Coaching Alternative Parenting Strategies (CAPS) Study
| Status: | Enrolling by invitation |
|---|---|
| Healthy: | No |
| Age Range: | 3 - Any |
| Updated: | 10/28/2017 |
| Start Date: | February 2016 |
| End Date: | January 2020 |
Coaching Alternative Parenting Strategies (CAPS) Study: Targeting Neurobiological and Behavioral Mechanisms of Self-regulation in High-risk Families
This is a randomized, controlled trial of Parent-Child Interaction Therapy (PCIT) designed to
test the effects of PCIT on self-regulation and behavior in child maltreating (CM) parents
and their elementary-school children. Two hundred-fifty (250) maltreating mothers and their
children (age 5-8 years) will be drawn from Child Protective Services and randomized to the
PCIT intervention or a control condition (services as usual). Key contextual risk factors
will be assessed, including cumulative risk, parent mental health, and parent substance use.
A multirater, multimethod approach to assessment will include measures of self-regulation,
parenting skills and children's behavior outcomes. Families will be followed to 1 year for CM
recidivism. Findings from this proposed study are expected to have significant implications
for optimizing CM parenting interventions by (a) determining the sensitivity of CM parent and
child neurobehavioral self-regulation systems to intervention, and (b) identifying individual
differences in self-regulation that mediate and moderate response to intervention and
long-term maintenance of gains.
test the effects of PCIT on self-regulation and behavior in child maltreating (CM) parents
and their elementary-school children. Two hundred-fifty (250) maltreating mothers and their
children (age 5-8 years) will be drawn from Child Protective Services and randomized to the
PCIT intervention or a control condition (services as usual). Key contextual risk factors
will be assessed, including cumulative risk, parent mental health, and parent substance use.
A multirater, multimethod approach to assessment will include measures of self-regulation,
parenting skills and children's behavior outcomes. Families will be followed to 1 year for CM
recidivism. Findings from this proposed study are expected to have significant implications
for optimizing CM parenting interventions by (a) determining the sensitivity of CM parent and
child neurobehavioral self-regulation systems to intervention, and (b) identifying individual
differences in self-regulation that mediate and moderate response to intervention and
long-term maintenance of gains.
Child maltreatment (CM) constitutes a serious public health problem in the United States and
is known to compromise children's developing self-regulation skills and amplify risk for
substance use and other regulatory disorders. Parent-Child Interaction Therapy (PCIT), an
intensive, 20-session parenting intervention, has been shown to improve the quality of CM
parenting, improve positive parenting and child behavior, and produce declines in CM
recidivism (Chaffin et al., 2004) though the mechanisms underlying its effects are little
understood. This project addresses gaps in the CM intervention literature in that it (a) uses
an experimental intervention design to test a theoretical model of change underlying PCIT's
effects, (b) includes a battery of neurobehavioral measures of self-regulation, and (c) uses
observational measures of parenting in an RCT of an evidence-based intervention for
strengthening parent self-regulation, reducing CM, and supporting improvements in child
regulation and behavior. Study aims are to:
Aim 1: Test the main effects of PCIT on CM-specific outcomes, including reductions in harsh,
aversive parenting and CM recidivism and promotion of children's behavioral adjustment. It is
hypothesized that intervention families will show significantly greater behavior improvements
(i.e., decreased negative parenting, increased positive parenting, and decreased child
internalizing/externalizing problems) at posttest and lower CM recidivism at 6-month
follow-up, compared to families receiving services as usual (SAU).
Specific Aim 2: Determine the impact of PCIT on indices of CM parents' self-regulation.
First, the investigators will test the hypothesis that PCIT exerts direct effects on
improving CM parents' capacities for self-regulation in the context of parenting. Second, the
investigators will investigate how measures of self-regulation in parents mediate PCIT
intervention effects on reductions in CM and improvements in parenting. Third, the
investigators will explore whether parents' preintervention self-regulation levels moderate
intervention effects on outcomes. The moderating roles of CM subtype (i.e., physical abuse
vs. neglect), severity, and other key sociocontextual factors on the outcomes of interest
also will be considered.
Specific Aim 3: Investigate the impact of PCIT on neurobehavioral indices of CM children's
self-regulation. CM exerts detrimental effects on children's developing capacities to
regulate attention, emotion, physiology, and behavior. Deficits in these domains confer
heightened risk for psychopathology, early-onset conduct problems, and later substance abuse.
The investigators hypothesize that PCIT, though directed primarily toward parenting, will
effect improvements in neurobiological indicators of CM children's self-regulation at
post-treatment, relative to the control group. Next, the investigators will test the extent
to which child outcomes are mediated through intervention effects on parenting. It is
hypothesized that child regulatory deficits and behavior problems will be attenuated by
PCIT-based reductions in aversive parenting that result from the intervention.
is known to compromise children's developing self-regulation skills and amplify risk for
substance use and other regulatory disorders. Parent-Child Interaction Therapy (PCIT), an
intensive, 20-session parenting intervention, has been shown to improve the quality of CM
parenting, improve positive parenting and child behavior, and produce declines in CM
recidivism (Chaffin et al., 2004) though the mechanisms underlying its effects are little
understood. This project addresses gaps in the CM intervention literature in that it (a) uses
an experimental intervention design to test a theoretical model of change underlying PCIT's
effects, (b) includes a battery of neurobehavioral measures of self-regulation, and (c) uses
observational measures of parenting in an RCT of an evidence-based intervention for
strengthening parent self-regulation, reducing CM, and supporting improvements in child
regulation and behavior. Study aims are to:
Aim 1: Test the main effects of PCIT on CM-specific outcomes, including reductions in harsh,
aversive parenting and CM recidivism and promotion of children's behavioral adjustment. It is
hypothesized that intervention families will show significantly greater behavior improvements
(i.e., decreased negative parenting, increased positive parenting, and decreased child
internalizing/externalizing problems) at posttest and lower CM recidivism at 6-month
follow-up, compared to families receiving services as usual (SAU).
Specific Aim 2: Determine the impact of PCIT on indices of CM parents' self-regulation.
First, the investigators will test the hypothesis that PCIT exerts direct effects on
improving CM parents' capacities for self-regulation in the context of parenting. Second, the
investigators will investigate how measures of self-regulation in parents mediate PCIT
intervention effects on reductions in CM and improvements in parenting. Third, the
investigators will explore whether parents' preintervention self-regulation levels moderate
intervention effects on outcomes. The moderating roles of CM subtype (i.e., physical abuse
vs. neglect), severity, and other key sociocontextual factors on the outcomes of interest
also will be considered.
Specific Aim 3: Investigate the impact of PCIT on neurobehavioral indices of CM children's
self-regulation. CM exerts detrimental effects on children's developing capacities to
regulate attention, emotion, physiology, and behavior. Deficits in these domains confer
heightened risk for psychopathology, early-onset conduct problems, and later substance abuse.
The investigators hypothesize that PCIT, though directed primarily toward parenting, will
effect improvements in neurobiological indicators of CM children's self-regulation at
post-treatment, relative to the control group. Next, the investigators will test the extent
to which child outcomes are mediated through intervention effects on parenting. It is
hypothesized that child regulatory deficits and behavior problems will be attenuated by
PCIT-based reductions in aversive parenting that result from the intervention.
Inclusion Criteria:
- Resident of Lane County
- Parent is 18 or older
- Biological or custodial mother of a child between age 3 and 7 years at baseline
- Resides in the same home setting with the child
- Must be fluent in English
- Mom and child must be physically able to complete the assessment
- Family has an open case with Lane County Dept. Health Services.
Exclusion Criteria:
- Child sexual abuse in the family
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