(2014). Parent-child interaction therapy for child disruptive behaviour

Parent-Child Interaction Therapy for Child Disruptive
Behaviour Disorders: A Meta-Analysis
Michelle A. Ward, Jennifer Theule, & Kristene Cheung
Department of Psychology, University of Manitoba
Method
Disruptive Behaviour Disorders (DBD)
•  Disruptive behaviour is the leading reason that children are referred
to mental health professionals (Kazdin, 2003).
•  The American Psychiatric Association (2000) has identified three
separate DBD:
•  Attention Deficit Hyperactivity Disorder (ADHD)
•  Symptoms of inattentiveness and/or hyperactivity and
impulsivity.
•  Oppositional Defiant Disorder (ODD)
•  The persistent and recurrent demonstration of animosity and
noncompliance towards powers of authority.
•  Conduct Disorder (CD)
•  Consistently demonstrating a complete disregard for social
norms and the rights of others.
•  Often follows a previous diagnosis of ODD in early childhood.
•  A meta-analysis was conducted.
Literature search
Database: PsycINFO, Medline, ERIC,
ProQuest Dissertations and Theses,
and Google Scholar
Limits: English-language articles only
Published or prepared before June 2013
Search results combined (k = 536)
Results
1. a) When comparing treatment groups to control groups, PCIT
was found to have a large effect on improving externalizing
behaviour problems (d = 1.39).
b) When comparing child externalizing behaviour pre- and posttreatment, PCIT revealed a large effect size (d = 1.58).
2. The effectiveness of PCIT did not differ significantly for males or
females.
3. A childhood diagnosis of ADHD, ODD, or CD was not found to
significantly moderate the effect size.
Discussion
•  The results of this meta-analysis provide support for PCIT as an
effective intervention for child DBD.
Parent-Child Interaction Therapy
(PCIT)
Articles screened on basis
of title and abstract
•  An early intervention, developed by Dr. Sheila Eyberg, that
integrates attachment and social learning theory (Eyberg, 1988).
•  Involves 9–12 weekly sessions with a trained therapist.
•  The goal is to strengthen the parent-child relationship through two
stages (Eyberg, 1988).
•  Child-Directed Interaction Phase
•  Aims to maximize positive communication during childinitiated play.
•  Parent-Directed Interaction Phase
•  Parents learn to effectively direct play sessions.
•  Parents are taught to reinforce positive behaviour and to
provide suitable consequences for undesirable behaviour.
Excluded (k = 469)
Excluded (k = 56)
Included (k = 67)
Manuscript review and
application of inclusion
criteria
Not an eligible population: 23
Overlapping sample: 10
Follow-up study: 9
PCIT modified or shortened: 5
Dissertation later published: 3
Not an eligible comparison of
outcomes presented: 3
•  PCIT has been Implemented by clinicians in recent years to treat
DBD symptomology (Eyberg et al., 2001).
No direct measure of
externalizing behaviour: 2
Included (k = 11)
PCIT not implemented: 1
Objective
To determine the efficacy of PCIT when used with children who have
been diagnosed with DBD.
Research Questions
1. Is PCIT an effective intervention for young children (ages 2–5) with
DBD? If yes, how effective?
2. Does gender moderate the effectiveness of PCIT?
3. Does the effectiveness of PCIT differ for children with ADHD, ODD,
or CD?
•  Eleven studies met criteria for inclusion.
•  This included 1 unpublished and 10 published reports.
•  Year of publication ranged from 1991 to 2010.
•  Number of participants:
•  Total (n = 308)
•  Treatment (n = 190)
•  Control (n = 118)
•  Each study was coded following a coding manual.
•  Gender and specific diagnosis were not found to moderate the
effectiveness of PCIT.
•  More studies may be needed to accurately assess the impact
of these variables.
•  10 studies were excluded because they used overlapping samples.
•  This demonstrates a necessity for future research to use
independent samples to effectively support PCIT efficacy.
•  9 of the 11 studies that met criteria for this meta-analysis were
conducted by the developer of PCIT and her collaborators.
•  Future research should further determine PCIT efficacy by:
•  Using independent non-overlapping samples.
•  Evaluating PCIT in independent research labs (Chambless et al.,
1993).
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental
disorders (4th ed., text rev.). Washington, DC: Author.
Chambless, D. L. (1993). Task force on promotion and dissemination of psychological
procedures. A report adopted by the Division 12 Board, October 1993. Washington:
American Psychological Association.
Eyberg, S. (1988). Parent-Child Interaction Therapy: Integration of traditional and behavioral
concerns. Child & Family Behavior Therapy, 10(1), 33–46. Retrieved from http://
search.proquest.com/docview/617552407?accountid=14569
Eyberg, S. M., Funderburk, B. W., Hembree-Kigin, T. L., McNeil, C. B., Querido, J. G., & Hood, K.
K. (2001). Parent-Child Interaction Therapy with behavior problem children: One and
two year maintenance of treatment effects in the family. Child & Family Behavior
Therapy, 23(4), 1–20. doi:10.1300/J019v23n04_01
Kazdin, A. E. (2003). Psychotherapy for children and adolescents. Annual Review of
Psychology, 54, 253–276. Retrieved from http://www.annualreviews.org.proxy1.
lib.umanitoba.ca/doi/abs/10.1146/annurev.psych.54.101601.145105
Acknowledgments
This research was funded by the University of Manitoba.
•  Data was entered and analyzed through Comprehensive MetaAnalysis program (CMA).
o  An array of effects were determined.
Correspondence
Michelle Ward at [email protected]
Jennifer Theule at [email protected]

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