Skip to main content
Log in

Parent-Child Interaction Therapy for Preschool Aged Youth: A Meta-Analysis of Developmental Specificity

  • Review
  • Published:
Child & Youth Care Forum Aims and scope Submit manuscript

Abstract

Background

Parent–child interaction therapy (PCIT) is an evidence-based approach typically used for children aged 2–7 with externalizing disorders. Research suggests that PCIT is effective in treating a broad range of populations and problems. Several adaptations of PCIT have been developed for its use with children younger than the age of 2, though it is unclear how efficacious these adaptations are. Given the differences in terminology used in the developmental adaptations of PCIT, the current meta-analysis defines 12–24-month-olds as younger preschoolers and 25–59-month-olds as older preschoolers.

Objectives

The current meta-analysis aims to synthesize the literature on PCIT with children younger than the age of 5 and compare the effect of PCIT for younger preschoolers and older preschoolers.

Methods

Searches of PsycINFO and PubMed yielded 30 studies meeting inclusion criteria which were aggregated via meta-analysis.

Results

Statistical analyses suggest that PCIT overall has a large aggregate effect size when examining child externalizing symptoms, child internalizing symptoms, caregiver distress, and caregiver behaviors. PCIT interventions for older preschoolers were found to be comparably effective as PCIT adaptations for younger preschoolers in improving child externalizing symptoms, caregiver distress, and caregiver behaviors.

Conclusions

Overall, this meta-analysis provides preliminary findings that PCIT adaptations for younger preschoolers are effective in improving the well-being of children and caregivers. These adaptations may have benefits beyond the outcomes examined in this meta-analysis and future studies should continue to focus on the effects of these adaptations.

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.

Fig. 1

Similar content being viewed by others

References

References marked with an asterisk (*) indicate studies included in the meta-analysis

  • Bigfoot, D. S., & Funderburk, B. W. (2011). Honoring children making relatives: The cultural translation of parent-child interaction therapy for American Indian and Alaska Native families. Journal of Psychoactive Drugs, 43, 309–318. https://doi.org/10.1080/02791072.2011.628924

    Article  PubMed  Google Scholar 

  • *Bagner, D. M., Coxe, S., Hungerford, G. M., Garcia, D., Barroso, N. E., Hernandez, J., & Rosa-Olivares, J. (2016). Behavioral parent training in infancy: A window of opportunity for high risk families. Journal of Abnormal Child Psychology, 44(5), 901–912. https://doi.org/10.1007/s10802-015-0089-5

    Article  PubMed  PubMed Central  Google Scholar 

  • *Bagner, D. M., Rodriguez, G. M., Blake, C. A., & Rosa-Olivares, J. (2013). Home-based preventive parenting intervention for at-risk infants and their families: An open trial. Cognitive Behavioral Practice, 20(3), 334–348. https://doi.org/10.1016/j.cbpra.2012.08.001

    Article  PubMed  Google Scholar 

  • *Bagner, D. M., Sheinkopf, S. J., Vohr, B. R., & Lester, B. M. (2010). Parenting intervention for externalizing behavior problems in child born premature: An initial examination. Journal of Developmental and Behavioral Pediatrics., 31(3), 209–216. https://doi.org/10.1097/DBP.0b013e3181d5a294

    Article  PubMed  PubMed Central  Google Scholar 

  • Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., & Juffer, F. (2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129(2), 195–215. https://doi.org/10.1037/0033-2909.129.2.195

    Article  PubMed  Google Scholar 

  • *Bhuiyan, N. N. (2015). Improving imitation skills and behavior of children diagnosed with autism spectrum disorder using child directed interaction therapy. [Doctoral dissertation, University of Florida]. ProQuest Dissertations and Theses Global.

  • Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009). Introduction to meta-analysis. John Wiley.

    Book  Google Scholar 

  • *Brown, M. S. (2004). Effects of early childhood-conjoint behavioral consultation (EC-CBC) on preschool child compliance. [Doctoral dissertation, University of Nebraska]. ProQuest Dissertations and Theses Global.

