The Center for Effective Therapy (CET) at The Baker Center for Children and Families places great value on providing the highest quality of evidence-based care for all. Parent-Child Interaction Therapy (PCIT) is a gold-standard treatment designed for children between the ages of 2-7 who experience behavioral challenges, ADHD, trauma, anxiety, ASD, attachment challenges, and social skills difficulties. PCIT was traditionally administered in-person, but the COVID-19 pandemic created unexpected shifts in the ways that our clinicians, and clinicians all over the world, provide treatment. Where sessions previously had taken place in clinics, PCIT was being delivered via telehealth to provide continued access to care during a global emergency.
A team at CET, in collaboration with our Quality Care Initiative (QCI), decided to evaluate whether this change in treatment delivery impacted the results we see with PCIT. From previous research, we know that internet delivered Parent-Child Interaction Therapy (I-PCIT) is similarly effective to standard in-person PCIT. Although, we did not know if the added stressors from the pandemic would impact the effectiveness of the treatment. The purpose of the study was to evaluate if there were differences in treatment outcomes between families who received PCIT in-person prior to the pandemic and those who received I-PCIT during the pandemic, both through CET.
Why might a pandemic impact treatment outcomes for I-PCIT?
The COVID-19 pandemic led to increased stress for children and families across the world, and it was known to exacerbate the impact of mental and behavioral health disorders. The pandemic brought with it unprecedented stressors for families, including high levels of consistent health concerns, financial issues, unemployment, school closures, and increased levels of isolation. The many stressors that came with the pandemic elevated the levels of distress that parents experience and increased the likelihood of childhood maltreatment. In the face of big changes and prominent global pandemic related stressors, there was a large range of mental and behavioral health responses experienced by all. For kids and adolescents, we saw increases in problems like anxiety, depression, irritability, mood swings, inattention, sleep disturbance, challenging behaviors and disrupted attachments, especially in young children. For children who had pre-existing problems, the effects of the pandemic were amplified by the difficulty of accessing treatment, high rates of developing more co-morbid changes when mental health goes under addressed, and the negative impacts of quarantining.
Amid unprecedented growing rates of mental health challenges for youth during the pandemic and the stressors that come along with living through a global emergency, our team was still providing I-PCIT and feeling hopeful that the treatment would be effective. The research study aimed to discover if I-PCIT was still effective, even with all these additional stressors.
The study revealed that despite increased levels of parental stress and child behavioral challenges during the pandemic, I-PCIT remained just as effective and proved to be able to meet the increased needs of the population. This means that the children who received PCIT in person before the pandemic had no differences in treatment outcomes compared to those who received I-PCIT during the pandemic. Clinicians who provide PCIT can move forward feeling confident that an I-PCIT course of treatment will be effective despite added stressors due to uncontrollable events, like a pandemic.
The study also highlighted some additional benefits of I-PCIT, including increased accessibility of care. The use of I-PCIT, as compared to traditional in person PCIT, breaks down transportation barriers, reduces the financial burden of accessing care, and reduces the need for technical equipment that is usually necessary to conduct in person PCIT. It also allows families and clinicians to conduct treatment in the natural home environment, which can allow caregivers and providers to collaborate, and problem solve challenges that arise due to the environment in session.
Overall, we now have the data to back up our hope that I-PCIT would be just as effective during pandemic times as in person PCIT pre-pandemic, and we continue to offer both treatment models to clients who are a good fit for PCIT.