Barriers to Clinician Implementation of Parent–Child Interaction Therapy (PCIT) in New Zealand and Australia: What Role for Time-Out?

Background: Parent–Child Interaction Therapy (PCIT) is an effective parent training approach for a commonly occurring and disabling condition, namely conduct problems in young children. Yet, despite ongoing efforts to train clinicians in PCIT, the intervention is not widely available in New Zealand and Australia. Methods: We undertook a cross-sectional online survey of clinicians in New Zealand and Australia who had completed at least the 40-h initial PCIT training, to understand the barriers they encountered in their implementation efforts, and the extent to which attitudes toward time-out influenced implementation. The overall response rate was 47.5% (NZ: 60%; Australia: 31.4%). Results: Responses suggested that participants generally viewed PCIT as both acceptable and effective. Australian participants reported seeing significantly more clients for PCIT per week than those in NZ (Medians 0 and 2, respectively; χ2(1) = 14.08, p < 0.001) and tended to view PCIT as more effective in treating disruptive and oppositional behaviour (95% CI: −0.70, −0.13, p = 0.005). Participants currently seeing PCIT clients described it as more enjoyable to implement than those not using PCIT (95% CI: −0.85, −0.10, p = 0.01). Thirty-eight percent of participants indicated that they adapt or tailor the standardised protocol, primarily by adding in content relating to emotion regulation, and removing content relating to time-out. Participants generally felt that they had fewer skills, less knowledge, and less confidence relating to the Parent-Directed Interaction phase of PCIT (which involves time-out), compared with the Child-Directed Interaction phase. Conclusion: While we had hypothesised that time-out represented an intra-intervention component that detracted from implementation success, results suggested that clinician concern over the use of time-out was present but not prominent. Rather, the lack of access to suitable equipment (i.e., one-way mirror and ear-piece) and difficulties associated with clients attending clinic-based sessions were barriers most commonly reported by clinicians. We suggest that future research might consider whether and how PCIT might be “re-implemented” by already-trained clinicians, moving beyond simply training more clinicians in the approach.

PCIT engagement and persistence among child welfare-involved families: Associations with harsh parenting, physiological reactivity, and social cognitive processes at intake

Parent-Child interaction therapy (PCIT) has been shown to improve positive, responsive parenting and lower risk for child maltreatment (CM), including among families who are already involved in the child welfare system. However, higher risk families show higher rates of treatment attrition, limiting effectiveness. In N = 120 child welfare families randomized to PCIT, we tested behavioral and physiological markers of parent self-regulation and socio-cognitive processes assessed at pre-intervention as predictors of retention in PCIT. Results of multinomial logistic regressions indicate that parents who declined treatment displayed more negative parenting, greater perceptions of child responsibility and control in adult–child transactions, respiratory sinus arrhythmia (RSA) increases to a positive dyadic interaction task, and RSA withdrawal to a challenging, dyadic toy clean-up task. Increased odds of dropout during PCIT's child-directed interaction phase were associated with greater parent attentional bias to angry facial cues on an emotional go/no-go task. Hostile attributions about one's child predicted risk for dropout during the parent-directed interaction phase, and readiness for change scores predicted higher odds of treatment completion. Implications for intervening with child welfare-involved families are discussed along with study limitations.

PCIT engagement and persistence among child welfare-involved families: Associations with harsh parenting, physiological reactivity, and social cognitive processes at intake

Parent-Child Interaction Therapy (PCIT) has been shown to improve positive, responsive parenting and lower risk for child maltreatment (CM), including among families who are already involved in the child welfare system. However, higher-risk families show higher rates of treatment attrition, limiting effectiveness. In N = 120 child welfare families randomized to PCIT, we tested behavioral and physiological markers of parent self-regulation and socio-cognitive processes assessed at pre-intervention as predictors of retention in PCIT. Results of multinomial logistic regressions indicate that parents who declined treatment displayed more negative parenting, greater perceptions of child responsibility and control in adult-child transactions, respiratory sinus arrhythmia (RSA) increases to a positive dyadic interaction task, and RSA withdrawal to a challenging, dyadic toy clean-up task. Increased odds of dropout during PCIT’s Child-Directed Interaction phase were associated with greater parent attentional bias to angry facial cues on an Emotional Go/No-Go task. Hostile attributions about one’s child predicted risk for dropout during the Parent-Directed Interaction phase, and readiness for change scores predicted higher odds of treatment completion. Implications for intervening with child welfare-involved families are discussed along with study limitations.

