Parent Whispering - the art of empowering parents to change, to improve their child's behaviour. A study looking at the feasibility and utility of delivering Parent-Child Interaction Therapy (PCIT) to vulnerable New Zealand families in two real world settings (community and residential).

Parent-child interaction therapy (PCIT). PCIT is a family-behavioural treatment for parent-child dyads, where the young child (2-7years of age) has severe behaviour problems and/or there are serious concerns regarding parenting. Parents and their child attend weekly therapy sessions (45-60 minutes in length) and commit to 5 minute therapy homework (recorded daily). The PCIT therapist coaches the parent (from behind a one-way screen using a transmitting and receiving device), during live parent-child interactions. PCIT is a manualised programme where parents complete weekly rating scales to monitor their child's behaviour (self-report), homework compliance (self-report) and the parent-child relationship (assessed by the therapist using a standardised coding sheet). To ensure treatment integrity, the therapist completes weekly session integrity checklists, video-tapes sessions, and attends monthly PCIT supervision. Additionally a random selection of videotaped sessions will be assessed by an external PCIT supervisor, to ensure inter-rater reliability of 80%. PCIT has two phases of treatment. Child Directed Interaction (CDI), where the parent learns to follow their child's lead during play and how to use the positive PRIDE skills of giving labelled Praise, Reflecting appropriate language, Imitating play sequences, Describing how their child plays and showing Enjoyment when they are with their child. They also learn to refrain from using questions, commands and negative talk during interactions with their child. Any annoying or obnoxious behaviour is handled with active ignoring and positive redirecting and play stops for any dangerous and destructive play. During CDI the relationship develops warmth and the interactions become more positive. In order to master this phase of treatment and move on to phase two,the parent must give 10 Labelled Praises, 10 Behavioural Descriptions, 10 Reflections of language, and use no more than 3 questions, commands or negative talk, in a 5 minute play sequence. The child's behaviour must have improved and their play become more organised according to the parental reports and therapist observations. In the second phase of treatment, Parent Directed Interaction (PDI), the parent learns to give good commands, set limits and boundaries and a sensitive discipline process to handle non-compliance. The child learns to listen and make good choices. Mastery criteria for PDI is when the parent can give 4 positively stated commands (using the correct process 75% of the time) and the child is able to comply 75% of the time. Therapy does not stop until master criteria is reached and the child's behaviour ratings has fallen well below normal limits according to the Eyberg Child Behavioural Inventory (ECBI) i.e a total score of 115 or below. For this study, collation of data will stop after 12 sessions of therapy.