  • *Budd, K. S., Hella, B., Bae, H., Meyerson, D. A., & Watkin, S. C. (2011). Delivering parent-child interaction therapy in an urban community clinic. Cognitive and Behavioral Practice, 18, 502–514. https://doi.org/10.1016/j.cbpra.2010.12.002

    Article  Google Scholar 

  • Campbell, S. B., Shaw, D. S., & Gilliom, M. (2000). Early externalizing behavior problems: Toddlers and preschoolers at risk for later maladjustment. Development and Psychopathology, 12, 467–488. https://doi.org/10.1017/s0954579400003114

    Article  PubMed  Google Scholar 

  • *Chronis-Tuscano, A., Lewis-Morrarty, E., Woods, K. E., & O’Brien, K. A. (2014). Parent-child interaction therapy with emotion coaching for preschoolers with attention-deficit/hyperactivity disorder. Cognitive and Behavioral Practice. https://doi.org/10.1016/j.cbpra.2014.11.001

    Article  Google Scholar 

  • *Comer, J. S., Furr, J. M., Miguel, E. M., Cooper-Vince, C. E., Carpenter, A. L., Elkins, R. M., Kerns, C. E., Cornacchio, D., Chou, T., Coxe, S., DeSerisy, M., Sanchez, A. L., Golik, A., Martin, J., Myers, K. M., & Chase, R. (2017). Remotely delivering real-time parent training to the home: An initial randomized trial of internet-delivered parent-child interaction therapy (I-PCIT). Journal of Consulting and Clinical Psychology, 85(9), 909–917. https://doi.org/10.1037/ccp0000230

    Article  PubMed  Google Scholar 

  • *Comer, J. S., Puliafico, A. C., Aschenbrand, S. C., McKnight, K., Robin, J. A., Goldfine, M. E., & Albana, A. M. (2012). A pilot feasibility evaluation of the CALM program for anxiety disorders in early childhood. Journal of Anxiety Disorders, 26, 40–49. https://doi.org/10.1016/j.janxdis.2011.08.011

    Article  PubMed  Google Scholar 

  • Cooley, M. E., Veldorale-Griffin, A., Petren, R. E., & Mullis, A. K. (2014). Parent-child interaction therapy; A meta-analysis of child behavior outcomes and parent stress. Journal of Family Social Work, 17, 191–208. https://doi.org/10.1080/10522158.2014.888696

    Article  Google Scholar 

  • *Cullinan, C. C. (2015). Evaluation of an abbreviated parent-child interaction therapy intervention in a pediatric primary care setting. [Doctoral dissertation, West Michigan University]. ProQuest Dissertations and Theses Global.

  • Davis, E. M., Garcia, D., Rothenberg, W. A., Barnett, M. L., Davidson, B., Espinosa, N., Tonarely, N. A., Robertson, E. L., Alonso, B., San Juan, J., & Jent, J. F. (2022). A preliminary analysis of parent-child interaction therapy plus natural helper support to increase treatment access and engagement for low-income families of color. Children and Youth Services Review, 134, 106370.

    Article  PubMed  PubMed Central  Google Scholar 

  • Evidence Partners (2020). Distiller SR [Computer Software]. Retrieved from https://www.evidencepartners.com/products/distillersr-systematic-review-software/

  • Eyberg, S. M., Funderburk, B. W. (2011). Parent-child interaction therapy protocol, PCIT International.

  • Eyberg, S. M. (2005). Tailoring and adapting parent-child interaction therapy to new populations. Education and Treatment of Children, 28(2), 197–201.

    Google Scholar 

  • Eyberg, S. M., Nelson, M. M., Ginn, N. C., Bhuiyan, N., & Boggs, S. R. (2013). Dyadic parent-child interaction coding system (DPICS) comprehensive manual for research and training (4th ed.). PCIT International Inc.

    Google Scholar 

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

    Google Scholar 

  • Gardner, F., Shaw, D. S., Dishion, T. J., Burton, J., & Supplee, L. (2007). Randomized prevention trial for early conduct problems: Effects on proactive parenting and links to toddler disruptive behavior. Journal of Family Psychology, 21(3), 398–406. https://doi.org/10.1037/0893-3200.21.3.398

    Article  PubMed  Google Scholar 

  • Girard, E. I., Wallace, N. M., Kohlhoff, J. R., Morgan, S. S. J., & McNeil, C. B. (2018). Parent- child interaction therapy with toddlers: Improving attachment and emotion regulation. Springer Nature AG.

  • *Gran, M. I. (2016). Parent-child interaction therapy: Effectiveness in home-based versus office-based settings. [Doctoral dissertation, Pacifica Graduate Institute]. ProQuest Dissertations and Theses Global.

  • *Gross, D., Belcher, H. M. E., Budhathoki, C., Ofonedu, M. E., Dutrow, D., Uveges, M. K., & Slade, E. (2019). Reducing preschool behavior problems in an urban mental health clinic: A pragmatic, non-inferiority trial. Journal of the American Academy of Child and Adolescent Psychiatry, 58(6), 572–581. https://doi.org/10.1016/j.jaac.2018.08.013

    Article  PubMed  Google Scholar 

  • *Gross-Kaminetsky, A. (2019). The effect of PCIT-CALM on child and parent anxiety and parenting behaviors. [Doctoral dissertation, Hofstra University]. ProQuest Dissertations and Theses Global.

