Kauffman Best Practices Project Final Report - The Chadwick Center ...

defiant disorder, adjustment disorder with disturbance of conduct, or show
similar but sub-clinical or atypical behavior problems not meeting full
diagnostic criteria. Reductions in child behavior problems related to PCIT
have been found to be robust and durable over time, and generalizable from
home to school environments. Benefits also appear to generalize to untreated
children in the same family, and include improvements in the quality of
parent-child relationships. PCIT as a child treatment may be conducted with
parents, foster parents or others in a parental role. Benefits have been found
to be stable across genders and a variety of ethnic groups.
PCIT may also be useful for behavior problems associated with Attention
Deficit Hyperactivity Disorder (ADHD). However, treatment for children with
behavior problems involving ADHD should also be evaluated for specific
concurrent ADHD interventions, such as stimulant medication.
As a treatment for physically abusive parents, PCIT has also been found to be
efficacious for parents with children ages 4 - 12 where physical abuse occurred
within the context of child discipline, which is the most common context for
physical abuse. Efficacy as a parent treatment has been found among multiproblem
parents with significant past child welfare report histories, and PCIT
appears to be fairly sufficient as a parent treatment, in that efficacy does
not appear to be enhanced by the addition of supplemental services such as
individual or family counseling. Benefits have been found to be stable across
parent gender and ethnic groups.
Contraindications
WHILE PCIT IS VERY EFFECTIVE IN ADDRESSING CERTAIN TYPES OF PROBLEMS,
THERE ARE CLEAR LIMITATIONS IN ITS USE. THESE INCLUDE:
• Parents and children need to have consistent ongoing contact in order to be
able to effectively change parent-child patterns of interaction. PCIT is not
appropriate for families in which the parent and child have very limited
(i.e., one hour weekly visitation) or no ongoing contact.
• There is no research to support the use of PCIT with very young children
(less than two and a half years of age) and only limited research with older
age children (older than eight years of age). There is no research to support
the use of PCIT with adolescents.
• PCIT is not appropriate for parents with mental health problems that may
include auditory/visual hallucinations and/or delusions.
• Due to the process of ‘coaching’ parents, it is difficult to conduct PCIT
with parent/child who are hearing impaired and/or who have significant
expressive or receptive language skills.
PCIT has also not been evaluated with sexually abusive parents, parents
engaging in sadistic physical child abuse, or seriously mentally ill parents. At
this point, it is contraindicated with these groups. In fact, given the underlying
dynamic of parental control and misuse of power over the child, teaching the
abusive parent better means of control over the child may be harmful.
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