Chaffin, M., Silovsky, J., Funderburk, B., Valle, L. A., Brestan, E. V., Balachova, T., Bonner, B. L. (2004). Parent-Child Interaction Therapy with physically abusive parents: Efficacy for reducing further abuse reports. Journal of Consulting and Clinical Psychology, 72(3), 500-510.

Type of Study: Randomized controlled trial
Number of Participants: 112 Parent Child dyads

Population:

• Age range — 4 and 12 years
• Race/Ethnicity — Not Specified
• Gender — Not Specified
• Status — Abusive parents and abused children referred from the Child Welfare System.

Location / Institution: Oklahoma

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: The effects of motivational enhancement were not tested separately from PCIT in this study. Parent-Child dyads were randomly assigned to receive one of three interventions: PCIT with a motivational enhancement module (SM/PCIT), PCIT with motivational enhancement plus individualized enhancement services (SM/PCIT + Indiv.), or a standard community-based parenting group. Measurements included the Child Abuse Potential Inventory, the Child Neglect Index, and the Abuse Dimensions Inventory. Interactions were coded with the Dyadic Parent-Child Interaction Coding System (DPICS-II). Children were also assessed with the Behavior Assessment System for Children. Measures of depression and substance abuse were also included for parents. The SM/PCIT group had better overall retention, including early retention, as well as lower child welfare report recidivism [relapse] rates than did standard services. Additional individualized enhancements did not show an effect.

Length of post-intervention follow-up: Median 850 days.

Chaffin, M., Valle, L. A., Funderburk, B., Gurwitch, R., Silovsky, J., Bard, D., Kees, M. (2009). A motivational intervention can improve retention in PCIT for low-motivation child welfare clients. Child Maltreatment, 14(4), 356-368.

Type of Study: Randomized controlled trial
Number of Participants: 192 parents

Population:

• Age range — Average parent age 29 years with a child between ages 2.5 to 12 years
• Race/Ethnicity — 60% non-Hispanic Caucasian, 19% African American, 9% Native American, 7% ethnically Hispanic, and 6% Asian or other
• Gender — 75% female
• Status — Parents were referred for parenting services and had on average a mean of 6 and a median of 4 referrals to the state child welfare system.

Location / Institution: Not Specified

Summary: (To include comparison groups, outcomes, measures, notable limitations)
(Note: Same sample as Chaffin, Funderburk, et al., in press) A motivational orientation intervention (SM Group) designed to improve parenting program retention was field tested versus standard orientation across two parenting programs, Parent–Child Interaction Therapy (PCIT) and a standard didactic parent training group. Both interventions were implemented by center staff within a frontline child welfare parenting center. Participants had an average of six prior child welfare referrals, primarily for neglect. A double-randomized design was used to test main and interaction effects. The motivational intervention improved retention when combined with PCIT (cumulative survival = 85% vs. around 61% for the three other design cells). Benefits were robust across demographic characteristics and participation barriers, but were concentrated among participants whose initial level of motivation was low to moderate. There were negative effects for participants with relatively high initial motivation. The findings suggest that using a motivational intervention combined with PCIT can improve retention when used selectively with relatively low to moderately motivated child welfare clients.

Length of post-intervention follow-up: None.

Chaffin, M., Funderburk, B., Bard, D., Valle, L.A., & Gurwitch, R. (in press). A motivation-PCIT package reduces child welfare recidivism in a randomized dismantling field trial. Journal of Consulting and Clinical Psychology.

Type of Study: Randomized controlled trial
Number of Participants: 192 parents

Population:

• Age range — 20-57 years
• Race/Ethnicity — 60% Caucasian, 19% African American, 9% Native American, 7% Hispanic, and 6% Other
• Gender — 75% female, 25% male
• Status — Maltreating biological parents, step-parents or primary caregivers referred for parenting services at a small, inner city, non-profit, community-based agency operating a parenting program under contract with the single state child welfare system. 66% had all children removed to foster care at baseline.

Location / Institution: Oklahoma

Summary: (To include comparison groups, outcomes, measures, notable limitations)
(Note: Same sample as Chaffin, M. et al. (2009).) Objectives were to test effectiveness in a field agency rather than in a laboratory setting, and to dismantle the SM Group vs. services as usual (SAU) orientation and Parent-Child Interaction Therapy (PCIT) vs. SAU parenting component effects. Assessment information was drawn from three sources—self-report questionnaires administered via audio-assisted computerized self-interview (ACASI) using touch-screen computers, observational coding of parent-child interactions, and administrative data from the state child welfare database. Measures used included Readiness for Parenting Change Scale (REDI), Child Abuse Potential Inventory (CAP), Dyadic Parent–Child Interaction Coding System (DPICS-II), Child and Parent-Directed Interaction (CDI and PDI), and P.R.I.D.E. skills. Following a 2 X 2 sequentially randomized experimental design, parents were randomized first to orientation condition (SM Group vs. SAU) and then to a parenting condition (PCIT vs. SAU). Cases were followed for child welfare recidivism for a median of 904 days. An imputation-based approach was used to estimate recidivism survival complicated by significant treatment related differences in timing and frequency of children returned home. Findings demonstrated that previous laboratory results can be replicated in a field implementation setting, and among parents with chronic and severe child welfare histories, supporting a synergistic SM+PCIT benefit. Methodological considerations for analyzing child welfare event history data complicated by differential risk deprivation are also emphasized. Limitations included lack of a no-treatment control group, results were obtained at a single agency with a small number of part-time clinicians that may affect generalization to other settings, and a lower level of fidelity control than in a laboratory trial may reduce internal validity.

Length of post-intervention follow-up: Median unadjusted follow-up time: 904 days. Median risk deprivation-adjusted follow-up time: 730 days.