An examination of parent-child interaction therapy in practice - a qualitative study

Abstract

Background: Parent Child Interaction Therapy (PCIT) is commonly used in preschool children with SLI. Review studies conclude that PCIT is effective for this group. However, these reviews included many different approaches. Also, it appears that SLTs often adapt PCIT. To maintain the effectiveness of PCIT there is need to develop a framework. This framework should include the critical components of PCIT and should be feasible in practice. Aim: This study aims to identify the potentially critical components in PCIT according to literature and SLTs, and to find rationales SLTs give for the way they structure PCIT. Both parameters are important for the long term goal, that is, to develop a framework that is relevant to practice. Methods: Semi-structured interviews were conducted with ten SLTs who had at least one year experience in delivering PCIT in preschool children with SLI. The interviews were transcribed and analysed, using thematic analysis. A literature search is conducted in order to find studies about PCIT in preschool children with SLI which yielded 12 papers. Results: There are four potentially critical components identified from the interview data: parents’ engagement, parents’ understanding, parents’ reflection and therapists’ skills. Data from the interviews suggest that these components needs to be in balance to increase the successfulness of PCIT. The potentially critical components were minimally discussed in the selected papers. The reasons SLTs give for the way they structure PCIT are mainly based on organizational constraints, family needs and practicalities. Conclusion and implications of key findings: SLTs experience PCIT as valuable but challenging due to organisational constraints, the variety in families and practicalities. The successfulness of PCIT is affected by the four critical components. A framework is needed which should include these components and should be feasible in practice.