Parent-child interaction therapy: A meta-analysis

Rae Thomas, Bridget Abell, Haley J Webb, Elbina Avdagic, Melanie J Zimmer-Gembeck

Research output: Contribution to journalArticleResearchpeer-review

25 Citations (Scopus)

Abstract

CONTEXT: Parent-child interaction therapy (PCIT) is effective at reducing children's externalizing behavior. However, modifications are often made to PCIT, and it is not known whether these impact effectiveness.

OBJECTIVE: To systematically review and meta-analyze the effects of PCIT on child externalizing behaviors, considering modifications, study design, and bias.

DATA SOURCES: We searched PubMed, PsycINFO, Education Resources Information Center, Sociological Abstracts, and A+ Education.

STUDY SELECTION: We selected randomized controlled or quasi-experimental trials.

DATA EXTRACTION: We analyzed child externalizing and internalizing behaviors, parent stress, parent-child interactions, PCIT format, and study design and/or characteristics.

RESULTS: We included 23 studies (1144 participants). PCIT was superior to control for reducing child externalizing (standardized mean difference [SMD]: -0.87, 95% confidence interval [CI]:-1.17 to -0.58). PCIT studies that required skill mastery had significantly greater reductions in externalizing behavior than those that did not (Mastery: SMD: -1.09, 95% CI: -1.44 to -0.73; Nonmastery: SMD: -0.51,95% CI: -0.85 to -0.17, P = .02). Compared with controls, PCIT significantly reduced parent-related stress (mean difference [MD]: -6.98, 95% CI: -11.69 to -2.27) and child-related stress (MD: -9.87, 95% CI: -13.64 to -6.09). Children in PCIT were observed to be more compliant to parent requests (SMD: 0.89, 95% CI: 0.50 to 1.28) compared with controls. PCIT effectiveness did not differ depending on session length, location (academic versus community settings), or child problems (disruptive behaviors only compared with disruptive behavior and other problems).

LIMITATIONS: Results for parent-child observations were inconsistently reported, reducing the ability to pool important data.

CONCLUSIONS: PCIT has robust positive outcomes across multiple parent-reported and observed parent-child interaction measures, and modifications may not be required even when implemented in diverse populations.

Original languageEnglish
Article numbere20170352
JournalPediatrics
Volume140
Issue number3
DOIs
Publication statusPublished - 1 Sep 2017

Fingerprint

Meta-Analysis
Therapeutics
Confidence Intervals
Child Behavior
Education
Information Centers
Aptitude
Behavior Therapy
PubMed

Cite this

Thomas, R., Abell, B., Webb, H. J., Avdagic, E., & Zimmer-Gembeck, M. J. (2017). Parent-child interaction therapy: A meta-analysis. Pediatrics, 140(3), [e20170352]. https://doi.org/10.1542/peds.2017-0352
Thomas, Rae ; Abell, Bridget ; Webb, Haley J ; Avdagic, Elbina ; Zimmer-Gembeck, Melanie J. / Parent-child interaction therapy : A meta-analysis. In: Pediatrics. 2017 ; Vol. 140, No. 3.
@article{843c23237e484a47a50bffc14a37e4f6,
title = "Parent-child interaction therapy: A meta-analysis",
abstract = "CONTEXT: Parent-child interaction therapy (PCIT) is effective at reducing children's externalizing behavior. However, modifications are often made to PCIT, and it is not known whether these impact effectiveness.OBJECTIVE: To systematically review and meta-analyze the effects of PCIT on child externalizing behaviors, considering modifications, study design, and bias.DATA SOURCES: We searched PubMed, PsycINFO, Education Resources Information Center, Sociological Abstracts, and A+ Education.STUDY SELECTION: We selected randomized controlled or quasi-experimental trials.DATA EXTRACTION: We analyzed child externalizing and internalizing behaviors, parent stress, parent-child interactions, PCIT format, and study design and/or characteristics.RESULTS: We included 23 studies (1144 participants). PCIT was superior to control for reducing child externalizing (standardized mean difference [SMD]: -0.87, 95{\%} confidence interval [CI]:-1.17 to -0.58). PCIT studies that required skill mastery had significantly greater reductions in externalizing behavior than those that did not (Mastery: SMD: -1.09, 95{\%} CI: -1.44 to -0.73; Nonmastery: SMD: -0.51,95{\%} CI: -0.85 to -0.17, P = .02). Compared with controls, PCIT significantly reduced parent-related stress (mean difference [MD]: -6.98, 95{\%} CI: -11.69 to -2.27) and child-related stress (MD: -9.87, 95{\%} CI: -13.64 to -6.09). Children in PCIT were observed to be more compliant to parent requests (SMD: 0.89, 95{\%} CI: 0.50 to 1.28) compared with controls. PCIT effectiveness did not differ depending on session length, location (academic versus community settings), or child problems (disruptive behaviors only compared with disruptive behavior and other problems).LIMITATIONS: Results for parent-child observations were inconsistently reported, reducing the ability to pool important data.CONCLUSIONS: PCIT has robust positive outcomes across multiple parent-reported and observed parent-child interaction measures, and modifications may not be required even when implemented in diverse populations.",
author = "Rae Thomas and Bridget Abell and Webb, {Haley J} and Elbina Avdagic and Zimmer-Gembeck, {Melanie J}",
note = "Copyright {\circledC} 2017 by the American Academy of Pediatrics.",
year = "2017",
month = "9",
day = "1",
doi = "10.1542/peds.2017-0352",
language = "English",
volume = "140",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "AMER ACAD PEDIATRICS",
number = "3",

}

Thomas, R, Abell, B, Webb, HJ, Avdagic, E & Zimmer-Gembeck, MJ 2017, 'Parent-child interaction therapy: A meta-analysis' Pediatrics, vol. 140, no. 3, e20170352. https://doi.org/10.1542/peds.2017-0352

Parent-child interaction therapy : A meta-analysis. / Thomas, Rae; Abell, Bridget; Webb, Haley J; Avdagic, Elbina; Zimmer-Gembeck, Melanie J.