  • *Hosogane, N., Kodaira, M., Kihara, N., Saito, K., & Kamo, T. (2018). Parent-child interaction therapy (PCIT) for young children with attention-deficit hyperactivity disorder (ADHD) in Japan. Annals of General Psychiatry. https://doi.org/10.1186/s12991-018-0180-8

    Article  Google Scholar 

  • Hudson, S., Levickis, P., Down, K., Nicholls, R., & Wake, M. (2015). Maternal responsiveness predicts child language at ages 3 and 4 in a community-based sample of slow-to-talk toddlers. International Journal of Language and Communication Disorders, 50(1), 136–142. https://doi.org/10.1111/1460-6984.12129

    Article  PubMed  Google Scholar 

  • *Kohlhoff, J., & Morgan, S. (2014). Parent-child interaction therapy for toddlers: A pilot study. Child and Family Behavior Therapy, 36(2), 121–139. https://doi.org/10.1080/07317107.2014.910733

    Article  Google Scholar 

  • *Kohlhoff, J., Morgan, S., Briggs, N., Egan, R., & Niec, L. (2020). Parent-child interaction therapy with toddlers: A community-based randomized controlled trial with children aged 14–24 months. Journal of Clinical Child and Adolescent Psychology. https://doi.org/10.1080/15374416.2020.1723599

    Article  PubMed  Google Scholar 

  • *Lee, J. (2019). Effect of PCIT on persistent irritability and severe anger outbursts in early childhood. [Doctoral dissertation, Hofstra University]. ProQuest Dissertations and Theses Global.

  • Leung, C., Tsang, S., Sin, T. C., & Choi, S. Y. (2015). The efficacy of parent-child interaction therapy with Chinese families: Randomized controlled trial. Research on Social Work Practice, 25, 117–128. https://doi.org/10.1177/1049731513519827

    Article  Google Scholar 

  • *Lieneman, C. C. (2018). Emotion regulation and attrition in parent-child interaction therapy. [Doctoral dissertation, West Virginia University]. https://researchrepository.wvu.edu/cgi/viewcontent.cgi?article=7127&context=etd

  • Lipsey, M. W., & Wilson, D. B. (2001). Practical Meta-Analysis. SAGE Publications Inc.

    Google Scholar 

  • Lyon, A. R., & Budd, K. S. (2010). A community mental health implementation of parent-child interaction therapy (PCIT). Journal of Child and Family Studies, 19, 654–668.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Masse, J. J. (2009). Examining the efficacy of parent-child interaction therapy with high-functioning autism. [Doctoral dissertation, West Virginia University]. https://researchrepository.wvu.edu/etd/2853/

  • McCabe, K., & Yeh, M. (2009). Parent-child interaction therapy for Mexican Americans: A randomized clinical trial. Journal of Clinical Child and Adolescent Psychology, 38, 753–759. https://doi.org/10.1016/j.beth.2011.11.001

    Article  PubMed  Google Scholar 

  • McNeil, C. B., & Hembree-Kigin, T. L. (2010). Parent-child interaction therapy. Boston: Springer.

    Book  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(4), 445-454.

    Article  Google Scholar 

  • *Naik-Polan, A. T., & Budd, K. S. (2014). Stimulus generalization of parenting skills during parent-child interaction therapy. Journal of Early and Intensive Behavior Intervention, 5(3), 71–92. https://doi.org/10.1037/h0100424

    Article  Google Scholar 

  • *Niec, L. N., Hemme, J. M., Yoff, J. M., & Brestan, E. V. (2005). Parent-child interaction therapy: The rewards and challenges of a group format. Cognitive and Behavioral Practice, 12, 113–125. https://doi.org/10.1016/S1077-7229(05)80046-X

    Article  Google Scholar 

  • *Nixon, R. D. V. (2001). Changes in hyperactivity and temperament in behaviourally disturbed preschoolers after parent-child interaction therapy (PCIT). Behaviour Change, 18(3), 168–176. https://doi.org/10.1375/bech.18.3.168

    Article  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(2), 251–260. https://doi.org/10.1037/0022-006x.71.2.251

    Article  PubMed  Google Scholar 

  • *Perkarsky, R. (2012). Effects of the child directed phase of parent-child interaction therapy on behavioral impulsivity in young children. [Doctoral dissertation, Hofstra University]. ProQuest Dissertations and Theses Global.

