presentation

Links between prevention of child physical abuse & prevention of antisocial behavior : Links between prevention of child physical abuse & prevention of antisocial behavior With special attention for Parent Child Interaction Therapy Marianne Junger Developmental Psychology UU M.Junger@uu.nl


Plan : Plan Links in research 1. Relationships between victimization & offending Links in prevention 2. Primary prevention: Nurse-Family Partnership 3. Secondary prevention: PCIT


1. Relationships between victimization & offending : 1. Relationships between victimization & offending 1.1 Risk factors: overlap


1.1 Risk factors for externalizing behavior, neglect & physical abuseChild factors : 1.1 Risk factors for externalizing behavior, neglect & physical abuse Child factors


1.1 Risk factors for externalizing behavior, neglect & physical abuseParent factors : 1.1 Risk factors for externalizing behavior, neglect & physical abuse Parent factors


1.1 Risk factors for externalizing behavior, neglect & physical abuseBackground mother : 1.1 Risk factors for externalizing behavior, neglect & physical abuse Background mother


1. Relationships between victimization & offending : 1. Relationships between victimization & offending Similar risk factors Processes are unclear Parenting: lack of affection Lack of adequate discipline Parental stress


1. Relationships between victimization & offending : 1. Relationships between victimization & offending 1.2 Offenders tend of be victims many studies Conclusions


Relationships between victimization & offending : Relationships between victimization & offending Conclusion Overlap in risk factors At individual level: overlap If one can prevent one, one also prevents the other?


Plan : Plan Links in research 1. Relationships between victimization & offending Links in prevention 2. Primary prevention: Nurse-Family Partnership 3. Secondary prevention: PCIT


2. Primary prevention: Nurse-Family Partnership : 2. Primary prevention: Nurse-Family Partnership 3 RCT’s For teenage pregnant women: Predominantly low-income, unmarried mothers, first-born children During 2 first years of baby’s life A nurse visits mother every 2 weeks for + 3 years Improve health and functioning mother and child Flexible


Primary prevention: Nurse-Family PartnershipSocial behavior: results : Primary prevention: Nurse-Family Partnership Social behavior: results Olds, D., Charles R. Henderson, J., Cole, R., Eckenrode, J., Kitzman, H., Luckey, D., et al. (1998). Long-term Effects of Nurse Home Visitation on Children's Criminal and Antisocial Behavior: 15-Year Follow-up of a Randomized Controlled Trial. Journal of the American Medical Association, 280(14), 1238-1244.


Primary prevention: Nurse-Family PartnershipResults : Primary prevention: Nurse-Family Partnership Results After 15 years 79% reduction in child abuse and neglect PILOT in Netherlands “programma voorzorg” RCT: Fran van Leerdam (VU)


Plan : Plan Links in research 1. Relationships between victimization & offending Links in prevention 2. Primary prevention: Nurse-Family Partnership 3. Secondary prevention: PCIT


Secondary prevention: PCITDiagnosis : Secondary prevention: PCIT Diagnosis Developed by Sheila Eyberg (Univ. of Florida) Children with behavior problems Often ADHD as well


Secondary prevention: PCITCharacteristics : Secondary prevention: PCIT Characteristics What Happens? Use of one-way mirror In-vivo coaching Two phases (not time limited) Relationship Enhancement Phase Discipline Phase Research based Collection of data: questionnaires and videoed interactions Treatment vs. supported waitlist


Secondary prevention: PCITGOALS : Secondary prevention: PCIT GOALS Child-directed interaction: CDI Strengthen parent-child relationship Parent-directed interaction: PDI Controlling child behavior: Adequate discipline


Secondary prevention: PCITCDI : Secondary prevention: PCIT CDI PRIDE Skills Praise the child Reflect the child’s statements Imitate the child’s play Describe the child’s behaviour Enthusiastic play Ignore inappropriate behaviour (unless dangerous or destructive) Avoid asking questions, giving commands and criticizing


Secondary prevention: PCITPDI : Secondary prevention: PCIT PDI Specific Skills Be specific with commands Every command stated positively Respectful and polite Essential commands only Tone of voice neutral


Secondary prevention: PCITPDI : Secondary prevention: PCIT PDI Specific PDI Skill: Time out procedure Use of time out chair Time out room Until child cooperates


3. Secondary prevention: PCITPDI : 3. Secondary prevention: PCIT PDI Effects Eyberg Child Behavior Inventory – ECBI After two years


ECBI Intensity Scores  and 2-Year Effect Size : ECBI Intensity Scores and 2-Year Effect Size 2.32 1.Eyberg SM, Funderburk BW, Hembree-Kigin TL, McNeil CB, Querido JG, Hood K. Parent-child interaction therapy with behavior problem children: One and two year maintenance of treatment effects in the family. Child and Family Behavior Therapy. 2001;23:1-20.


3. PCIT for Physically abused children : 3. PCIT for Physically abused children Chaffin & colleagues Three groups PCIT N=42 PCIT Enhanced N=33 Control group N=35 Attrition PCIT groups (resp.): 24% & 18% CC: 48%


3. PCIT for Physically abused children : 3. PCIT for Physically abused children Chaffin & colleagues After 850 days: re-occurrence PA 34% overall again PA-reports


3. PCIT for Physically abused children : 3. PCIT for Physically abused children Chaffin M, Silovsky JF, Funderburk B, et al. Grant final report: physical abuse treatment outcome project: Application of parent-child interaction therapy (pcit) to physically abusive parents. 25. Available at: http://ccan.ouhsc.edu/FINAL%20REPORT.pdf.


PCIT In the Netherlands : PCIT In the Netherlands PI-research & De Bascule (Amsterdam) Frederique Coelman, Ron Heinrich Translates + pilot implementation Research UU


Conclusions : Conclusions Links in research Relationships between victimization & offending Links in prevention 2. Primary prevention: Nurse-Family Partnership Secondary prevention: PCIT Both help for externalizing behavior For child physical abuse


Slide28 : Thank you for your attention Any questions