster care are Attachment and Biobehavioral Catch-up (ABC; [ 23 ]), Multidimensional Treatment Foster Care for Preschoolers (MTFC-P; [ 21 ]), Parent-Child Interaction Therapy (PCIT; [ 66 , 67 ]), Promoting First Relationships (PFR; [ 68 , 69 ]), and Parent Management Training-Oregon Model (PMTO; [ 70 ]). However, little is known about the effectiveness of these or comparable prevention and intervention programs in the Netherlands.…”

Child Directed Interaction Training for young children in kinship care: A pilot study

“…Most studies of PCIT with children with histories of maltreatment have focused on biological parents (Chaffin et al, 2004; Chaffin, Funderburk, Bard,Valle, & Gurwitch, 2011) or traditional foster caregivers (McNeil, Herschell, Gurwitch, & Clemens-Mowrer, 2005; Mersky, Topitzes, Grant-Savela, Brondino, & McNeil, 2014; Mersky, Topitzes, Janczewski, & McNeil, 2015) using full-protocol PCIT. A randomized trial of PCIT as a foster parent training model for non-kinship foster parents caring for children with externalizing behavior problems in the clinical range demonstrated improvement in both child externalizing and internalizing child symptoms (Mersky et al, 2014) as well as caregiver parenting stress (Mersky et al, 2015).…”

“…A randomized trial of PCIT as a foster parent training model for non-kinship foster parents caring for children with externalizing behavior problems in the clinical range demonstrated improvement in both child externalizing and internalizing child symptoms (Mersky et al, 2014) as well as caregiver parenting stress (Mersky et al, 2015). However, kinship caregivers were intentionally excluded from these studies.…”