Adapting PCIT-Health for Telehealth Delivery: A Case Study

Abstract

During the COVID-19 pandemic, children's physical health and access to mental health resources have been two critical concerns. Parent-Child Interaction Therapy-Health (PCIT-Health) is a treatment model aimed at helping parents manage children's general behavior and their behavior in obesogenic contexts (screen time and mealtime). Due to social distancing guidelines, PCIT-Health was adapted for remote delivery through video conferencing. In this article, we describe the experience of implementing virtual PCIT-Health with a family. The family's progress through treatment is described, along with the challenges associated with remote service delivery and how those challenges were addressed. Progress through treatment was measured with questionnaires administered to caregivers and with observational measures of parent-child interactions. The results from these measures indicate that caregivers experienced a reduction in stress and improvements in their child's behavior after PCIT-Health completion. They also reported engaging in healthier management of their child's screen time and mealtime behaviors. As coded from observational assessments, parents increased their use of positive parenting practices. Telehealth-delivered PCIT-Health is a promising treatment modality for increasing parenting skills and improving child behavior.

Keywords: PCIT; feeding; obesity; problematic media use; telehealth.

Figure 1

Parental Perception of Ellen’s Psychosocial Competence Throughout Treatment. Note: CDI = child-directed interaction; PDI = parent-directed interaction; HDI = health-directed interaction; T = teach session. The Johnsons’ perception of Ellen’s psychosocial competencies throughout the PATCH program as measured by the Psychosocial Strengths Inventory for Children and Adolescents.

Figure 2

Parental Perception of Ellen’s Disruptive Behaviors Throughout Treatment. Note: PDI = parent-directed interaction; HDI = health-directed interaction; T = teach session. The Johnsons’ perception of Ellen’s disruptive behaviors at four time-points—pre-treatment, post-treatment, and at the transition of each phase as measured by the Eyberg Child Behavior Inventory.

Figure 3

The Johnsons’ Use of the “Do Skills” Throughout Treatment. Note: CDI = child-directed interaction; PDI = parent-directed interaction; “Do Skills”: behavior descriptions, reflections, and labeled praises. The Johnsons’ use of “Do Skills” in a 5-minute coding throughout the PATCH program as measured by the Dyadic Parent–Child Interaction Coding System [55]. These were coded weekly by the doctoral student therapists; one set of codes is reported due to high inter-rater agreement (>80%).

Figure 4

The Johnsons’ Use of the “Don’t Skills” Throughout Treatment. Note: CDI = child-directed interaction; PDI = parent-directed interaction; “Don’t Skills”: questions, commands, criticisms. The Johnsons’ use of the “Don’t Skills” in a 5-minute coding throughout the PATCH program as measured by the Dyadic Parent–Child Interaction Coding System [55]. These were coded weekly by the doctoral student therapists; one set of codes is reported due to high inter-rater agreement (>80%).