Pilot Evaluation of Outcomes of Combined Parent-Child Cognitive-Behavioral Group Therapy for Families at Risk for Child Physical Abuse

Child physical abuse (CPA) is not only a highly prevalent public health problem, but it has been associated with a wide range of debilitating psychosocial sequelae that may develop during childhood and persist into adulthood. This paper outlines a treatment model. Combined Parent-Child Cognitive-Behavioral Therapy (CPC-CBT), that addresses the complex needs of the parent who engages in physically abusive behavior and the traumatized child. This pilot program was conducted to examine the feasibility of a CBT group approach that incorporates the child into the offending parent's treatment. It highlights the use of gradual exposure, developing a trauma narrative and abuse clarification to address PTSD symptoms in children. Parent components include motivational interviewing and consequence review, cognitive and behavioral anger-control strategies, and the examination of parent-child interactions to assist parents in modulating their emotions, remaining calm, and using effective problem-solving during child-rearing situations. Pilot data examining pre- to posttreatment changes for parents and children participating in the 16-week group treatment program are presented. Participants were 12 caregivers, ages 25 to 54, and their 21 children, ages 4 to 14, who were referred for the treatment of issues related to CPA. About 48% of participating parents were referred for substantiated CPA against their children, while the other parents were deemed to be at-risk for CPA. Both parents and children reported significant pre- to posttreatment reductions in the use of physical punishment. Results also demonstrated pre- to posttreatment improvements in parental anger their children, and consistent parenting as well as children's posttraumatic stress symptoms and behavioral problems. Clinical and research implications for these preliminary findings are discussed.