Implementation fidelity and outcomes of psychologists working in a statutory child protection agency with children undergoing Parent-Child Interaction Therapy (PCIT) and PCIT with Trauma Directed Interaction (PCIT with TDI): a case study series

Parents and carers benefit from evidence-based parenting interventions that help with behavior management that also takes into account trauma symptoms in the child. The main child protection service in New South Wales, Australia delivers Parent Child Interaction Therapy (PCIT) and a novel adaptation, Trauma Directed Interaction (PCIT with TDI), to children who are unable to be cared for by their parents or carers This study employed a case series design to investigate treatment adherence (fidelity) for two psychologists working in a statutory child protection service with one delivering PCIT and the other delivering PCIT with TDI. The two psychologists studied had a range of 5-20 years of clinical experience (M = 12.5, SD = 10.61). A review of a total of ten video recorded therapy sessions, that conducted PCIT or PCIT with TDI, was conducted to determine how well the psychologists adhered to the treatment protocol using the Treatment Integrity Checklists for both standard PCIT (n = 4) and PCIT with TDI (n = 4). Level of adherence for both psychologists was high. Pre and post measures were obtained for behavioural and trauma symptoms for the children of the two clinicians involved in the fidelity check (n = 8). The clinician conducting PCIT had significant treatment effects for behaviour intensity and trauma symptoms and the clinician conducting PCIT with TDI did not have significant findings on the outcome measures used between pre- and post-intervention. Potential explanations for the findings, limitations of the current study, and directions for future research are discussed.