Evaluating the Feasibility of Internet-delivered PCIT
Condition: Oppositional Defiant Disorder; Conduct Disorder; Disruptive Behavior Disorder Nos
MeSH terms: Mental Disorders; Problem Behavior; Conduct Disorder; Attention Deficit and Disruptive Behavior Disorders
Study type: Interventional

Summary: 
      The present study is leveraging a randomized-controlled design to evaluate an Internet-based
      format for the delivery of Parent-Child Interaction Therapy (I-PCIT). Drawing on
      videoteleconferencing technology, this format affords real-time interactions for the
      provision of care traditionally delivered in person, regardless of a family's geographic
      proximity to a mental health facility. Moreover, drawing on technological innovation to
      deliver interventions directly to families in their natural settings may extend the
      ecological validity of PCIT, as treatment is delivered in the very context in which child
      problems occur. Families seeking treatment for early child disruptive behavior problems
      (N=40) are being randomly assigned to either receive Internet-delivered PCIT or clinic-based
      PCIT. Outcomes and feasibility/acceptability will be assessed across the treatment phase as
      well as at post-treatment and 6-month follow-up.
    

Detailed description: 
      Establishing the feasibility of an Internet-based format for the delivery of evidence-based
      parent management is a critical step in the evaluation of technological innovations and their
      potential for advancing children's mental health care. Drawing on teleconferencing
      technology, such a format affords real-time interactions for the provision of care
      traditionally delivered in person, regardless of a family's geographic proximity to a mental
      health facility. Moreover, drawing on technological innovation to deliver interventions
      directly to families in their natural settings may extend the ecological validity of
      treatments, as treatments are delivered in the very contexts in which child problems occur.

      The objective of the present study is to develop an Internet-delivered Parent-Child
      Interaction Therapy (PCIT) protocol for preschoolers with Oppositional Defiant Disorder (ODD)
      or Conduct Disorder (CD) and to evaluate via randomized controlled trial (RCT) the
      feasibility and acceptability of enrolling, retaining, and treating children with I-PCIT
      relative to traditional PCIT. Phase I will involve development of an Internet-delivered PCIT
      (I-PCIT) protocol and treatment materials, including therapist treatment manual and online
      session handouts. Phase II will entail a case series: the PI will treat 5 consecutive
      preschool ODD/CD cases with I-PCIT, affording opportunity to further work out any
      difficulties with protocol or equipment. Phase III will entail testing the feasibility and
      acceptability of I-PCIT in a pilot RCT conducted with 40 children (ages 3-5) meeting for a
      Diagnostic and Statistical Manual (DSM-IV) principal diagnosis of ODD or CD and their
      parent(s) randomly assigned to I-PCIT or traditional PCIT. Parents will provide informed
      consent. All eligible families will receive evidence based treatment. Treatment will either
      be either in-clinic Parent-Child Interaction Therapy (PCIT) or Internet-delivered PCIT
      (I-PCIT). Formal evaluations will be conducted at baseline, post-treatment, and 6-month
      follow-up. Families can opt to participate in two optional psychophysiological components of
      the study (one involving behavioral tasks while parents are monitored via physiological
      equipment, and one involving play tasks while children are monitored via physiological
      equipment). All assessments will be conducted in the Department of Psychology at Florida
      International University (FIU), in the Center for Children and Families.
    

Intervention name(s): Parent-Child Interaction Therapy (PCIT); Internet-delivered PCIT (I-PCIT)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): PCIT is a short-term intervention that incorporates principles of play therapy into behavioral parent training, drawing on attachment and social learning theories to emphasize positive attention, consistency, problem solving, and communication. Treatment is delivered in the clinic.; I-PCIT is a short-term intervention that incorporates principles of play therapy into behavioral parent training, drawing on attachment and social learning theories to emphasize positive attention, consistency, problem solving, and communication. Treatment is delivered to families in their own home in real-time via videoconferencing over the Internet by a remote therapist.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Internet-delivered treatment v. clinic-delivered treatment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment