Cheryl B. McNeil

Parent-Child Interaction Therapy with Behavior Problem Children: One and Two Year Maintenance of Treatment Effects in the Family

ABSTRACT Parent-Child Interaction Therapy (PCIT) is an empirically supported treatment for conduct-disordered young children in which parents learn the skills of child-directed interaction (CDI) in the first phase of treatment and parent-directed interaction (PDI) in the second. This study examined the long-term treatment outcome for 13 families who had participated in a treatment study examining the effects of treatment phase sequence one and two years earlier. Seven families were in the CDI-First treatment group and six families were in the PDI-First group. Immediately after treatment, 11 of the 13 families had achieved clinically significant changes on both observational and parent report measures, and there is no significant difference between treatment groups. Treatment effects were maintained at one-year follow-up for eight of the 13 families, and at two-year follow-up for nine families, with no long- term impact of phase sequence evident at either follow-up assessment. This study represents the first long-term follow-up of families treated with PCIT. Results suggest that this treatment may be successful in achieving long-term gains for most families of conduct-disordered preschoolers and that phase sequence has little impact on treatment outcome.

Parent-child interaction therapy: New directions in research

Parent-Child Interaction Therapy (PCIT) is a short-term, evidence-based parent training program for families with 2- to 6-year-old children experiencing behavioral, emotional, or family problems. Based on both attachment theory and social learning theory, PCIT research has provided evidence of efficacy, generalization, and maintenance. The new directions in PCIT research are highlighted in this article.

Parent-Child Interaction Therapy: An Intensive Dyadic Intervention for Physically Abusive Families

A designated priority in the field of child maltreatment is the development of empirical approaches for treating abusive families. This article describes parent-child interaction therapy (PCIT), an intervention that has been shown to be effective for helping parents manage young children with severe behavioral problems. The potential application of this treatment program to the child maltreatment field is examined by (a) providing a social learning perspective to explain the development and stability of some physically abusive parent-child relationships, (b) outlining the effectiveness of PCIT with similar populations, and (c) discussing the unique benefits that PCIT may offer the field of child maltreatment. The limitations of PCIT with physically abusive families are also discussed.

The Inclusion of Fathers in Behavioral Parent Training: A Critical Evaluation

ABSTRACT Behavioral parent training (BPT) is one of the most commonly utilized research treatments for young children with externalizing behaviors. Most BPT research, however, has been conducted with mothers. Thus, insufficient data exist as to the benefits of father participation in BPT. This paper provides rationales for why fathers should be included in BPT and an extension of previous critiques on father participation in BPT to critically evaluate recent research (1989–2003) in the same area. Several limitations of this body of research make it difficult to draw conclusions about the benefit of including fathers in BPT. Future research should be conducted with methodologically-sound designs to examine treatment outcome with fathers.

DSM–IV and disorders of childhood and adolescence: Can structural criteria be functional?

The structural, descriptive basis of the diagnostic categories outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) is contrasted to a system of functional analysis, with regard to (a) clinical diagnosis, (b) target behavior identification, (c) treatment design, (d) treatment evaluation, and (e) clinical research. It is noted that structural classification is a useful starting point for these activities but that functional analysis has greater utility for target behavior identification and treatment design by giving consideration to antecedent and consequent events, skills repertoires, response interrelations, and support systems. Examples of melding structural classification and functional analytic systems are provided with reference to certain childhood disorders: mental retardation, disruptive behavior disorders, and anxiety disorders. Recommendations are made for an elaboration of the DSM axes to include (a) psychosocial and environmental resources and deficits, and (b) idiographic case analysis. It is suggested that these axes will assist in systematizing functional analysis and making it more accessible to all clinicians and researchers.

The ADHD Classroom Kit: A Whole-Classroom Approach for Managing Disruptive Behavior.

In this article, an inclusive treatment package for children with ADHD, The ADHD Classroom Kit (Kit), is described. Components of the Kit are categorized in three areas: consequences for appropriate behavior, consequences for inappropriate behavior, and peer-mediated interventions. The empirical rationale for each component of the Kit is discussed. Also, a case study of a 6-year-old girl (Carol) with reported disruptive behavior problems is presented as preliminary data supporting the Kits effectiveness. An A-B-A reversal design was used in Carols classroom. Mean frequencies of appropriate behavior were 61.3% (baseline), 78.5% (Kit), and 70.7% (reversal). In addition, mean frequencies of on-task behavior were 76.2% (baseline), 87.8% (Kit), and 82.5% (reversal). Implications for future research and practice with the Kit are addressed.

A comparison between African American and Caucasian children referred for treatment of disruptive behavior disorders

ABSTRACT To develop more culturally sensitive treatments for child behavior problems it is important to examine the impact that ethnicity has on behavioral assessment, diagnosis and treatment. The current study investigated archival data of African American and Caucasian families referred for treatment of disruptive behavior problems. Subjects were 56 children between the ages of 35 and 90 months (M = 64 months). Half of the participants were African American (n = 28) and half were Caucasian (n = 28). Subjects from the two groups were matched on age, gender, income, and treatment location. Following the completion of pretreatment assessments (e.g., Eyberg Child Behavior Inventory, Parenting Stress Index), subjects and their parent(s) received treatment using Parent-Child Interaction Therapy (PCIT). No significant differences between groups were found on the pretreatment measures or measures of treatment outcome. Results are discussed with respect to the importance of considering cultural issues when assessing child behavior disorders and providing parent training.

Evaluation of a treatment manual and workshops for disseminating, parent-child interaction therapy.

This study’s main purposes were to: (a) evaluate a treatment manual as a dissemination strategy, (b) compare two workshop formats for evidence-based treatment (EBT) training, and (c) provide preliminary data on therapist characteristics potentially associated with successful EBT adoption. Forty-two community-based clinicians were assigned to one of two training groups (didactic or experiential). Behavior observation and self-report data were collected at four time points. Results suggest that reading a treatment manual is useful, but not sufficient. Experiential and didactic training were equally effective in increasing knowledge, skill, and satisfaction; however, after a 2-day training, few participants demonstrated mastery of skills.

Evaluation of Foster Parent Training Programs: A Critical Review

Foster parents have special needs which must be addressed to retain them in the child welfare system. Several of these needs may be addressed within their foster parent training experience; however, little research is available to determine the effectiveness of these training programs. What little research is available is frought with methodological limitations, calling into question the reliability, validity, or generalizability of study results. This article provides a comprehensive review of 17 studies, published between 1980 and 2007, investigating foster parent training programs. The studies reviewed include 1 investigation relying solely on case records, 1 case study, and 15 group studies (5 using no control group and 10 utilizing a control group). This article points out research deficiencies and outlines several suggestions for future research.

Psychometric Properties and Reference Point Data for the Revised Edition of the School Observation Coding System

The psychometric properties of a new observation coding system for childrens disruptive classroom behavior were evaluated. The Revised Edition of the School Observation Coding System (REDSOCS) was used to observe 51 young children clinic-referred for conduct-disordered behavior and 182 nonreferred children from the classrooms of the referred children. Reference point data for the REDSOCS categories with preschoolers were obtained from the sample of nonreferred children. Interobserver reliability and concurrent validity of the three REDSOCS categories with teacher rating scales of oppositional behavior and hyperactivity were demonstrated. Initial evidence of convergent and discriminant validity was established through correlations of the REDSOCS categories with the subscales of the Revised Conners Teacher Rating Scale. Differences in REDSOCS scores between the nonreferred children and children referred for school behavior problems provided