Parent-Child Interaction Therapy (PCIT) and telehealth: Clinician and caregiver perspectives

Abstract

Background: The Metropolitan-Boston Complex Trauma Treatment Initiative (MB-CTTI) offers adjunctive clinical services to highly traumatized youth with established care. MB-CTTI engaged the Institute for Community Health (ICH) to evaluate this program. Since the onset of the COVID-19 pandemic, our research focused on understanding the impact of telehealth services. One technique that has become increasingly central to the work is Parent-Child Interaction Therapy (PCIT), an approach that involves therapists providing in-the-moment coaching through an earpiece to a caregiver interacting with their child. MB-CTTI clinicians adapted the therapy to provide services remotely, with the caregiver and child in their own home.

Methods: ICH interviewed 4 clinicians and 12 caregivers who participated in PCIT services to assess the impact of the program on multiple levels. Interview audio was recorded on zoom and transcribed in Otter.ai. Themes were identified in the transcripts using framework analysis.

Results:  PCIT was easily adapted as a telehealth service, using a webcam and headset to allow caregivers to participate from their own homes. Both clinicians and caregivers commented on the convenience and ease of scheduling sessions, and clinicians noted it was helpful to see participants in their home environment. Clinicians also reflected positively on the impact they were able to make, despite hesitancy around such a structured and remote approach. Caregivers noted improvements in their child’s behavior, and also the strong relationship that clinicians were able to build with them and their children, despite conducting sessions remotely.

Conclusions: Both caregivers and clinicians found remote PCIT to be successful and to have a positive impact on children and families. Despite initial skepticism, clinicians found the highly structured therapy to work well for this population, and to adapt well to remote administration. Adapting the MB-CTTI program to remote engagement allowed clinicians to continue to provide effective therapeutic support to children and families throughout the pandemic, at a time when in-person services weren’t possible. Remote PCIT decreased scheduling and travel burden on participants, especially caregivers. Overall, the PCIT services adapted well to a  telehealth structure, reducing the burden of participation while still offering the prescribed structure.

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