Parent–Child Care as a Brief Dyadic Intervention for Children With Mild to Moderate Externalizing Problems: A Case Study

Abstract

Although many parenting interventions have been shown efficacious in reducing externalizing behavior problems in young children, they often take months to implement and tend to target children with moderate to severe behavior problems. Parent-Child Care (PC-CARE) was designed to be an engaging, brief (six-session) dyadic intervention to reduce mental health symptoms even for children with few behavior problems and/or parents who are unable to commit to lengthy treatments. We present an evidence-based case study of a 5-year-old child with mild externalizing problems and his biological parents, who participated in PC-CARE. Standardized measures were collected, and the child's and parents' emotional availability were assessed at pre-and posttreatment. Weekly codings of parent-child interactions and parent-reported measures of child behaviors were also collected. This child's behavioral symptoms improved from pre-to posttreatment (per parents' reports and observation), and he maintained this improved behavior 1 month after treatment. The parents similarly demonstrated improvement in their use of parenting skills and emotional availability. Aspects of treatment that may affect effectiveness are discussed. Keywords pediatric/child, behavioral intervention, behavioral management, behavioral therapy 1 Theoretical and Research Basis for Treatment Although as many as one in five children in the United States are reported to have mental health problems (Houtrow & Okumura, 2011; Merikangas et al., 2010; Simon, Pastor, Reuben, Huang, & Goldstrom, 2015), many children remain untreated due to issues with access to and participation in mental health services. Specifically, inadequate provider capacity (Substance Abuse and Mental Health Services Administration, 2013) and lack of insurance (Bethell et al., 2011) can be barriers to treatment access. Even when families gain access to a mental health provider, a third never attend their first appointment (Harrison, McKay, & Bannon, 2004). Among those who do begin services, high attrition rates suggest that keeping families engaged is one of the greatest