None listed
Conditions
Brief summary
Despite a considerable number of clinicians having been trained in Parent-Child Interaction Therapy (PCIT) in Aotearoa / New Zealand, few are using the treatment, with barriers to use including a lack of suitable equipment and lack of professional support. This pragmatic, parallel-arm, pilot RCT includes PCIT-trained clinicians who are not delivering, or only rarely utilising, this effective treatment. The study aims to assess the feasibility, acceptability, and cultural responsivity of study methods and intervention components, and to collect variance data on the proposed future primary outcome variable, in preparation for a future, larger trial. It compares a novel “re-implementation” intervention with a refresher training and problem-solving control. Intervention components have been systematically developed to address barriers and facilitators to clinician use of PCIT using implementation theory, and a draft logic model with hypothesised mechanisms of action, derived from a series of preliminary studies. The intervention includes complimentary access to necessary equipment for PCIT implementation (AV equipment, a ‘pop-up’ time-out space, toys), a mobile senior PCIT co-worker, and weekly PCIT consultation, for a six-month period. Relative to training initiatives, little research attention has been directed at resurrecting stalled implementation efforts. Results from this pragmatic pilot RCT will refine and shape knowledge relating to what it might take to embed the ongoing delivery of PCIT in community settings, providing more children and families with access to this effective treatment.
Interventions
All participants:
All participants will undertake a two-day Parent-Child Interaction Therapy (PCIT) refresher training, the content of which is informed by PCIT International's 'recalibration' training, and previous research into implementation barriers encountered by PCIT-trained clinicians in Aotearoa / New Zealand. This complimentary, catered training will be delivered outside of typical working hours, to facilitate clinician attendance regardless of their current employment context. It will
All participants: All participants will undertake a two-day Parent-Child Interaction Therapy (PCIT) refresher training, the content of which is informed by PCIT International's 'recalibration' training, and previous research into implementation barriers encountered by PCIT-trained clinicians in Aotearoa / New Zealand. This complimentary, catered training will be delivered outside of typical working hours, to facilitate clinician attendance regardless of their current employment context. It will delivered by a senior PCIT trainer in Tamaki Makaurau / Auckland. Incorporated within the two training days, all participants will receive the following enhanced supports: • A collection of resources to support delivery, including detailed virtual delivery resources and demonstration of these. Access to a Dropbox with all resources and materials. • A complimentary pack of 25 Eyberg Child Behaviour Inventory (ECBI; Eyberg & Pincus, 1999) questionnaires to use with future PCIT clients, and a complimentary PCIT treatment protocol in the event that this has been misplaced since their initial PCIT training. • Facilitated discussion and problem-solving sessions around using PCIT in various contexts including private practice, should participants choose to do this. For example, what to charge for PCIT, how to obtain referrals, and where suitable clinic rooms are located. • Discussion, facilitated by a Maori PCIT provider, relating to how to deliver PCIT in a culturally responsive way. After the two training days, all participants across both the intervention and control groups will be offered optional complimentary weekly 1hr group PCIT-oriented consultation sessions with a senior PCIT clinician, for the six month trial period. Participants may attend in-person, or join remotely via video-conference if they prefer. If the number of participants regularly attending is greater than 12, a second group will be offered. Intervention: Clinicians allocated to the intervention condition will receive the following: • A pack of suitable PCIT toys to use with children and families, which will be provided free of charge. • Access to a mobile co-worker / ‘PCIT partner’ who can be booked through an online booking system free of charge at any time. This senior PCIT clinician will be available to join a client session to support the clinician (the participating clinician is responsible for obtaining client consent for this to occur), or to plan or debrief sessions, as requested by the clinician, and in any location of the clinician’s choice. It is our intention to recruit a senior Maori PCIT clinician to this role, as Maori are the Indigenous people of Aotearoa / New Zealand and a number of PCIT-trained clinicians are Maori (14.8% in our 2021 survey). • Access to portable, relocatable audiovisual equipment, including a high quality digital remote camera, which allows viewing of the clinic room from a nearby room. Along with a Bluetooth earpiece to facilitate clinician coaching of the parent(s) from the nearby room. • Access to an in-room pop-up cubicle to be used if the child requires a brief time-out, that is transportable to the clinic room that the participant clinician is choosing to use for their work. These components will be available immediately after the refresher training, for the six month trial period. The toy package will be held by the individual participating clinicians, and all other components booked through an online booking system.
Sponsors
University of Auckland | Waipapa Taumata Rau
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
20 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Clinicians must have completed a recognised 40-hour initial training in PCIT within the past 10 years and be registered to practise in Aotearoa / New Zealand at the time of participation in the trial. Having been eligible for the PCIT initial training implies that included clinicians will be allied health and medical clinicians with a Masters degree or equivalent (i.e. psychologists, psychiatrists, social workers, psychotherapists, occupational therapists, and nurses). Eligible clinicians are not required to be employed in a clinical role, and may be in an administrative or managerial role, as it is possible that they may elect to adopt PCIT in a part-time private practice context. Where the clinician is already seeing a full caseload of PCIT clients, they will remain eligible for inclusion as we are interested in whether provision of additional supports might influence the nature and quality of implementation. For example, the PCIT treatment protocol recommends use of a time-out room in the Parent-Directed Interaction phase, and clinicians have indicated that this requirement can be problematic, which at times results in this phase being omitted or adapted (Woodfield et al., 2021).
Exclusion criteria
Clinicians who are based outside of the Tamaki Makaurau / Auckland region will be excluded from this pilot trial, due to resource constraints, as the mobile co-worker will be Tamaki Makaurau / Auckland-based in the pilot trial.
Outcome results
None listed