Skip to main content
Log in

Behavioral Outcomes of Parent-Child Interaction Therapy and Triple P—Positive Parenting Program: A Review and Meta-Analysis

  • Original Paper
  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

Abstract

We conducted a review and meta-analyses of 24 studies to evaluate and compare the outcomes of two widely disseminated parenting interventions—Parent-Child Interaction Therapy and Triple P-Positive Parenting Program. Participants in all studies were caregivers and 3- to 12-year-old children. In general, our analyses revealed positive effects of both interventions, but effects varied depending on intervention length, components, and source of outcome data. Both interventions reduced parent-reported child behavior and parenting problems. The effect sizes for PCIT were large when outcomes of child and parent behaviors were assessed with parent-report, with the exclusion of Abbreviated PCIT, which had moderate effect sizes. All forms of Triple P had moderate to large effects when outcomes were parent-reported child behaviors and parenting, with the exception of Media Triple P, which had small effects. PCIT and an enhanced version of Triple P were associated with improvements in observed child behaviors. These findings provide information about the relative efficacy of two programs that have received substantial funding in the USA and Australia, and findings should assist in making decisions about allocations of funding and dissemination of these parenting interventions in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. A list of references to papers excluded from this review is available from the authors.

References

  • Abidin, R. R. (1990). Parenting stress index (3rd Ed.). Virginia: Paediatric Psychology Press.

    Google Scholar 

  • Achenbach, T. M. (1991). Manual for the child behavior checklist/4–18 and 1991 profile. Burlington, VT: University of Vermont Department of Psychiatry.

    Google Scholar 

  • American Psychological Association. (1995). Task Force on Promotion and Dissemination of Psychological Procedures, Division of Clinical Psychology, Training in and dissemination of empirically-validated psychological treatments: Report and recommendations. The Clinical Psychologist, 48, 3–23.

    Google Scholar 

  • Bagner, D. M., & Eyberg, S. M. (2003). Father involvement in parent training: When does it matter? Journal of Clinical Child and Adolescent Psychology, 32, 599–605.

    Article  PubMed  Google Scholar 

  • Becker, B. J. (1988). Synthesizing standardized mean-change measures. British Journal of Mathematical and Statistical Psychology, 41, 257–278.

    Google Scholar 

  • Barlow, J., & Stewart-Brown, S. (2000). Behavior problem and group-based parent education programs. Journal of Developmental and Behavioral Pediatrics, 21, 356–370.

    Article  PubMed  Google Scholar 

  • Berlin, L. J., O’Neal, C. R., & Brooks-Gunn, J. U. (1998). What makes early intervention programs work? The program, its participants, and their interaction. Zero To Three, February-March, 4–15.

  • *Bor, W., Sanders, M. R., & Markie-Dadds, C. (2002). The effects of the Triple P- Positive Parenting Program on preschool children with co-occurring disruptive behavior and attentional/hyperactive difficulties. Journal of Abnormal Child Psychology, 30, 571–587.

    Article  PubMed  Google Scholar 

  • Brestan, E. V., & Eyberg, S. M. (1998). Effective psychosocial treatments of conduct disordered children and adolescents: 29 years, 82 studies, and 5,272 kids. Journal of Clinical Child Psychology, 27, 180–189.

    Article  PubMed  Google Scholar 

  • *Brestan, E. V., Eyberg, S. M., Boggs, S. R., & Algina, J. (1997). Parent-Child Interaction Therapy: Parents’ perceptions of untreated siblings. Child & Family Behavior Therapy, 19, 13–28.

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Chamberlain, P., & Reid, J. (1987). Parent observation and report of child symptoms. Behavioral Assessment, 9, 97–109.

    Google Scholar 

  • Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7–18.

    Article  PubMed  Google Scholar 

  • *Connell, S., Sanders, M. R., & Markie-Dadds, C. (1997). Self-directed behavioral family intervention for parents of oppositional children in rural and remote areas. Behavior Modification, 21, 379–408.

    Article  PubMed  Google Scholar 

  • Dadds, M. R., Schwartz, S., & Sanders, M. R. (1987). Marital discord and treatment outcome in behavioral treatment of child conduct disorders. Journal of Consulting and Clinical Psychology, 55, 396–403.

