Re-Implementation of Parent–Child Interaction Therapy (PCIT) in the Community: Findings From a Pilot Randomized Controlled Trial

Background This study explored the feasibility, acceptability, and Māori cultural responsivity of study methods and components of an intervention to support clinicians to resume implementation of Parent–Child Interaction Therapy (PCIT), an evidence-based treatment for disruptive behavior in young ch...

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Main Authors: Melanie J Woodfield, Sarah Fortune, Tania Cargo, Sally Merry, Sarah E Hetrick
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:Implementation Research and Practice
Online Access:https://doi.org/10.1177/26334895251363418
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author Melanie J Woodfield
Sarah Fortune
Tania Cargo
Sally Merry
Sarah E Hetrick
author_facet Melanie J Woodfield
Sarah Fortune
Tania Cargo
Sally Merry
Sarah E Hetrick
author_sort Melanie J Woodfield
collection DOAJ
description Background This study explored the feasibility, acceptability, and Māori cultural responsivity of study methods and components of an intervention to support clinicians to resume implementation of Parent–Child Interaction Therapy (PCIT), an evidence-based treatment for disruptive behavior in young children. Method This pragmatic, parallel-arm, randomized, controlled pilot trial ran for a 6-month period and included PCIT-trained clinicians who were not delivering, or only rarely using PCIT in their work. Re-implementation strategies were systematically developed and theory-driven and included a mobile co-worker, a portable time-out space, audio-visual equipment, weekly consultation groups, and 2-day targeted PCIT refresher training. Results Pre-specified progression criteria included enrolling 20 clinicians, a maximum of 20% attrition, and a monthly survey response rate of at least 80%. Fourteen clinicians enrolled in the trial, there was no attrition, and an 89.8% average survey response rate was achieved. Secondary outcomes included clinician ratings of the usefulness and acceptability of intervention components. The time-out cubicle was considered relatively less useful and acceptable, while the refresher training and manuals were preferred. Study methods and intervention components were considered acceptable by the small proportion of Māori participants. Clinician self-reported Capability, Opportunity, and Motivation to implement PCIT fluctuated monthly across both groups. Pre-/post-changes in each domain within the Theoretical Domains Framework generally showed similar improvement from baseline to follow-up in both groups. There was no observable difference in PCIT adoption in either group. Conclusion To the best of our knowledge, this is the first study to pragmatically attempt to re-implement a parent training intervention in a community setting, several years after clinicians’ initial training in the approach (here, an average of 5.36 years). Low attrition and high survey response rates highlighted the feasibility of the data collection methodology. Important opportunities to improve the design of an adequately powered definitive trial are highlighted to minimize future resource waste.
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spelling doaj-art-745331c14c72496596ec00549e557da12025-08-20T03:56:51ZengSAGE PublishingImplementation Research and Practice2633-48952025-07-01610.1177/26334895251363418Re-Implementation of Parent–Child Interaction Therapy (PCIT) in the Community: Findings From a Pilot Randomized Controlled TrialMelanie J Woodfield0Sarah Fortune1Tania Cargo2Sally Merry3Sarah E Hetrick4 Te Whatu Ora (Health New Zealand), Te Toka Tumai Auckland, Auckland, New Zealand Department of Social and Community Health, Faculty of Medical and Health Sciences, , Auckland, New Zealand Department of Psychology, , Auckland, New Zealand Te Ara Hāro—Centre for Infant, Child and Adolescent Mental Health, Department of Psychological Medicine, , Auckland, New Zealand Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, AustraliaBackground This study explored the feasibility, acceptability, and Māori cultural responsivity of study methods and components of an intervention to support clinicians to resume implementation of Parent–Child Interaction Therapy (PCIT), an evidence-based treatment for disruptive behavior in young children. Method This pragmatic, parallel-arm, randomized, controlled pilot trial ran for a 6-month period and included PCIT-trained clinicians who were not delivering, or only rarely using PCIT in their work. Re-implementation strategies were systematically developed and theory-driven and included a mobile co-worker, a portable time-out space, audio-visual equipment, weekly consultation groups, and 2-day targeted PCIT refresher training. Results Pre-specified progression criteria included enrolling 20 clinicians, a maximum of 20% attrition, and a monthly survey response rate of at least 80%. Fourteen clinicians enrolled in the trial, there was no attrition, and an 89.8% average survey response rate was achieved. Secondary outcomes included clinician ratings of the usefulness and acceptability of intervention components. The time-out cubicle was considered relatively less useful and acceptable, while the refresher training and manuals were preferred. Study methods and intervention components were considered acceptable by the small proportion of Māori participants. Clinician self-reported Capability, Opportunity, and Motivation to implement PCIT fluctuated monthly across both groups. Pre-/post-changes in each domain within the Theoretical Domains Framework generally showed similar improvement from baseline to follow-up in both groups. There was no observable difference in PCIT adoption in either group. Conclusion To the best of our knowledge, this is the first study to pragmatically attempt to re-implement a parent training intervention in a community setting, several years after clinicians’ initial training in the approach (here, an average of 5.36 years). Low attrition and high survey response rates highlighted the feasibility of the data collection methodology. Important opportunities to improve the design of an adequately powered definitive trial are highlighted to minimize future resource waste.https://doi.org/10.1177/26334895251363418
spellingShingle Melanie J Woodfield
Sarah Fortune
Tania Cargo
Sally Merry
Sarah E Hetrick
Re-Implementation of Parent–Child Interaction Therapy (PCIT) in the Community: Findings From a Pilot Randomized Controlled Trial
Implementation Research and Practice
title Re-Implementation of Parent–Child Interaction Therapy (PCIT) in the Community: Findings From a Pilot Randomized Controlled Trial
title_full Re-Implementation of Parent–Child Interaction Therapy (PCIT) in the Community: Findings From a Pilot Randomized Controlled Trial
title_fullStr Re-Implementation of Parent–Child Interaction Therapy (PCIT) in the Community: Findings From a Pilot Randomized Controlled Trial
title_full_unstemmed Re-Implementation of Parent–Child Interaction Therapy (PCIT) in the Community: Findings From a Pilot Randomized Controlled Trial
title_short Re-Implementation of Parent–Child Interaction Therapy (PCIT) in the Community: Findings From a Pilot Randomized Controlled Trial
title_sort re implementation of parent child interaction therapy pcit in the community findings from a pilot randomized controlled trial
url https://doi.org/10.1177/26334895251363418
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