Group PCIT in a CommunityBased Setting

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Group PCIT in a Community-Based Setting

• Elizabeth V. Brestan, Ph.D.
• Lori Ridgeway, B. S.
• Lori Klinger, M. S.
• Department of Psychology
• Auburn University

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• University of Florida
• Sheila Eyberg, Ph.D.
• University of Oklahoma Health Sciences Center
• Beverly Funderburk, Ph.D.
• Jane Silovsky, Ph.D.
• Cheryl McNeil, Ph.D.

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What is Parent-Child Interaction Therapy?
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Parent-Child Interaction Therapy

• Work with the parent and child together
• Designed to treat children (3 to 7 years) with
  disruptive behavior problems
• Use of coaching with a bug-in-the-ear from a
  one-way mirror
• Consists of two phases of treatment (averaging 14
  to 20 weekly sessions) focusing on relationship
  enhancement and behavior management

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PCIT Populations

• Head Start, Physical Abuse, Substance Abuse,
  Foster Families, Children with Sexual Behavior
  Problems, Children with Separation Anxiety
  Disorder
• Hembree-Kigin, T., McNeil, C.B. (1995).
  Parent-Child Interaction Therapy. New York
  Plenum.

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PCIT Physical Abuse

• University of Oklahoma Health Sciences Center
• Center on Child Abuse and Neglect
• Physical Abuse Treatment Outcome Study
• Chaffin, M., Silovsky, J. F., Funderburk, B.,
  Valle, L. A., Brestan, E. V., Balachova, T.,
  Jackson, S., Lensgraf, J., Bonner, B. L.
  (2004). Parent-child interaction therapy with
  physically abusive parents Efficacy for reducing
  future abuse reports. Journal of Consulting and
  Clinical Psychology, 72, 500-510.

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Physical Abuse Report
Investigation by Oklahoma County Child Welfare
Services
Court ordered 6 months of treatment for 110
parent-child dyads
Standard Community Group
PCIT
Enhanced PCIT
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Physical Abuse Report Survival
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Mean Changes in Observed Parent Negative Behaviors
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What does group PCIT look like?
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Group PCIT

• Center on Child Abuse and Neglect
• Infant Parenting Program
• Robin Gurwitch, Ph.D.
• Cheryl McNeil, Ph.D.
• Central Michigan University
• Larissa Niec, Ph.D.

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• PCIT Group Manual
• PCIT Jeopardy
• R34
• Larissa Niec, Ph.D.
• Resubmitted

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Group PCIT

• 3 to 6 families
• 2-3 hour sessions
• Group cohesion/social support
• Pilot group preliminary support
• Niec, L. N., Hemme, J., M., Yopp, J. M.,
  Brestan, E. V. (in press). Parent-Child
  Interaction Therapy The Rewards and Challenges
  of a Group Format. Child and Family Behavioral
  Practice

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Child Advocacy Center of East Alabama

• Emphasis on prosecution
• Individual therapy
• New focus prevention
• Summer 2003

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Post TX
Follow Up
Pre TX
6 months
12 weeks
ECBI DPICS CAP PSI TAI
ECBI DPICS CAP PSI TAI
ECBI DPICS PSI CAP
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Funding

• We may be cheap, but we have class!
• Two 7-hour therapists
• Volunteers

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• Alabama Department of Consumer and Economic
  Affairs Grant
• 3 year renewable training grant
• Oct 2003
• Oct 2004

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• Auburn University Outreach Scholarship Grant
• Funded for 2004
• Under review for 2005

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• City of Opelika
• HUD funds

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Referrals

• DHR
• From 2 x 4 to 2 choices
• The duct tape challenge
• AUDaily
• A ringer is a good thing

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Removing Barriers

• Community-based setting
• Supper
• Transportation
• Childcare
• Rewards/Donations

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How many corn dogs can 7 children eat in one
night?

• 7
• 14
• 10
• 20

(Answer 20)
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Referrals to date
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• (10 intakes x 3 hours each) within 2 weeks
  (_at_!) / 2 therapists

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ECBI for Completers(n 10 )
Denotes p .001 Denotes p .000
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PSI for Completers(n 10 )
Denotes p .001
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Drop-outs

• Illness
• School/Work demands
• DHR case dropped
• Foot-in-the-mouth moment

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DHR Case Study

• Referred to the PCIT group following suspected
  physical abuse
• Both were single Caucasian mothers, in their
  mid-twenties, low SES
• Family 1
• 5-year-old female
• Family 2
• 5-year-old male

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ECBI Intensity
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ECBI Problem
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PSI Total Score
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CAP Total Abuse Score
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Observations on Working with Neglectful Parents

• Focus on physical punishment is not always
  primary
• Relationship building (CDI) is the most crucial
  element
• Some techniques needed modification (Selective
  ignoring)
• Problem-solving regarding attending to other
  children during CDI

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Limitations of the group format

• Focus on child behavioral problems and parenting
  skill, not on other aspects of family (e.g.,
  domestic violence, substance abuse, parent
  psychopathology)
• Continued need for coordination with other
  treatment/support agencies
• Some families may not be appropriate for group
  PCIT