    Article  PubMed  Google Scholar 

  • Driskell, J. E., Willis, R. P., & Copper, C. (1992). Effects of overlearning on retention. Journal of Applied Psychology, 77, 615–622.

    Article  Google Scholar 

  • *Eyberg, S. M., Boggs, S. R., & Algina, J. (1995). Parent-Child Interaction Therapy: A psychosocial model for the treatment of young children with conduct problem behavior and their families. Psychopharmacology Bulletin, 31, 83–91.

    PubMed  Google Scholar 

  • *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 and Family Behavior Therapy, 23, 1–19.

    Article  Google Scholar 

  • Eyberg, S., & Pincus, D. (1999). Eyberg child behavior inventory and sutter-eyberg student behavior inventory-revised: Professional manual. Florida: Psychological Assessment Resources Inc.

    Google Scholar 

  • *Eyberg, S. M., & Robinson, E. A. (1982). Parent-Child interaction training: Effects on family functioning. Journal of Clinical Child Psychology, 11, 130–137.

    Article  Google Scholar 

  • Foote, R. C., Eyberg, S. M., & Schuhmann, E. M. (1998). Parent-Child Interaction Approaches to the treatment of child behavior problems. In T. H. Ollendick, & Prinz, R. J. (Eds.), Advances in Clinical Child Psychology (pp. 125–151). New York and London: Plenum Press.

    Google Scholar 

  • Foote, R. C., Schuhmann, E. M., Jones, M. L., & Eyberg, S. M. (1998). Parent-child interaction therapy: A guide for clinicians. Clinical Child Psychology and Psychiatry, 3, 361–373.

    Article  Google Scholar 

  • *Funderburk, B. W., Eyberg, S. M., Newcomb, K., McNeil, C. B., Hembree-Kigin, T., & Capage, L. (1993). Parent-Child Interaction Therapy with behavior problem children: Maintenance of treatment effects in the school setting. Child and Family Behavior Therapy, 20, 17–38.

    Article  Google Scholar 

  • Geeraert, L., Van Den Noortgate, W., Grietens, H., & Onghena, P. (2004). The effects of early prevention programs for families with young children at risk for physical child abuse and neglect: A meta-analysis. Child Maltreatment, 9, 277–291.

    Article  PubMed  Google Scholar 

  • Hembree-Kigin, T. L., & McNeil, C. B. (1995). Parent-child interaction therapy. New York: Plenum Press.

    Google Scholar 

  • Herschell, A. D., Calzada, E. J. Eyberg, S. M., & McNeil, C. B. (2002). Parent-child interaction therapy: New directions in research. Cognitive and Behavioral Practice, 9, 9–16.

    Google Scholar 

  • *Hoath, F. E., & Sanders, M. R. (2002). A feasibility study of enhanced group Triple P- Positive Parenting Program for parents of children with attention-deficit/hyperactivity disorder. Behavior Change, 19, 191–206.

    Google Scholar 

  • Hollenstein, T., Granic, I., Stoolmiller, M., & Snyder, J. (2004). Rigidity in parent-child interactions and the development of externalizing and internalizing behavior in early childhood. Journal of Abnormal Child Psychology, 32, 595–607.

    Article  PubMed  Google Scholar 

  • *Hood, K. K., & Eyberg, S. M. (2003). Outcomes of Parent-Child interaction therapy: Mother’s reports on maintenance three to six years after treatment. Journal of Clinical Child and Adolescent Psychology, 32, 419–429.

    Article  PubMed  Google Scholar 

  • *Ireland, J. L., Sanders, M. R., & Markie-Dadds, C. (2003). The impact of parent training on marital functioning: A comparison of two group versions of the Triple P-Positive Parenting Program for parents of children with early-onset conduct problems. Behavioral and Cognitive Psychotherapy, 31, 127–142.

    Article  Google Scholar 

  • Johnson, B. T. (1989). Software for the meta-analytic review of research literatures. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Kumpfer, K. L., & Alvarado, R. (2003). Family strengthening approaches for the prevention of youth problem behaviors. American Psychologist, 58, 457–465.

