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The goal of this feasibility study is to evaluate feasibility of Internet-delivered Parent-Child Interaction Therapy for parents of children 2-7 years with disruptive behaviors. The main questions it aims to answer are:
Participants will receive a 10-week online intervention of Parent-Child Interaction Therapy and answer questionnaires online weekly.
Severe early behavioral problems increase the risk of impaired functioning in childhood and later life. Parent-Child Interaction Therapy (PCIT) is particularly effective for young children (age 2-7) with disruptive behaviors but is unimplemented in Sweden. Barriers to PCIT implementation include time constraints for parents and therapist challenges. An abbreviated internet-delivered version, iPCIT, may address these barriers. The objective of the study is to evaluate feasibility and acceptability of iPCIT.
Research questions
This study will use an uncontrolled pretest-posttest design, all participants will receive the intervention. The intervention consists of 10 weekly modules delivered over the Internet with guided support from an experienced CBT-trained psychologist and 5 biweekly videosessions where parents practice parental skills in a play situation with their child while receiving feedback and support from their therapist.
Assessments will be made pretreatment, weekly during treatment for the primary outcome and potential mediators, posttreatment, at the primary endpoint 2 months after treatment completion and at follow up 6 months after treatment completion. Twenty participants (parents of children aged 2-7 years) will be included. All outcome data will be collected digitally and include for feasibility: treatment credibility, working alliance, compliance with the treatment (number of modules completed), any adverse events, subjective overall relief and satisfaction with treatment. For potential efficacy, the clinical effect in the group will be analyzed on pre- to post-measurements, including weekly measurements and 2 months follow up after treatment termination (primary endpoint). The participants will be followed 6 months after treatment completion to analyze long term clinical effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| iPCIT | Other | Online parent management training (PMT) to teach parental skills (10 weekly online modules) combined with videosession for coaching of parental skills (5 biweekly sessions) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Internet-delivered Parent-Child Interaction Therapy | Behavioral | Parent management training delivered online where Internet-modules are combined with video sessions for live coaching. |
| Measure | Description | Time Frame |
|---|---|---|
| Eyberg Child Behavior Inventory | Caregiver report form measuring disruptive behaviors in children. 36 items with answers ranging from 1 (never) to 7 (always). Minimum value: 36. Maximum value: 252. A higher score means worse outcome. | From pretreatment to 18 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Weekly assessment of Child Behavior Forms | Short caregiver report form measuring disruptive behaviors in children. Two scales with 9 items each with answers ranging from 1 (never) to 7 (always). Minimum value: 9. Maximum value: 63. A higher score means worse outcome. | From pretreatment to 18 weeks |
| Child Behavior Checklist |
| Measure | Description | Time Frame |
|---|---|---|
| Working Alliance Inventory | Questionnaire measuring alliance with therapist. 6 items scored on a scale from 1 (never) to 7 (always). Minimum value: 6. Maximum value: 42. A higher score means better outcome. | Treatment week 3 |
| Credibility Rating Scale |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Marianne Bonnert, PhD | Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Stockholm Sweden | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre for Psychiatry Research, Karolinska Institutet | Stockholm | Sweden |
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| ID | Term |
|---|---|
| D000066553 | Problem Behavior |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D002652 | Child Behavior |
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Uncontrolled feasibility study using pretest-posttest design with 2 mo FU as primary endpoint.
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Self-reported outcomes assessed online without any influence from study staff.
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|
Caregiver report form identifying problem behavior in children. 99 items with answers ranging from 0 (do not agree) to 2 (strongly agree). Minimum value: 0. Maximum value: 198. A higher score means worse outcome. |
| From pretreatment to 10 weeks |
| Dyadic Parent-Child Interaction Coding System | Observation System measuring parental behavior and child behavior. The frequency of specified behaviors are measured during a five minute long standardized play situation. | From pretreatment to 10 weeks |
| Brunnsviken Brief Quality of Life Scale | Questionnaire about quality of life. 12 items with answers ranging from 1 (strongly disagree) to 4 (strongly agree). Minimum value: 0. Maximum value: 96. A higher score means better outcome. | From pretreatment to 18 weeks |
| Perceived Stress Scale | Questionnaire measuring overall stress. A 7-item version of the scale will be used with answers ranging from 0 (never) to 4 (very often). Minimum value: 0. Maximum value: 28. A higher score means worse outcome. | From pretreatment to 18 weeks |
| Parental Stress Scale | Questionnaire measuring stress induced by parenthood. 18 items with answers from 1 ("strongly disagree") to 5 ("strongly agree"). Minimum value: 18. Maximum value: 90. A higher score means worse outcome. | From pretreatment to 18 weeks |
| Difficulties in Emotion Regulation Scale | Questionnaire measuring emotion regulation ability. 16 items with answers ranging from 1 (almost never) to 5 (almost always). Minimum value: 16. Maximum value: 80. A higher score means worse outcome. | From pretreatment to 18 weeks |
| Parenting Young Children Scale | Questionnaire measuring parental strategies. 6 items with answers ranging from 1 (never) to 7 (many times a day). Minimum value: 6. Maximum value: 42. A higher score means better outcome. | From pretreatment to 18 weeks |
Questionnaire measuring treatment credibility. 5 items scored on a scale from 0 (not at all) to 10 (very). Minimum value: 0. Maximum value: 50. A higher score means better outcome.
| Treatment week 3 |
| The Client Satisfaction Questionnaire | Questionnaire measuring satisfaction with treatment. 8 items with answers ranging from 1 (bad) to 4 (very good). Minimum value: 8. Maximum value: 32. A higher score means better outcome. | Posstreatment (treatment week 10) |
| Subjective Adequate Relief Questionnaire | Questionnaire that measures self-perceived change in symptoms as a result of the treatment. The scale consists of 1 item rated from 0 (much worse) to 6 (much better). | Posstreatment (treatment week 10) |
| Adverse events questionnaire | Short 6-item questionnaire to identify if any adverse events have occurred due to treatment | Posstreatment (treatment week 10) |