The Effectiveness of Parent-Child Interaction Therapy for Victims of Interparental Violence
Timmer, Susan G., Ware, Lisa M., Urquiza, Anthony J., Zebell, Nancy M., Violence and Victims
This study compares the effectiveness of Parent-Child Interaction Therapy (PCIT) in reducing behavior problems (e.g., aggression, defiance, anxiety) of 62 clinic-referred, 2- to 7-year-old, maltreated children exposed to interparental violence (IPV) with a group of similar children with no exposure to IPV (N = 67). Preliminary analyses showed that IPV-exposed dyads were no more likely to terminate treatment prematurely than non IPV-exposed dyads. Results of repeated-measures MANCOVAs showed significant decreases in child behavior problems and caregivers' psychological distress from pre- to posttreatment for IPV-exposed and IPV nonexposed groups, and no significant variation by exposure to IPV. Stress in the parent role related to children's difficult behaviors and the parent-child relationship decreased from pre- to posttreatment, but parental distress did not decrease significantly over the course of PCIT. Results of an analysis testing the benefits of a full course of treatment over the first phase of treatment showed that dyads completing the full course of treatment reported significantly greater improvements in children's behavior problems than those receiving only the first phase of treatment.
Keywords : interparental violence ; parent-child interaction therapy ; treatment outcomes
Children exposed to interparental violence (IPV) are considered at risk for adverse outcomes because of the heightened likelihood of being maltreated themselves ( Jaffe, Wolfe, & Wilson, 1990 ), the trauma and distress connected with witnessing chronic interparental violence ( Graham-Bermann & Levendosky, 1998 ), and the disruption of the parent-child relationship ( Erel & Burman, 1995 ; Margolin, Gordis, Medina, & Oliver, 2003 ). Mega- and meta-analyses of research on children with chronic exposure to IPV show that these children have more externalizing behavior problems (e.g., aggressive, defiant, destructive behavior), depression, and other psychopathology compared to children with no exposure to IPV ( Sternberg, Baradaran, Abbott, Lamb, & Guterman, 2006 ; Wolfe, Crooks, Lee, McIntyre-Smith, & Jaffe, 2003 ). Furthermore, without intervention, the effects of exposure to interparental violence (IPV) have been found to persist, relating to risks of delinquent behavior in adolescence ( Carlson, 1990 ) and violent behavior in adulthood ( Sugarman & Hotaling, 1989 ). The purpose of this study is to examine the effectiveness of Parent-Child Interaction Therapy (PCIT) in meeting the needs of mother-child dyads exposed to IPV by reducing children's behavior problems and decreasing mothers' distress.
There is little consensus among domestic violence experts on suitable treatments for children exposed to IPV ( Davies & Krane, 2006 ). This lack of consensus likely results from the tension between advocates for mothers experiencing intimate partner violence and advocates for their children. Interviews of child protection workers and advocates for women with a history of intimate partner violence conducted by Beeman, Hagemeister, and Edleson (1999) revealed that the child protection workers were likely to hold mothers accountable for children's safety. In contrast, women's advocates' believed that mothers should set their own goals and make their own decisions about their family's safety. Furthermore, advocates of women with a history of intimate partner violence argue that children's mental health needs should not be separated from those of their mothers ( Davies & Krane, 2006 ), while child advocates argue that the mothers' noncompliance with safety plans contributes to children's mental health problems ( Beeman, et al., 1999 ). Other scholars argue that both camps oversimplify a set of varied and complex family dynamics, instead advocating a "both/and" approach (e.g., Buchbinder & Eisikovits, 2004 ; Goldner, Penn, Sheinberg, & Walker, 1990 ).
As outlined by Goldner et al. …