From your Pocket to the Front Lines: Evaluating New Ways to Connect

Families to PCITJason Jent, PhD

Assistant Professor of Clinical PediatricsDirector, UM PCIT305

Acknowledgments

Connecting Families

Pocket PCIT

Utilization of natural helpers to recruit and engage families from Little Havana into PCIT

Primary Care PCIT

Pocket PCIT

The Identified Problems:

- high attrition rates in behavioral parent training (Lyon & Budd, 2010; Werba et al., 2003)

- Concerns regarding effective practice of skills at home

- Concerns about where families access information about parenting

- Accessibility of evidence-based intervention (Kazdin, 2008)

- What happens to all of those paper treatment handouts?

Pocket PCIT

Proposed Solution: A mobile resource that parents can access when parents need that info the most

The interprofessional partnership: PCIT + Telehealth + Graphic Designer

Implementation Plan:

- Develop and publish an iBook that families can use during PCIT or that families can use to learn about PCIT.

-Evaluate the effectiveness of Pocket PCIT (74 families enrolled to date)

Pocket PCIT: What Is It?

Paper handouts vs. mobile devices with sustainable resources

Provides additional resources for caregivers to learn skills

Practical resources for implementation of PRIDE skills

Treatment engagement strategies

Multimedia approach to learning

7th grade reading level

Free to families

Pocket PCIT Demo

The Reach of Pocket PCIT iBook directs families to PCIT

international website to find a certified provider

337 downloads in US, Canada, Australia, New Zealand, Japan, Netherlands, UK, and Spain

If You Want To Try Out Pocket PCIT

Download iBooks app on iPhone, iPad, or Mac

Go to iBooks Store

Search for Pocket PCIT

Google Pocket PCIT

PCIT + Natural HelpersThe Identified Problems:

- Hispanic children at increased risk for conduct disorders and less likely to access treatment (Chang, Natsuaki, & Chen, 2013)

- Zip code analysis revealed PCIT305 rarely served any families from Little Havana

- ConnectFamilias identified unmet treatment needs for families with children with disruptive behaviors

- Families interested in receiving parenting support from natural helpers (Niec et al., 2014)

- Natural Helpers did not feel equipped to provide that parenting support for children with disruptive behaviors

PCIT + Natural Helpers Proposed Solution: Train NHs to recruit families for PCIT and

reinforce PCIT principles during weekly home visits

The interprofessional partnership: PCIT + ConnectFamilias

Implementation Plan:

- Train NHs on PCIT recruitment, retention, and reinforcement strategies

-Provide tablet and video resources to help

guide NH activities

-Evaluate the feasibility of the training model

-Troubleshoot identified concerns

-Implement and evaluate services within Little Havana to increase access and possibly reduce stigma

Primary Care PCIT

The Identified Problems:

- Some families with young children (0-3) at Uhealth/Jackson pediatric practices unwilling to attend parenting services within traditional provider setting (e.g., location, stigma)

- Intensity level for traditional parenting services not needed

- Permissive parenting

Primary Care PCIT Proposed Solution: Recruit Healthy Steps families to receive brief group-

based PCIT (Berkovits et al., 2010) within or near their pediatric practice.

The interprofessional partnership: PCIT + Healthy Steps for Young Children + Pediatric Practices

Implementation Plan:

- Healthy Steps Specialists recruit families based on assessment measures of parenting stress and parenting behaviors and/or physician or self-referral.

- Healthy Steps Specialists attend all Primary Care PCIT sessions to provide warm hand off and ongoing coordinated support

- Certified PCIT therapist provides Primary Care PCIT in English and Spanish to seven groups totaling approximately 30 families per year (16 families to date; 16% attrition rate)

- Families with continued parent training needs following Primary Care PCIT are linked to traditional PCIT services.

Integrating Interprofessional Behavioral Health

Develop mechanisms for integration of culturally sensitive behavioral health care systems within MCCD

Develop and evaluate interprofessional behavioral health programs

What other opportunities exist for promoting interprofessional

behavioral health care to the families we serve?

ReferencesBerkovits, M. D., O’Brien, K. A., Carter, C. G., & Eyberg, S. M. (2010). Early identification andintervention for behavior problems in primary care: A comparison of two abbreviated versions of parent–child interaction therapy. Behavior Therapy, 41 (3), 375–387. doi:10.1016/ j.beth.2009.11.002

Chang, J., Natsuaki, M. N., & Chen, C. N. (2013). The importance of family factors and generation status: mental health service use among Latino and Asian Americans. Cultural Diversity and Ethnic Minority Psychology, 19, 236. doi: 10.1037/a0032901

Kazdin, A. E. (2008). Evidence-based treatment and delivery of psychological services: Shifting our emphases to increase impact. Psychological Services, 5, 201-215.

Lyon, A. R., & Budd, K. S. (2010). A community mental health implementation of Parent-Child Interaction Therapy (PCIT). Journal of Child and Family Studies, 19, 654-668. DOI: 10.1007/s10826-010-9353-z

Niec, L.N., Acevedo-Polakovich, I.D., Abbenante-Honold, E.S., Christian, A.S., Barnett, M.L., & Peer, S.O. (2014). Working together to solve disparities: Latina/o parents’ contributions to the adaptation of a preventive intervention, Psychological Services. 11(4). 410-20. doi: 10.1037/a0036200

Werba, B., Eyberg, S. M., Boggs, S. R., & Algina, J. (2006). Predicting the outcome of parent–child interaction therapy: Success and Attrition. Behavior Modification, 30, 618–646. doi:10.1177/0145445504272977.