Susan G. Timmer

Challenging Children in Kin Versus Nonkin Foster Care: Perceived Costs and Benefits to Caregivers

This study uses social exchange theory as a framework for examining 102 kin and 157 nonkin foster parents’ perceptions of their foster children, their relationships with them, and their own functioning. The authors argue that these perceptions reflect perceived costs and benefits of parenting these children, which may influence their investment in them. All children in the study were referred to Parent-Child Interaction Therapy (PCIT) for treatment of the children’s behavior problems, participating with their foster parents. Analyses showed that nonkin caregivers rated their foster children’s behavior problems as significantly more severe than kin caregivers but rated themselves as significantly less stressed. Analyses predicting early treatment termination showed that kin caregivers were more likely than nonkin caregivers to complete the course of treatment in PCIT, particularly if they reported elevated levels of parental distress. The authors discuss the implications of these findings for foster children’s placement stability and long-term success.

The effectiveness of parent-child interaction therapy for victims of interparental violence

This study compares the effectiveness of Parent–Child Interaction Therapy (PCIT) in reducing behavior problems (e.g., aggression, defiance, anxiety) of 62 clinic-referred, 2- to 7-year-old, maltreated children exposed to interparental violence (IPV) with a group of similar children with no exposure to IPV (N = 67). Preliminary analyses showed that IPV-exposed dyads were no more likely to terminate treatment prematurely than non IPV-exposed dyads. Results of repeated-measures MANCOVAs showed significant decreases in child behavior problems and caregivers’ psychological distress from pre- to posttreatment for IPV-exposed and IPV nonexposed groups, and no significant variation by exposure to IPV. Stress in the parent role related to children’s difficult behaviors and the parent–child relationship decreased from pre- to posttreatment, but parental distress did not decrease significantly over the course of PCIT. Results of an analysis testing the benefits of a full course of treatment over the first phase of treatment showed that dyads completing the full course of treatment reported significantly greater improvements in children’s behavior problems than those receiving only the first phase of treatment.

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.

Efficacy of Adjunct In-Home Coaching to Improve Outcomes in Parent-Child Interaction Therapy.

Objectives: The purpose of this study is to test whether increasing the exposure to coaching by adding an in-home component to clinic-delivered Parent—Child Interaction Therapy (PCIT) will increase the speed of parenting skill acquisition and show greater improvements in children’s behaviors and parental stress. Methods: Seventy-three parent—child dyads participating in clinic-based PCIT are randomly assigned to an adjunct PCIT or Social Support treatment group. The sample of children is 58% male and ranges in age from 1.7 to 8.2 years. Results: Analyses show that participation in adjunct PCIT services is associated with greater use of positive verbalizations and leads to improvement on measures of parent functioning. Conclusions: The meaning of these findings with respect to change and the process of treatment is discussed.

Autobiographical Memory Specificity in Child Sexual Abuse Victims

The present study examined the specificity of autobiographical memory in adolescents and adults with versus without child sexual abuse (CSA) histories. Eighty-five participants, approximately half of whom per age group had experienced CSA, were tested on the autobiographical memory interview. Individual difference measures, including those for trauma-related psychopathology, were also administered. Findings revealed developmental differences in the relation between autobiographical memory specificity and CSA. Even with depression statistically controlled, reduced memory specificity in CSA victims relative to controls was observed among adolescents but not among adults. A higher number of posttraumatic stress disorder criteria met predicted more specific childhood memories in participants who reported CSA as their most traumatic life event. These findings contribute to the scientific understanding of childhood trauma and autobiographical memory functioning and underscore the importance of considering the role of age and degree of traumatization within the study of autobiographical memory.

Parent-Child Interaction Therapy for sexual concerns of maltreated children: A preliminary investigation.

The current study examines whether an evidence-based treatment for externalizing behavior problems may reduce sexual concerns among children with maltreatment histories. An archival analysis identified 44 children between the ages of 3 and 8 exhibiting externalizing problems and co-morbid sexual concerns who were treated using Parent-Child Interaction Therapy (PCIT). A second group of children receiving PCIT for externalizing behaviors without sexual concerns was included for comparison purposes (n=143). Wilcoxon Signed-Ranks Tests indicated significant improvement among the group with sexual concerns, with 63.6% of children no longer displaying clinically significant sexual concerns at post-treatment. In addition, these children showed a decline in general externalizing problems comparable to that observed among the group of children receiving PCIT and not displaying sexual concerns. Lastly, logistic regression analyses showed that pre-treatment posttraumatic stress scores did not moderate improvement of sexual concerns, suggesting that posttraumatic stress-related sexual concerns may improve from PCIT treatment. These findings suggest that evidence-based parent training interventions, specifically PCIT, may successfully reduce sexual concerns among children who experienced maltreatment.

