Parent-Child Interaction Therapy for Mexican Americans: Results of a Pilot Randomized Clinical Trial at Follow-up☆
Highlights
► A pilot randomized clinical trial compared culturally modified PCIT to standard PCIT and treatment as usual (TAU). ► The treatments were compared on parent-reported symptoms 6 to 24 months posttreatment. ► All three treatments produced improvement at long-term follow-up. ► The culturally modified intervention significantly outperformed TAU over the long-term, but the standard version did not. ► The culturally modified version differed from the standard version ON only one measure.
Section snippets
Hypotheses
Consistent with the findings at post-treatment, we hypothesized that families in the GANA program would continue to have lower rates of parent reported child internalizing and externalizing symptoms, parenting stress, and parental depression than those receiving TAU. We predicted that PCIT would demonstrate intermediate outcomes between GANA and TAU.
Participants
Participants were 58 MA families of children with clinically significant behavior problems seen for treatment at a community mental health clinic between September 2003 and February 2006. Families were eligible if: (a) the parent identified the child as MA and between the ages of 3 and 7; (b) the child received a score above the clinical cut point on the Intensity Scale of the Eyberg Child Behavior Inventory (Eyberg & Pincus, 1999); (c) neither parent nor child was participating in any other
Results
All results reflect intent-to-treat analyses. Long-term follow-up rates did not differ across conditions χ2(2, N = 58) = 3.89, p = .14. First, we calculated effect sizes to determine the size of the treatment gains between pretreatment and long-term follow-up for each of the three conditions. Means and standard deviations of outcome measures at baseline and follow-up are summarized in Table 2, as well Cohen's d for each treatment condition. Long-term effect sizes for GANA were consistently “large,”
Discussion
This study found that all three treatment approaches (GANA, PCIT, and TAU) produced significant parent-reported improvements among young MA children with behavior problems that were still significant at follow-up. For all three conditions, families began treatment at approximately 2.5 standard deviations above the mean on the ECBI, and 1.5 standard deviations above the mean on CBCL Externalizing Problems. By long-term follow-up, all three groups fell, on average, below the clinical cut point of
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2022, Children and Youth Services ReviewCitation Excerpt :Efforts have focused on making evidence-based interventions more culturally responsive and developing novel engagement strategies in order to reach communities where utilization of services remains low. One example of cultural adaptation to evidence-based parenting interventions comes from McCabe and colleagues who developed a culturally adapted version of Parent-Child Interaction Therapy (PCIT) entitled Guiando a Niños Activos (McCabe & Yeh, 2009; McCabe, Yeh, Lau, & Argote, 2012; McCabe, Yeh, & Zerr, 2020) which takes into consideration the cultural values of Mexican-American families (e.g., familismo) and focuses on overcoming family barriers to engagement. This research highlights the importance of engaging extended family members and addresses inappropriate treatment expectations at the onset of treatment in order to combat premature dropout.
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This research was supported by National Institute of Mental Health grant K01MH1924 and a Faculty Research Grant from the University of San Diego.