Can 'Live Coaching' of Parents Help Behaviour Problems?

Can ‘Live Coaching’ of Parents Help Manage Behaviour Problems in Children?

Can conduct problems in children be resolved with parents wearing an earpiece and being coached by an expert on what to say to their child?

This is one of the defining features of a parent training programme that’s been running in Auckland since 2010. The programme known as Parent-Child Interaction Therapy (PCIT) has been shown to work overseas, but until now has not been robustly evaluated for its effectiveness here.

Now, thanks to a $119,570 Foxley Fellowship grant from the Health Research Council of New Zealand (HRC), Auckland clinical psychologist and PCIT practitioner Dr Melanie Woodfield can finally test if the programme ‘sticks’ with those families who have tried it.

Dr Woodfield works with the Auckland District Health Board and is one of 16 recipients announced in the HRC’s latest career development awards, in the general category. Awarded in this category were five Sir Charles Hercus Health Research Fellowships, one Clinical Practitioner Research Fellowship, nine Clinical Research Training Fellowships and one Foxley Fellowship worth more than $5.5 million in total.

Dr Woodfield feels investment into effective, timely interventions like PCIT is vital. “It’s incredibly heart-warming to be given the time and space to do this research and the grant shows that children’s mental health is up there with other priorities for funding.”

PCIT is designed for children aged 2.5 – 7 years with conduct problems and other complex needs. “Some children have challenging behaviour that lasts beyond the ‘terrible twos’ and begins to have serious consequences, with difficulties that continue into adulthood,” says Dr Woodfield.

The PCIT programme originated in the United States and is widely used there, but in New Zealand it is only available through a handful of services, including a clinic established by Dr Woodfield and a colleague in 2013 within Auckland’s Kari Centre. As it stands, the service is only accessed by those referred to Auckland District Health Board’s Child and Adolescent Mental Health Services.

Dr Woodfield aims to determine the effectiveness of the programme by following up families that have completed it, as well as exploring how more families can access this unique intervention.

As part of the programme, parents wear an earpiece and interact with their child in a specific way while a highly-trained clinician provides live support and immediate feedback from behind a one-way mirror.

Towards the end of treatment, the clinician accompanies the parent and child on a public outing (with the parent wearing the earpiece discretely) to encourage skills to generalise beyond the clinic. Siblings are also included in later sessions, to help parents manage the relationship between their children.

Another thing that sets PCIT apart from other parenting programmes, says Dr Woodfield, is that parents can only move to the second part of the programme if they have reached ‘mastery’ of the first components.

Dr Woodfield hopes to explore ways to modify the programme so it can be accessible to more families. Childhood conduct problems have been shown to lead to a wide spectrum of adverse adult mental and physical health outcomes. “Early intervention could be the key to preventing major adult psychiatric disorders,” she says.

She also notes that interventions for young children are a lot less costly and more successful than interventions for older adults, where treatment becomes more complex. “A small investment in young children with challenging behaviour can pay significant dividends in later years – for the child, their family and for society.”

HRC Chief Executive Professor Kath McPherson says early interventions that actually do help ‘early' are key to reducing the burden on families and whānau at such a key time for childhood development, as well as reducing the burden on mental health services in New Zealand.

“We need to respond to the current and future needs of our population. New Zealand is now very aware of the crucial importance of mental health and wellbeing and innovative measures like these warrant good investigation and attention.”

See below for the list of all recipients in the HRC’s general career development awards category. Lay summaries of research projects will be available on the HRC website on Tuesday 31st October.

Visit www.hrc.govt.nz/funding-opportunities/recipients and filter for ‘Career development awards’ and ‘2018’.

2018 HRC Career Development Awards

Foxley Fellowship

Dr Melanie Woodfield, Auckland DHB

Optimising parent-child interaction therapy for childhood conduct problems

24 months, $119,570

Sir Charles Hercus Health Research Fellowship

Dr Htin Lin Aung, University of Otago, Dunedin

Combatting tuberculosis at local and international frontlines

48 months, $500,000

Dr Lisa Connor, Victoria University of Wellington

Impact of microenvironment on dendritic cell function

48 months, $500,000

Dr Hamish Jamieson, University of Otago, Christchurch

Big data – Creating new insights into heart failure

48 months, $500,000

Dr Michael Pankhurst, University of Otago, Dunedin

Bi-modal anti-Müllerian hormone signalling in the ovary

48 months, $500,000

Dr Daniel Ribeiro, University of Otago, Dunedin

Process evaluation of trials: maximising the potential for implementation

48 months, $498,919

Clinical Practitioner Research Fellowship

Dr Deborah Snell, Canterbury DHB

Management of psychological factors after mild traumatic brain injury

60 months, $412,831

Clinical Research Training Fellowship

Ms Varsha Asrani, University of Auckland

Developing a gut dysfunction scoring tool in critical illness

48 months, $317,420

Dr Ahmed Barazanchi, University of Auckland

Development and application of a risk prediction tool for emergency laparotomy

24 months, $204,737

Dr William Good, Auckland DHB (host: Counties Manukau DHB)

The role of a sublingual bacterial vaccine in adult bronchiectasis patients

36 months, $319,500

Dr Rebecca Griffith, University of Auckland

Long-term outcomes of children born at risk of neonatal hypoglycaemia

30 months, $248,380

Dr Sharon Leitch, University of Otago, Dunedin

Improving patient safety in New Zealand general practice

36 months, $320,000

Dr Wiremu MacFater, University of Auckland

Perioperative local anaesthetic

24 months, $210,236

Dr Gemma Poke, University of Otago, Wellington

Genetic characterisation of the epileptic encephalopathies

36 months, $320,000

Dr Clinton Turner, Auckland DHB

The prognostic significance of immune cell infiltrates in meningioma

48 months, $237,430

Dr Mark Zhu, University of Auckland

Designing and using animal models to improve tendon healing

36 months, $313,820

ENDS

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