PCIT engagement and persistence among child welfare-involved families: Associations with harsh parenting, physiological reactivity, and social cognitive processes at intake

Parent-Child Interaction Therapy (PCIT) has been shown to improve positive, responsive parenting and lower risk for child maltreatment (CM), including among families who are already involved in the child welfare system. However, higher-risk families show higher rates of treatment attrition, limiting effectiveness. In N = 120 child welfare families randomized to PCIT, we tested behavioral and physiological markers of parent self-regulation and socio-cognitive processes assessed at pre-intervention as predictors of retention in PCIT. Results of multinomial logistic regressions indicate that parents who declined treatment displayed more negative parenting, greater perceptions of child responsibility and control in adult-child transactions, respiratory sinus arrhythmia (RSA) increases to a positive dyadic interaction task, and RSA withdrawal to a challenging, dyadic toy clean-up task. Increased odds of dropout during PCIT’s Child-Directed Interaction phase were associated with greater parent attentional bias to angry facial cues on an Emotional Go/No-Go task. Hostile attributions about one’s child predicted risk for dropout during the Parent-Directed Interaction phase, and readiness for change scores predicted higher odds of treatment completion. Implications for intervening with child welfare-involved families are discussed along with study limitations.

284 Effect of formulating diets based on a ratio between STTD Ca and STTD P and the inclusion of phytase on growth performance, plasma Ca and P, and bone ash of pigs from 11 to 130 kg

A 126-d experiment was conducted to test the hypothesis that the requirement for Ca expressed as a ratio between standardized total tract digestible (STTD) Ca and STTD P obtained in short-term experiments may be applied to pigs fed diets without or with microbial phytase from 11 to 130 kg. In a 5-phase program, 160 pigs (11.2 ± 1.8 kg) were randomly allotted to 32 pens and 4 corn-soybean meal diets in a 2 × 2 factorial design with 2 formulation strategies (total Ca or STTD Ca), and 2 phytase levels (0 or 500 units/kg) assuming phytase released 0.11% STTD P and 0.16% total Ca. The STTD Ca:STTD P ratios were 1.40:1, 1.35:1, 1.25:1, 1.18:1, and 1.10:1 for phases 1 to 5. At the conclusion of each phase, weights of pigs and feed left in feeders were recorded and a blood sample from 1 pig per pen was collected. At the end of phases 1 (d 24) and 5, the right femur of 1 pig per pen was collected. Data were analyzed as main effects of formulation strategy and phytase level and their interaction. Phase effect was analyzed by repeated measures. No interactions were observed and formulation strategy and phytase did not impact growth performance, bone ash, or plasma Ca and P on d 24 (Table 1). On d 126, an interaction (P &lt; 0.05) between main effects was observed. Without phytase, pigs fed diets based on total Ca had greater bone ash than STTD Ca pigs, but with phytase, no differences were observed. A negative quadratic effect (P &lt; 0.05) of phase for plasma Ca and P was observed. In conclusion, STTD Ca:STTD P ratios can be used in diet formulation for growing-finishing pigs without affecting growth performance. Phytase ameliorates bone resorption caused by low Ca in STTD Ca diets.

The sensitivity to context modulates executive control: Evidence from Malayalam–English bilinguals

In two experiments, we examined the hypothesis that bilingual speakers modulate their cognitive control settings dynamically in the presence of different interlocutors, and this can be captured through performance on a non-linguistic attention task. We introduced Malayalam–English bilinguals to interlocutors with varying L2 dominance through a pre-experiment familiarisation and interaction phase. Later, participants did the Flanker task while the interlocutors appeared before each trial. While in experiment one participants did the Flanker task with equal distribution of trials, in experiment two we manipulated the monitoring demands by changing the frequency of trials. Results showed that high-L2 proficient bilinguals had lower conflict effect on the Flanker task in the presence of balanced interlocutors in both the experiments. The results provide strong evidence of dynamic adaptation of control settings in bilinguals with regard to different passively present interlocutors. The results further extend the predictions of the adaptive control hypothesis with novel manipulation.

KOMUNIKASI TERAPEUTIK DALAM KONSELING ANTARA KONSELOR DAN PASIEN PENYALAHGUNAAN NARKOBADI KLINIK BADAN NARKOTIKA NASIONAL PROVINSI JAWA BARAT

The purpose of this study was to determine Therapeutic Communication in Counseling between Counselors and Drug Abuse Patients. To answer the research objectives, the four focus of the researcher, namely the pre-interaction phase, the orientation phase, the working phase, and the termination phase of Counselor Therapeutic Communication in Rehabilitating Drug Abuse Patients at the National Narcotics Agency Clinic of West Java Province.This study uses qualitative research methods with descriptive studies. The number of informants in this study were four people, consisting of three key informants and one supporting informant. Data collection techniques used in this study are literature study, internet searching, indepth interviews, non-participant observation and documentation.The results of research conducted by the Clinical Counselor of the National Narcotics Board of West Java Province are the pre-interaction phase where the counselor studies patient data. The orientation phase in which the counselor performs the Screening approach and builds trusting relationships with the patient and the Assessment of the counselor ensures patient safety as well as establishes a counseling service plan, and a termination phase where a drug abuse counseling service has been completed and will be referred to post-rehabilitation