JMIR Publications

ABSTRACT

Background:

Throughout years of research, the well-known BPT program Parent-Child Interaction Therapy (PCIT) has been adapted and enhanced to tailor the treatment to the needs of families in community-based clinical care. The current study similarly wished to evaluate an add-on to PCIT that could be engaging for parents. As a way to enlarge practice opportunity, and potentially allow parents to achieve positive treatment effects sooner, the current study added virtual reality (VR) to PCIT.

Objective:

We expected that PCIT-VR would ameliorate positive parenting skills at a faster pace, as practicing positive parenting skills in the VR-tool would increase their overall practice time, thus leading to more confidence in the skills which could consequently increase the pace of skill acquisition. Furthermore, we hypothesized that due to overall amelioration of positive parenting skills, PCIT treatment effects such as diminishment of child disruptive behavior and parenting stress would decrease at a faster pace when VR was introduced.

Methods:

Families were recruited from a specialized child and adolescent psychiatry clinical practice in the Netherlands. Using a Single-Case Experimental Design (SCED), eleven families signed informed consent and received the staggered introduction of VR to treatment. As common with a SCED, visual inspection analyses and randomization tests were conducted. Group differences were evaluated with non-parametric tests and reliable changes indices.

Results:

Overall, our study reaffirmed that PCIT is an effective intervention for this population as there were positive treatment effects found in almost all cases. Furthermore, we found that there did not seem to be a clear relationship between the use of the VR-tool and PCIT treatment effects, although positive parenting skills visibly seemed to increase when VR was introduced to treatment for some parents. For all parents, questions and commands decreased with the introduction of VR. The current findings tentatively suggest that practicing with VR could potentially increase positive parenting skills and it could potentially also have impact on other treatment-related outcomes, such as child disruptive behavior and parenting stress.

Conclusions:

As this was the first time that VR was supplementary to PCIT, we gave preliminary evidence to the added value of this skill practice tool. We can only cautiously suggest that VR could be of added value to PCIT to increase confidence in parenting skills for certain parents, although there are complex factors that play into treatment success that must simultaneously be taken into consideration. These factors include parents having the motivation and (mental) capacity to change, and the complex psychological problems some families face. Although promising, we believe that due to the novelty of our VR-practice tool and the variety of results from our study, more research is necessary into PCIT-VR to draw further conclusions on its effects.