Therapist Experiences and Attitudes About Implementing Internet-Delivered Parent-Child Interaction Therapy During COVID-19

Abstract

It has been widely recognized that access to mental health treatment is imperative to address current and long-term stressors for children and parents during COVID-19. Internet-delivered Parent-Child Interaction Therapy (iPCIT, previously referred to as I-PCIT) is a strong model for remote service delivery during social distancing restrictions due to its empirical base. However, this treatment modality was not widely implemented before COVID-19, likely due to barriers to providing telehealth services. This mixed methods study conducted a follow-up survey to gather therapist experiences ( N = 223) in delivering iPCIT during COVID-19, including qualitative data on the benefits and challenges to delivering iPCIT. The vast majority of therapists (82%) indicated that they transitioned to deliver PCIT via telehealth in response to COVID-19. PCIT caseloads decreased slightly from the first survey to the COVID-19 follow-up survey, but the racial and ethnic composition of caseloads were not significantly different between the two surveys. Of the 183 therapists who transitioned to deliver PCIT via telehealth, 82% expressed interest in continuing to provide iPCIT following the COVID-19 pandemic. Reported benefits of iPCIT included decreased barriers to access and the ability to practice skills within the naturalistic home environment. Challenges to iPCIT were primarily issues with technology as well as other logistical barriers, which could limit engagement for some families. Findings from this study may be beneficial in improving future implementation of iPCIT during and post-COVID-19.

The impact of COVID-19 on child and adolescent mental health and treatment considerations

“…Among numerous behavioral parent training programs available, Parent-Child Interaction Therapy (PCIT) ( Eyberg & Funderburk, 2011 ) may be especially well-suited to reach families during the pandemic, given that “in-vivo” coaching of parenting skills can be delivered remotely in a very similar fashion as clinic-based PCIT ( Gurwitch et al, 2020 ). Community therapists delivering PCIT remotely mostly have found the switch to a virtual format acceptable, and see their ability to coach parents in their naturalistic settings as a benefit ( Barnett, Sigal, et al, 2021 ). These impressions align with findings from a study examining the outcomes of a clinic serving primarily Latinx families during the pandemic, where switching delivery of PCIT from in-person to a virtual model of delivery did not impact clinical outcomes; medium to large effects were still seen with regard to child internalizing and externalizing symptoms ( Garcia et al, 2021 ).…”

Predicting a Rapid Transition to Telehealth-Delivered Parent–Child Interaction Therapy Amid COVID-19: A Mixed Methods Study

“…Having a larger caseload in Fall 2019 predicted both the likelihood that therapists transitioned to iPCIT and the rapid transition time. Having a larger PCIT caseload has been associated with better implementation outcomes, including higher skill levels following consultation calls and sustained delivery of the model over time (Barnett et al, 2021a(Barnett et al, , 2021bJackson et al, 2017). The higher caseload in Fall 2019 could indicate several factors related to transitioning to iPCIT in this study.…”

“…Regarding innovation and bridging factors, the fact that PCIT had been previously adapted for telehealth facilitated purveyor organizations being able to quickly develop and disseminate training materials (Barnett et al, 2021a(Barnett et al, , 2021bGurwitch et al, 2020). A manual and video training with considerations for telehealth delivery of PCIT (e.g., how to set up the playroom for PCIT) were created and provided for free on PCIT listservs and websites.…”

Telehealth provision of parent–child interaction therapy during the COVID-19 pandemic: A case report.

“…CW’s positive response to a telehealth-delivered PCIT intervention supports that this is an effective adaptation of an EBP that can be applied in a real-world, pediatric setting. This broadens the scope of the literature on PCIT as a remote-intervention, and in doing so, emboldens the call to use the promise of telehealth-delivered PCIT to address clinical gaps in young children’s mental health care (Barnett et al, 2021; Gurwitch et al, 2020).…”