The Effectiveness of Parent–Child Interaction Therapy with Depressive Mothers: The Changing Relationship as the Agent of Individual Change

Abstract

This study uses a multi-method approach to investigate the effectiveness of Parent-Child Interaction Therapy (PCIT) in reducing children's behavior problems when parents report clinical levels of depressive symptoms. Participants were 132 children, 2-7 years of age, and their biological mothers, who either reported low (N = 78) or clinical levels of depressive symptoms (N = 54). Results showed that depressive mothers were likely to report more severe child behavior problems than non-depressive mothers at the pre-treatment assessment, but that depressive mothers reported greater reductions in child behavior problems than non-depressive mothers from pre- to post-treatment. The two groups showed similar levels of observed interaction quality at the pre-treatment assessment (i.e., parent and child emotional availability and parent verbalization patterns) and similar improvements in interaction quality from pre- to post-treatment. The implications of the findings for clinical practice were discussed.

The lasting impact of early‐life adversity on individuals and their descendants: potential mechanisms and hope for intervention

“…However, there is evidence that parenting interventions are less effective for the offspring of individuals with greater symptoms of psychopathology (e.g. Van Loon et al 2011;Webster-Stratton & Hammond 1990, but see also Gardner et al 2010;Timmer et al 2011). This suggests the need to concurrently target parental psychopathology, a strategy that has been shown to be more effective in the treatment of depressed mothers and their disruptive children (Sanders & McFarland 2000).…”

Cascading effects of BPT for child internalizing problems and caregiver depression

“…For example, a study conducted by Timmer and colleagues (2011) investigated the efficacy of PCIT (Eyberg & Funderburk, 2011) in reducing children’s behavior problems [i.e., clinical elevations on the Externalizing Subscale of the Child Behavior Checklist (CBCL; Achenbach, 2001) and clinical elevations on the Eyberg Child Behavior Inventory (ECBI; Eyberg, 1999)] in families in which the primary caregiver reported clinical levels of depressive symptoms [i.e., clinical elevations on depression subscales of two clinical symptom inventories: Symptom Checklist 90-R (SC-90R; Derogotis, 1994) and Brief Symptom Inventory (BSI; Derogotis, 1993)]. Results revealed significant pre- to post-treatment effects on the CBCL and ECBI for problem behavior for children of depressed and non-depressed mothers.…”

“…Behavioral Parent Training (BPT) is the standard of care for early onset DBDs; indeed, robust evidence shows significant post-treatment improvement in disruptive behaviors, which is hypothesized to occur via improvements in the parent-child relationship (e.g., Chorpita et al, 2011; Eyberg, Nelson, & Boggs, 2008; McMahon, Wells, & Kotler, 2006). Yet, preliminary data suggests BPT for DBDs may also yield changes in comorbid internalizing problems and caregiver depression (e.g., Carpenter, Pulifico, Kurtz, Pincus, & Comer, 2014; Timmer et al, 2011; Webster-Stratton & Herman, 2008). Greater understanding of how and why BPT has such cascading effects is consistent with calls for testing manual-based treatments with comorbid children (Jensen Doss, 2005) and cost-effective first-line treatments targeting clusters of symptoms within and across family systems (NIMH, 2015).…”

Parenting and Children's Resilience in Military Families

“…Parent-Child Interaction Therapy (PCIT) is also an evidence-based intervention developed for young children (2-7) with problematic externalizing behaviors and their civilian parents, and is being adapted for military families. Most studies of PCIT focus on behavioral outcomes; however, two studies examine attachment-based concepts such as maternal sensitivity (Thomas & Zimmer-Gembeck, 2011 ) and emotional availability (Timmer et al, 2011 ).…”