    Article  PubMed  Google Scholar 

  • *Leung, C., Sanders, M. R., Leung, S., & Lau, J. (2003). An outcome evaluation of the implementation of the Triple P-Positive Parenting Program in Hong Kong. Family Process, 42, 531–544.

    Article  PubMed  Google Scholar 

  • *Martin, A. J., & Sanders, M. R. (2003). Balancing work and family: A controlled evaluation of the Triple P-Positive Parenting Program as a work-site intervention. Child and Adolescent Mental Health, 8, 161–169.

    Article  Google Scholar 

  • McMahon, R. J., & Forehand, R. L. (2003). Helping the noncompliant child: Family-based treatment for oppositional behavior. New York: Guilford Press.

    Google Scholar 

  • *McNeil, C. B., Capage, L. C., Bahl, A., & Blanc, H. (1999). Importance of early intervention for disruptive behavior problems: Comparison of treatment and waitlist-control groups. Early Education and Development, 10, 445–454.

    Article  Google Scholar 

  • *McNeil, C. B., Eyberg, S., Eisenstadt, T. H., Newcomb, K., & Funderburk, B. (1991). Parent-Child Interaction Therapy with behavior problem children: Generalization of treatment effects to the school setting. Journal of Clinical Child Psychology, 20, 140–151.

    Article  Google Scholar 

  • Morris, S. B., & DeShon, R. P. (2002). Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychological Methods, 7, 105–125.

    Article  PubMed  Google Scholar 

  • Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., Morrissey-Kane, E., & Davino, K. (2003). What works in prevention. American Psychologist, 58, 449–456.

    Article  PubMed  Google Scholar 

  • *Nicholson, J. M., & Sanders, M. R. (1999). Randomized controlled trial of behavioral family intervention for the treatment of child behavior problems in stepfamilies. Journal of Divorce and Remarriage, 30, 1–23.

    Article  Google Scholar 

  • *Nixon, R. D. V. (2001). Changes in hyperactivity and temperament in behaviorally disturbed pre-schoolers after Parent-Child Interaction Therapy (PCIT). Behavior Change, 18, 168–176.

    Article  Google Scholar 

  • Nixon, R. D. V. (2002). Treatment of behavior problems in preschoolers: A review of parent training programs. Clinical Psychology Review, 22, 525–546.

    Article  PubMed  Google Scholar 

  • *Nixon, R. D. V., Sweeney, L., Erickson, D. B., & Touyz, S. W. (2003). Parent-Child Interaction Therapy: A comparison of standard and abbreviated treatments for oppositional defiant preschoolers. Journal of Consulting and Clinical Psychology, 71, 251–260.

    Article  PubMed  Google Scholar 

  • *Nixon, R. D. V., Sweeney, L., Erickson, D. B., & Touyz, S. W. (2004). Parent-Child Interaction Therapy: One and two year follow-up of standard and abbreviated treatments for oppositional preschoolers. Journal of Abnormal Child Psychology, 32, 263–271.

    Article  PubMed  Google Scholar 

  • Prinz, R., & Sanders, M. R. (2004, September). Preventing child abuse at a broad level: The U.S. Triple P system population-based trial. Paper presented at ISPCAN 15th International Congress on Child Abuse and Neglect, Brisbane Australia.

  • Reyno, S. M., & McGrath, P. J. (2006). Predictors of parent training efficacy for child externalizing behavior problems—a meta-analytic review. Journal of Child Psychology and Psychiatry, 47, 99–111.

    Article  PubMed  Google Scholar 

  • Robinson, E. A., & Eyberg, S. M. (1981). The dyadic parent-child interaction coding system: Standardisation and validation. Journal of Consulting and Clinical Psychology, 49, 245–250.

    Article  PubMed  Google Scholar 

  • Salas, E., & Cannon-Bowers, J. A. (2001). The science of training: A decade of progress. Annual Review of Psychology, 52, 471–499.

    Article  PubMed  Google Scholar 

  • Sanders, M. R., Cann, W., & Markie-Dadds, C. (2003). The Triple P-Positive Parenting Programme: A universal population-level approach to the prevention of child abuse. Child Abuse Review, 12, 155–171.

