Elsevier

Behavior Therapy

Volume 41, Issue 3, September 2010, Pages 375-387
Behavior Therapy

Early Identification and Intervention for Behavior Problems in Primary Care: A Comparison of Two Abbreviated Versions of Parent-Child Interaction Therapy

https://doi.org/10.1016/j.beth.2009.11.002Get rights and content

Abstract

Behavioral screening and preventive intervention were implemented for 3- to 6-year-olds in pediatric primary care with subclinical behavior problems. One hundred eleven children were screened with the Eyberg Child Behavior Inventory. Thirty children who scored within one standard deviation of the normative mean whose mothers indicated wanting help for their child's behavior were randomized to one of two abbreviated versions of Parent-Child Interaction Therapy (PCIT) for use in pediatric primary care: (a) a 4-session group preventive intervention called Primary Care PCIT (PC-PCIT); or (b) written materials describing basic steps of PCIT and guidelines for practice, called PCIT Anticipatory Guidance (PCIT-AG). Decreases in child problem behaviors and ineffective parenting strategies, and increases in parental feelings of control were not significantly different between versions at post-intervention or 6-month follow-up. Changes during intervention were significantly larger for both groups than changes during pretreatment baseline, with moderate to large effect sizes. These brief versions of PCIT are both promising primary care preventive interventions that deserve further study.

Section snippets

Participants

This study was approved by the Institutional Review Board at the university health sciences center. Maternal caregivers of 3- to 6-year-olds were recruited from three pediatric primary care clinics. Clinic 1 was a private pediatrician's office. Clinic 2 was a university-hospital-affiliated clinic serving primarily low-income families. Clinic 3 was a university-hospital-affiliated clinic serving families from a range of socioeconomic backgrounds. Screening packets with the ECBI and a survey of

Results

The mean ECBI Intensity score during the initial screening with 111 children was 115.06 (SD = 42.68), which is approximately ½ standard deviation above the normative mean (Eyberg & Pincus, 1999). For the three sites, mean ECBI Intensity scores were 103.27 (SD = 34.07; n = 44) at Clinic 1; 127.66 (SD = 49.00; n = 41) at Clinic 2; and 115.15 (SD = 40.89; n = 26) at Clinic 3. Differences between clinics were significant, F(2, 108) = 3.63, p = .030, with higher scores at Clinic 2 than Clinic 1, t(83) = 2.68, p = .009,

Discussion

Elevated levels of child behavior problems reported during pediatric primary care screening, and improvements in child behavior, parenting strategies, and parental sense of control reported following two brief preventive interventions for young children, highlight the need for and utility of psychological services within pediatric primary care. Our hypothesis that brief parenting groups would be more effective than self-directed anticipatory guidance was not supported. Substantial improvements

Acknowledgement

This research was supported by grants from the Florida Psychological Association and The Melissa Institute. We thank Nancy Worthington, M.D., and Kathleen Ryan, M.D. for their contributions to this research. This article is based on a dissertation by Michelle D. Berkovits (under her maiden name of Harwood), supervised by Sheila M. Eyberg. Some of the data were previously presented at the National Conference on Child Health Psychology in Miami, Florida, April 2008.

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