How Caregiver Depression Impacts Therapist Coaching In Parent Child Interactive Therapy Emotional Development

Rosalia Charpentier, Kailey Collins, and Kailyn Patria

Abstract:
Introduction: Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) is the only evidence-based treatment that targets young children's depressive symptoms by coaching the caregiver during interactions with the child to enhance the caregiver's skill learning and improve children's symptoms. Previous research has shown that mothers who are clinically depressed and partake in PCIT-ED treatment with their child are more likely to report the child's behavioral problems as severe at the pre-treatment assessment. More research is needed on the impact of caregiver depression on PCIT-ED treatment processes. The current study will examine how caregivers' depressive symptoms may be associated with different therapist coaching techniques.

Method: The sample consisted of 119 families in a randomized controlled trial of PCIT-ED. The caregivers had an average age of 35.5 with children averaging around age 5.2 (77% were White, 11% Black, 12% more than 1 race). Caregiver depression was assessed with the Beck Depression Inventory II, consisting of 21 items reflecting symptoms of depression, rated on a 4-point scale. Therapist coaching was assessed with the Therapist-Parent Interaction Coding System (TPICS), a behavioral observation system that focuses on how the therapist communicates with and coaches the caregiver.

Results: Caregivers who reported higher levels of depression received more directive coaching, r(119) = .21, p=.02, including more prompting statements, r(119)=.31, p<.001, as well as direct commands, r(119)=.20, p=.03.

Discussion: These findings emphasize the importance of considering caregiver depression in order for therapist coaching to better help families.