    Article  Google Scholar 

  • *Sanders, M. R., Markie-Dadds, C., Tully, L. A., & Bor, W. (2000). The Triple P-Positive Parenting Program: A comparison of enhanced, standard and self-directed behavioral family intervention for parents of children with early onset conduct problems. Journal of Consulting and Clinical Psychology, 68, 624–640.

    Article  PubMed  Google Scholar 

  • Sanders, M. R., Markie-Dadds, C., & Turner, K. M. T. (1998). Practitioner’s Manual for Enhanced Triple P. Milton, QLD: Families International Publishing Pty. Ltd.

  • *Sanders, M. R., & McFarland, M. (2000). Treatment of depressed mothers with disruptive children: A controlled evaluation of cognitive behavioral family intervention. Behavior Therapy, 31, 89–112.

    Article  Google Scholar 

  • *Sanders, M. R., Montgomery, D. T., & Brechman-Toussaint, M. L. (2000). The mass media and the prevention of child behavior problems: The evaluation of a television series to promote positive outcomes for parents and their children. Journal of Child Psychology and Psychiatry, 41, 939–948.

    Article  PubMed  Google Scholar 

  • *Sanders, M. R., Pidgeon, A. M., Gravestock, F., Connors, M. D., Brown, S., & Young, R. W. (2004). Does parental attributional retraining and anger management enhance the effects of the Triple P—Positive Parenting Program with parents at risk of child maltreatment? Behavior Therapy, 35, 513–535.

    Article  Google Scholar 

  • *Schuhmann, E. M., Foote, R. C., Eyberg, S. M., Boggs, S. R., & Algina, J. (1998). Efficacy of Parent-Child Interaction Therapy: Interim report of a randomized trial with short-term maintenance. Journal of Clinical Child Psychology, 27, 34–45.

    Article  PubMed  Google Scholar 

  • Serketich, W. J., & Dumas, J. E. (1996). The effectiveness of behavioral parent training to modify antisocial behavior in children: A metaanalysis. Behavior Therapy, 27, 171–186.

    Article  Google Scholar 

  • Shebilske, W. L., Jordan, J. A., Goettl, B. P., & Paulus, L. E. (1998). Observation versus hands-on practice of complex skills in dyadic, triadic, and tetradic training-teams. Human Factors, 40, 525–540.

    Article  Google Scholar 

  • Turner, K. M. T., Markie-Dadds, C., & Sanders, M. R. (1998). Facilitator’s manual for group triple P. Milton QLD: Families International Publishing Pty. Ltd.

  • Webster-Stratton, C., & Taylor, T. (2001). Nipping early risk factors in the bud: Preventing substance abuse, delinquency, and violence in adolescence through interventions targeted at young children (0–8 years). Prevention Science, 2, 165–192.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Hawley, K. M., & Jensen Doss, A. (2004). Empirically tested psychotherapies for youth internalizing and externalizing problems and disorders. Child and Adolescent Psychiatric Clinics of North America, 13, 729–815.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Weiss, B., Han, S. S., Granger, D. A., & Morton, T. (1995). Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychological Bulletin, 117, 450–468.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This project was greatly improved through our conversations with honours and postgraduate students working in the Family Interaction Research Program at Griffith University, including Elbina Avdagic, Angela Anthonysamy, Michelle Hanisch, Kate McCarthy, Leanne McGregor, Rhiarne Pronk, Mark Scholes, Anne Stuksrud, and Judith Warner. We also thank members of the Griffith Psychological Health Research Centre at Griffith University for their willingness to discuss some of the ideas presented in this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rae Thomas.

Additional information

*References marked with an* were included in the review and meta-analyses.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Thomas, R., Zimmer-Gembeck, M.J. Behavioral Outcomes of Parent-Child Interaction Therapy and Triple P—Positive Parenting Program: A Review and Meta-Analysis. J Abnorm Child Psychol 35, 475–495 (2007). https://doi.org/10.1007/s10802-007-9104-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-007-9104-9

Keywords

Navigation