Elsevier

Behavior Therapy

Volume 43, Issue 3, September 2012, Pages 606-618
Behavior Therapy

Parent-Child Interaction Therapy for Mexican Americans: Results of a Pilot Randomized Clinical Trial at Follow-up

https://doi.org/10.1016/j.beth.2011.11.001Get rights and content

Abstract

We examined treatment effects over a 6- to 24-month period posttreatment for 3 different interventions for externalizing behavior problems in young Mexican American (MA) children: a culturally modified version of Parent–Child Interaction Therapy (PCIT), called Guiando a Niños Activos (GANA), standard PCIT, and treatment as usual (TAU). Fifty-eight MA families with a 3- to 7-year-old child with clinically significant behavior problems were randomly assigned to GANA, standard PCIT, or TAU. As previously reported, all three treatment approaches produced significant pre-post improvement in conduct problems across a wide variety of parent-report measures, and those effects remained significant over the follow-up period. GANA produced results that were significantly superior to TAU on 6 out of 10 parent-report measures 6 to 24 months posttreatment, and GANA significantly outperformed PCIT on child internalizing symptoms. However, PCIT and TAU did not differ significantly from one another. These data suggest that both PCIT and GANA produce treatment gains that are maintained over time, and that GANA continues to outperform TAU over the long term.

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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    This research was supported by National Institute of Mental Health grant K01MH1924 and a Faculty Research Grant from the University of San Diego.

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