PCIT Training Implementation Project
Melanie Nelson, PhD, (Principal Investigator)
OUHSC and the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) are partnering to improve the quality and quantity of psychological services available to children and families in Oklahoma. The overarching goal of this specific project is to provided specialized training to child mental health practitioners in the use of evidence-based treatments for children traumatized by such experiences as abuse and family violence. Selected Oklahoma community mental health centers will serve as sites for this program. Oklahoma community mental health providers will receive intensive PCIT training (total: 7 days) conducted at OUHSC by OUHSC faculty. The first training (5 days) will focus on factors associated with the integration of PCIT into community mental health programs and on the development of skills specific to part on of PCIT - Child Directed Interaction (CDI). The second training (2 days conducted 3-4 months following the 5 day training) is dedicated to the development of skills specific to part two of PCIT - Parent Directed Interaction (PDI). This intensive training will be followed by either Remote Live or Phone Case Consultation, depending on the site. Agencies will receive a total of 11 months of PCIT consultation. Each site will receive five months of Remote Live Consulation (RLC) and six months of Phone Consulation (PC). Client-level outcome data will be collected and analyzed for group differences.
PCIT Implementation Project: Using technology to augment the effectiveness of parenting programs
Beverly Funderburk, PhD (Principal Investigator)
Parent-Child Interaction Therapy (PCIT) is an empirically well-supported behavioral parent training program for reducing aggressive behavior in young children, and for reducing future rates of child physical abuse. Prior randomized trial research conducted by OUHSC has found that an adapted version of PCIT we developed specifically for violent parents in the child welfare system reduced future child physical abuse recurrence rates from 49% to 19%. Our prior and ongoing studies have found the benefits of PCIT to be durable over time, to generalize across settings and across children in the same family, and we have developed culturally-specific adaptations of PCIT as well as adaptations for older abused children and their abusive parents. A number of blue-ribbon panels have recommended PCIT for scaled-up implementation in child abuse prevention and intervention service systems, but uptake of PCIT has been limited. One reason for this is that the traditional PCIT training models are a poor fit with field settings. PCIT has historically been taught in University-based training programs (graduate programs, internships, etc.) and includes several months of co-therapy mentoring where trainers work directly with trainees during live sessions. Replicating this mentored implementation approach is not feasible in most scaled-up field settings.
Over the past 6 months, OUHSC has pilot- and feasibility tested a system using internet-based telemedicine technology to deliver live, mentored PCIT training. We have piloted Remote Real Time (RRT) training at sites in Utah, Seattle, Alaska, Oregon and within Oklahoma. Feasibility appears excellent, and the approach has been well received. Moreover, RRT implementation revealed misapplications of the model that had gone unaddressed in phone consultation. The proposed research project will make use of planned, funded PCIT start-up implementations at 23 agency sites in Washington and Oklahoma. Using a multilevel interrupted time series randomized design, the proposed study will compare the RRT implementation approach with standard phone consultation (PC). Outcomes will include practitioner fidelity and competency and rates of future child welfare abuse reports. A mediational model is proposed wherein differences in downstream client outcomes are mediated by improved practitioner fidelity and competency. Cost effectiveness and practitioner response to the implementation approach will be examined.
See also www.pcit.org for a comprehensive list of PCIT research publications.