Skowron et al PCIT Improves Child-Welfare Parents’ Behavior, Self-Regulation, & Self-Perceptions

Objective: We conducted a large (N = 204) randomized, clinical trial to test the efficacy of Parent-Child Interaction Therapy (PCIT) on observed parenting and two key drivers of maladaptive parenting— self-regulation skills and harsh social cognitions—in a sample of child welfare-involved families. Method: Participants were randomly assigned to receive standard PCIT (n = 120) or services-as-usual (SAU; n = 84). The sample was characterized by low household income and significant exposures to adverse childhood experiences (ACEs) and substance abuse. Intention-to-treat analyses were conducted on multiply-imputed data followed by secondary per-protocol analyses. Results: Significant PCIT effects emerged on (a) increased positive parenting and reduced negative parenting (small-to-medium ITT effects and medium-to-large per-protocol effects); (b) gains in inhibitory control performance on the stop-signal task (small-to-medium ES); (c) gains in parent-reported emotion regulation and (d) positive, affirming self-perceptions (small-to-medium ES), relative to SAU control. The effects of PCIT on gains in parent emotion regulation were mediated by reductions in observed negative parenting. No main effects were observed on parent RSA scores or child attributions. Harsh child attributions moderated treatment response: PCIT parents who held the harshest child attributions displayed the greatest gains in labelled praises and declines in negative talk/criticism. Conclusions: This randomized trial presents the first evidence that PCIT improves inhibitory control and emotion regulation in child welfare-involved parents and provides independent replication of other published trials documenting gains in observed parenting.