Poster #59 - Predicting Mental Health Services Use in Children Referred to Parent–Child Interaction Therapy.

• In Event: 3-106 - Poster Session 11
  In Poster Session: PS 11 Section - Developmental Psychopathology

Integrative Statement

This study examines mental health (MH) services use annually across a 5-year period in children with and without histories of maltreatment referred to Parent–Child Interaction Therapy (PCIT) with their mothers on a voluntary or court-mandated basis. Maltreatment and externalizing behaviors in childhood predict MH problems in adolescence and adulthood (Campbell, 2000). PCIT has been found to be effective in reducing children’s externalizing behaviors, including in maltreating dyads (Chaffin et al., 2004). No study has examined the role of maltreatment, level of externalizing behaviors, and exposure to PCIT in long-term use of clinical services in children. Additionally, this study contributes to the long-standing debate on the effectiveness of court-mandated treatment (Snyder & Anderson, 2009).
We hypothesized that regardless of referral type, (H1) history of maltreatment and (H2) higher levels of externalizing behavior would predict more months in MH services in the first year after PCIT discharge; (H3) a higher dose of exposure to PCIT would predict fewer months in treatment during the first year after PCIT discharge. An additional research question concerned overall stability of MH service use over the five years post-PCIT and whether it differed by referral type. Child age was also examined by the type of referral as a predictor of MH services use.
Participants were 321 children between the ages of two and seven, referred to PCIT with their biological mothers. Just under half of all children (N = 144; 44.9%) referred to PCIT used other clinical programs after PCIT discharge. All data were collected during delivery of PCIT in a clinical setting. Maltreatment information was obtained from clinical case files; externalizing behaviors were pulled from CBCL (Achenbach & Rescorla, 2001), BPSI-SF-4 (Abidin, 1995), and ECBI (Eyberg & Pincus, 1999). The data on months in MH service use after PCIT were aggregated from treatment tracking system “Avatar”. Multi-group structural equation modeling (SEM) was used for the analyses (see Figures 1 & 2).
Results showed that 1) in both voluntary and court-mandated groups, maltreatment history positively predicted the number of months spent in MH treatment the first year post PCIT, and indirectly predicted use of services in the second year post PCIT, but not in any other subsequent year; 2) externalizing behavior scores at the start of PCIT positively predicted MH services use in the first year after PCIT, but only indirectly predicted such use in the second year post PCIT for court-mandated dyads; and 3) the dose of exposure to PCIT did not predict MH services use in either group. The overall trend of MH service use after PCIT discharge showed high stability: the best predictor of months spent in treatment in each consecutive year was the number of months spent in treatment in the previous year. Additionally, for court-mandated dyads, younger children had less exposure to PCIT. Compared to older children in voluntary dyads, younger children referred to PCIT spent more time in MH interventions in the 5th year post PCIT. The implications of these findings for clinical and developmental research will be discussed.

Authors

• Maria Usacheva, UC Davis
  Presenting Author

• Susan G Timmer, UC Davis CAARE Center
  Non-Presenting Author

• Daniel Ewon Choe, University of California, Davis
  Non-Presenting Author