In: Pediatrics, Vol. 140, No. 3, e20170352, 01.09.2017.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Parent-child interaction therapy

T2 - A meta-analysis

AU - Thomas, Rae

AU - Abell, Bridget

AU - Webb, Haley J

AU - Avdagic, Elbina

AU - Zimmer-Gembeck, Melanie J

N1 - Copyright © 2017 by the American Academy of Pediatrics.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - CONTEXT: Parent-child interaction therapy (PCIT) is effective at reducing children's externalizing behavior. However, modifications are often made to PCIT, and it is not known whether these impact effectiveness.OBJECTIVE: To systematically review and meta-analyze the effects of PCIT on child externalizing behaviors, considering modifications, study design, and bias.DATA SOURCES: We searched PubMed, PsycINFO, Education Resources Information Center, Sociological Abstracts, and A+ Education.STUDY SELECTION: We selected randomized controlled or quasi-experimental trials.DATA EXTRACTION: We analyzed child externalizing and internalizing behaviors, parent stress, parent-child interactions, PCIT format, and study design and/or characteristics.RESULTS: We included 23 studies (1144 participants). PCIT was superior to control for reducing child externalizing (standardized mean difference [SMD]: -0.87, 95% confidence interval [CI]:-1.17 to -0.58). PCIT studies that required skill mastery had significantly greater reductions in externalizing behavior than those that did not (Mastery: SMD: -1.09, 95% CI: -1.44 to -0.73; Nonmastery: SMD: -0.51,95% CI: -0.85 to -0.17, P = .02). Compared with controls, PCIT significantly reduced parent-related stress (mean difference [MD]: -6.98, 95% CI: -11.69 to -2.27) and child-related stress (MD: -9.87, 95% CI: -13.64 to -6.09). Children in PCIT were observed to be more compliant to parent requests (SMD: 0.89, 95% CI: 0.50 to 1.28) compared with controls. PCIT effectiveness did not differ depending on session length, location (academic versus community settings), or child problems (disruptive behaviors only compared with disruptive behavior and other problems).LIMITATIONS: Results for parent-child observations were inconsistently reported, reducing the ability to pool important data.CONCLUSIONS: PCIT has robust positive outcomes across multiple parent-reported and observed parent-child interaction measures, and modifications may not be required even when implemented in diverse populations.

AB - CONTEXT: Parent-child interaction therapy (PCIT) is effective at reducing children's externalizing behavior. However, modifications are often made to PCIT, and it is not known whether these impact effectiveness.OBJECTIVE: To systematically review and meta-analyze the effects of PCIT on child externalizing behaviors, considering modifications, study design, and bias.DATA SOURCES: We searched PubMed, PsycINFO, Education Resources Information Center, Sociological Abstracts, and A+ Education.STUDY SELECTION: We selected randomized controlled or quasi-experimental trials.DATA EXTRACTION: We analyzed child externalizing and internalizing behaviors, parent stress, parent-child interactions, PCIT format, and study design and/or characteristics.RESULTS: We included 23 studies (1144 participants). PCIT was superior to control for reducing child externalizing (standardized mean difference [SMD]: -0.87, 95% confidence interval [CI]:-1.17 to -0.58). PCIT studies that required skill mastery had significantly greater reductions in externalizing behavior than those that did not (Mastery: SMD: -1.09, 95% CI: -1.44 to -0.73; Nonmastery: SMD: -0.51,95% CI: -0.85 to -0.17, P = .02). Compared with controls, PCIT significantly reduced parent-related stress (mean difference [MD]: -6.98, 95% CI: -11.69 to -2.27) and child-related stress (MD: -9.87, 95% CI: -13.64 to -6.09). Children in PCIT were observed to be more compliant to parent requests (SMD: 0.89, 95% CI: 0.50 to 1.28) compared with controls. PCIT effectiveness did not differ depending on session length, location (academic versus community settings), or child problems (disruptive behaviors only compared with disruptive behavior and other problems).LIMITATIONS: Results for parent-child observations were inconsistently reported, reducing the ability to pool important data.CONCLUSIONS: PCIT has robust positive outcomes across multiple parent-reported and observed parent-child interaction measures, and modifications may not be required even when implemented in diverse populations.

UR - http://www.scopus.com/inward/record.url?scp=85028717798&partnerID=8YFLogxK

U2 - 10.1542/peds.2017-0352

DO - 10.1542/peds.2017-0352

M3 - Article

VL - 140

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 3

M1 - e20170352

ER -

Thomas R, Abell B, Webb HJ, Avdagic E, Zimmer-Gembeck MJ. Parent-child interaction therapy: A meta-analysis. Pediatrics. 2017 Sep 1;140(3). e20170352. https://doi.org/10.1542/peds.2017-0352