Parent-Child Interaction Therapy for Maltreated Children

This chapter describes how Parent-child Interaction Therapy (PCIT), an evidence based treatment for children with demonstrated value in decreasing child behavior problems, improving parenting skills, and enhancing parent-child relationships disruptive behaviors, can be used to treat maltreated children. This chapter provides an overview of PCIT, examples of the process of ‘coaching,’ and a description of progress toward treatment success. Specific attention is given to describing evidence supporting PCIT. Finally, a case is presented that documents the progression of a maltreated child in PCIT, including pre-treatment assessment, treatment didactics, parent coaching, achievement of treatment mastery, and generalization of positive client outcomes. The value of PCIT as a mental health treatment for abusive and high-risk families is described.

Patterns of Interaction Within Violent Families Use of Social Interaction Research Methodology

During the past two decades, there has been a tremendous growth in research related to interpersonal violence. From this research, researchers have acquired a greater understanding of the risk factors associated with abusive and violent events, the consequences of being victimized, and the characteristics of victims and perpetrators. One area yet to be fully explored involves the interactional processes between a victim and a perpetrator. This article provides a brief description of the advantages of examining the contextual aspects of interpersonal violence, describes a promising observational analysis technique that may prove enlightening to current interpersonal violence research, and describes some limitations of the application of social interaction research to violent relationships. The article “Antecedents of Coercive Interactions in Physically Abusive Mother-Child Dyads” (from this issue) is presented as an example of the value of behavioral observational methods in interpersonal violence research.

Coping style and memory specificity in adolescents and adults with histories of child sexual abuse

ABSTRACT Individuals with histories of childhood trauma may adopt a nonspecific memory retrieval strategy to avoid unpleasant and intrusive memories. In a sample of 93 adolescents and adults with or without histories of child sexual abuse (CSA), we tested the hypothesis that nonspecific memory retrieval is related to an individuals general tendency to use avoidant (i.e., distancing) coping as a personal problem-solving or coping strategy, especially in victims of CSA. We also examined age differences and other individual differences (e.g., trauma-related psychopathology) as predictors of nonspecific memories. Distancing coping was significantly associated with less specific autobiographical memory. Younger age, lower vocabulary scores, and non-CSA childhood maltreatment (i.e., physical and emotional abuse) also uniquely predicted less autobiographical memory specificity, whereas trauma-related psychopathology was associated with more specific memory. Implications for the development of autobiographical memory retrieval in the context of coping with childhood maltreatment are discussed.

Coaching to improve mealtime parenting in treating pediatric obesity.

Childhood obesity is a significant public health concern, with about 17% of children in the United States reported as obese (Centers for Disease Control and Prevention [CDC], 2012a). Family Mealtime Coaching (FMC) is a live coaching intervention using positive psychology interventions and modeling to improve mealtime parenting, child behavior and weight status, and parent–child communication. The purpose of this study was to examine how parent coaching affects feeding practices and pediatric obesity in 2 to 10 year olds. We used a pre-/postexperimental design comparing treatment assessments of children and their caregivers participating in FMC. Caregivers (N = 51) consented to participate in the study. Only those participants with at least 2 measurements of height and weight from which BMI could be calculated (N = 43) were included. The children averaged 6.96 years of age (SD = 2.7), ranging between 2 and 11 years of age, and 58% were female. The large majority were Latino (84%). Children’s baseline body mass index (BMI) averaged at the 97.3 percentile (SD = 3.4), and waist circumference averaged 78.02 cm. Results of analyses showed that children entering treatment within the upper limits of BMI percentile (i.e., 97th percentile or higher) were more likely to complete treatment and showed a significant reduction in BMI z score. The intervention also yielded significant increases in family style serving, intuitive eating, and mealtime communication; reduced maladaptive feeding comments among parents; and decreased problematic mealtime behaviors in the children. These findings suggest a promising empirical basis for using coaching to reshape feeding-related parent–child interactions.