Parenting Stress across Time-Limited Parent-Child Interaction Therapy

Caregivers of children with disruptive behavior problems often experience elevated parenting stress. Parent-child interaction therapy (PCIT), an evidence-based treatment for disruptive behavior problems, teaches caregivers behavior management strategies that target problem behaviors and improve the caregiver-child relationship. Although extensive evidence documents PCIT's effectiveness in treating child behavior problems, few studies have focused on caregiver outcomes in a time limited implementation of PCIT. We explored parenting stress trajectories across time limited weekly PCIT (1 session/week over 18 weeks). Caregivers (n = 64) completed assessments at 4 time points (baseline, mid-way through treatment, post treatment, 1-month following treatment), including measures of parenting stress and child behavior problems. Multilevel models (MLM) were used to examine change in parenting stress domains over time; specifically, the stress related to parenting a difficult child, parent-child dysfunctional interactions, and parental distress. After controlling for demographic and treatment variables, MLMs indicated that parent distress decreased during treatment, but there was no significant change in stress related to parenting a difficult child or parent-child dysfunctional interactions. Across domains, child behavior remained a consistent, significant predictor of parenting stress. Results suggest that overall PCIT reduces parenting stress, but a subset of caregivers may continue to have some difficulty managing interactions with their children after treatment. Findings also indicate that PCIT may target parenting stress domains differentially, which remain important targets for screening and intervention.