  • *Phillips, J., Morgan, S., Cawthorne, K., & Barnett, B. (2008). Pilot evaluation of parent-child interaction therapy delivered in an Australian community early childhood clinic setting. Australian and New Zealand Journal of Psychiatry, 42, 712–719. https://doi.org/10.1080/00048670802206320

    Article  PubMed  Google Scholar 

  • Phillips, S. T., & Mychailyszyn, M. P. (2021). A review of parent-child interaction therapy (PCIT): Applications for anxious youth. Children and Youth Services Review. https://doi.org/10.1016/j.childyouth.2021.105986

    Article  Google Scholar 

  • *Quetsch, L. B. (2019). A randomized controlled trial of parent-child interaction therapy with and without incentives in a community mental health setting. [Doctoral dissertation, West Virginia University]. https://researchrepository.wvu.edu/etd/6463/

  • Reef, J., Diamantopoulou, S., Meurs, I. V., Verhulst, F. C., & Ende, J. V. D. (2011). Developmental trajectories of child to adolescent externalizing behavior and adult DSM-IV disorder: Results of a 24-year longitudinal study. Social Psychiatry and Psychiatric Epidemiology, 46(12), 1233–1241. https://doi.org/10.1007/s00127-010-0297-9

    Article  PubMed  Google Scholar 

  • *Ros, R., Hernandez, J., Graziano, P. A., & Bagner, D. M. (2016). Parent training for children with or at risk for developmental delay: The role of parental homework completion. Behavior Therapy, 47(1), 1–13. https://doi.org/10.1016/j.beth.2015.08.004

    Article  PubMed  Google Scholar 

  • Rosenthal, R. (1979). The “file drawer problem” and tolerance for null results. Psychological Bulletin, 86, 638–641. https://doi.org/10.1037/0033-2909.86.3.638

    Article  Google Scholar 

  • Rosenthal, R. (1993). Meta-analytic procedures for social research. Sage.

    Google Scholar 

  • *Roslin, B. D. (2013). Adapting parent-child interaction therapy for selective mutism: A test of generalization across settings. [Doctoral dissertation, Hofstra University]. ProQuest Dissertations and Theses Global.

  • Shaw, D. S., Owens, E. B., Giovanelli, J. G., & Winslow, E. B. (2001). Infant and toddler pathways leading to early externalizing disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40(1), 36–43. https://doi.org/10.1097/00004583-200101000-00014

    Article  PubMed  Google Scholar 

  • Thomas, R., Abell, B., Webb, H. J., Avdagic, D., & Zimmer-Gembeck, M. J. (2017). Parent-child interaction therapy: A meta-analysis. Pediatrics. https://doi.org/10.1542/peds.2017-0352

    Article  PubMed  Google Scholar 

  • Thomas, R., & Zimmer-Gembeck, M. J. (2007). Behavioral outcomes of parent-child interaction therapy and Triple P—Positive Parenting Program: A review and meta-analysis. Journal of Abnormal Child Psychology, 35, 475–495. https://doi.org/10.1007/s10802-007-9104-9

    Article  PubMed  Google Scholar 

  • *Thurston, M. L. B. (1992). Parent-child interaction therapy and attachment theory: Interventions for preschoolers with behavior problems. [Doctoral dissertation, The University of Maine]. ProQuest Dissertations and Theses Global.

  • Valero-Aguayo, L., Rodríguez-Bocanegra, M., Ferro-García, R., & Ascanio-Velasco, L. (2021). Meta-analysis of the efficacy and effectiveness of parent child interaction therapy (PCIT) for child behaviour problems. Psicothema, 33(4), 544–555. https://doi.org/10.7334/psicothema2021.70

    Article  PubMed  Google Scholar 

  • Vetter, J. (2018). Parent-child interaction therapy for autism spectrum and attention-deficit/hyperactivity disorders: A review of the literature. Child and Family Behavior Therapy, 40(3), 204–232. https://doi.org/10.1080/07317107.2018.1487740

    Article  Google Scholar 

  • Ward, M. A., Thuele, J., & Cheung, K. (2016). Parent-child interaction therapy for child disruptive behaviour disorders: A meta-analysis. Child & Youth Care Forum, 45, 675–690. https://doi.org/10.1007/s10566-016-9350-5

    Article  Google Scholar 

  • Zisser-Nathenson, A. R., Herschell, A. D., & Eyberg, S. M. (2017). Parent-child interaction therapy and the treatment of disruptive behavior disorders. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (3rd ed., pp. 103–121). New York The Guilford Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sharon T. Phillips.

Ethics declarations

Conflict of interest

The authors have no relevant financial or nonfinancial interest to disclose. The authors have no conflict of interest to report.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 22 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Phillips, S.T., Mychailyszyn, M.P. Parent-Child Interaction Therapy for Preschool Aged Youth: A Meta-Analysis of Developmental Specificity. Child Youth Care Forum 52, 267–284 (2023). https://doi.org/10.1007/s10566-022-09694-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10566-022-09694-w

Keywords

Navigation