3 - (SYM 60) PCIT for Middle Childhood (PCIT-MC): Summary of a Standardized Protocol and Transdiagnostic Pilot Trial Results

Child conduct problems and related diagnoses and treatment referrals peak in middle childhood (i.e., ages 6–11; Ghandour et al., 2019), a period with unique biopsychosocial development and treatment considerations (DelGiudice, 2018; Forcino et al., 2019). Indeed, meta-analyses indicate that behavioral parent training (BPT) programs typically outperform individual treatments (e.g., CBT) for youth in middle childhood (Helander et al., 2024; McCart et al., 2006), but that extant BPTs are less effective for these school-aged youth versus preschoolers (Leijten et al., in press)–particularly when conduct problems are comorbid with internalizing symptoms (Weisz et al., 2017). Consequently, there is a need to develop and validate more effective, transdiagnostic behavioral treatments for youth in middle childhood (Weisz et al., 2023). This presentation will summarize one promising option, namely a standardized, developmental adaptation of Parent-Child Interaction Therapy (PCIT; Eyberg & Funderburk, 2011); i.e., PCIT for Middle Childhood (PCIT-MC; Peer et al., 2019). PCIT-MC includes a developmentally tailored Child-Directed Interaction phase and an adapted Parent-Directed Interaction phase that replaces standard PCIT’s time-out procedure with a response cost-incorporated token economy. This presentation will outline this protocol’s novel adaptations, its developmental need, and its growing empirical support, including outcomes of PCIT-MC’s first pilot trial (N = 13 youth ages 7–11). Results included large, clinically significant pre- to post-treatment improvements in child conduct problems (g = 1.54), internalizing symptoms (g = 1.14), psychosocial competencies (g = 1.18), and parenting skills (gs = 1.25–4.89), with high treatment acceptability (e.g., 92.3% completion). Single-case meta-analyses indicated that PCIT-MC outperformed PCIT’s standard protocol with middle childhood youth (gs = 1.32–2.11) and non-PCIT benchmarks. Additionally, PCIT-MC’s outcomes for autistic and allistic youth were equivalent. Moreover, phase-targeted parenting changes significantly predicted child behavior change during PCIT-MC (|r|s = .75–.99), and siblings of PCIT-MC-treated youth also experienced clinically significant, transdiagnostic improvements. These results suggest PCIT-MC is an efficacious transdiagnostic extension of PCIT for youth in middle childhood, with related implications for research and clinical practice for elementary-aged youth.