Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Date of Graduation

5-12-2022

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Department of Graduate Psychology

Advisor(s)

Trevor F. Stokes

Elena Savina

Bernice Marcopulos

Abstract

Traumatic brain injuries (TBIs) in childhood have been associated with disruptive behaviors and attentional problems that may worsen over time and are often experienced as challenging for those in caregiving roles. Parents of children with TBI may evoke negative interactions to manage their child’s behavior through reliance on ineffective parenting practices. This results in increasingly maladaptive parent-child interactions that maintain or worsen problem behaviors of the child and further disrupt family functioning. Despite the importance of family functioning on child post-injury outcomes, the availability of family-based treatments for children with TBI is extremely limited. Parent-Child Interaction Therapy (PCIT) is an empirically supported treatment for young children with oppositional and disruptive behaviors. Although children with TBI experience similar deficits in attention and behavioral regulation, research is lacking in supporting PCIT outcomes specifically for children with TBI. This research evaluated adaptations to the standard PCIT protocol that may benefit treatment of parents and their children with TBI. Using a multiple-baseline design, the current study examined the effectiveness of telehealth-delivered PCIT in the home setting for a 9-year-old child with TBI and co-occurring behavioral and attentional difficulties. Adaptations were consistent with the recommendations set forth by Eyberg (2005) and maintained the conceptual integrity of PCIT by keeping the theoretical and empirical foundation while adding components to target the unique challenges of the pediatric TBI population. Meaningful, observable changes were shown in parent behaviors in addition to improved parent-child interactions. Positive changes in the child’s compliance to parent directions were observed and reported by parents. A reduction in parent perception of behavior problem frequency and parent-reported satisfaction with treatment goals, procedures, and outcomes also support clinically meaningful results.

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