PCIT: Conceptualizing a continuum of prevention

Strengthening the parent-child relationship in early childhood has the potential to serve as a buffer against multiple negative developmental outcomes. Waiting until problems are pervasive or severe can be more costly, and most families in need of treatment do not receive it. Prevention models offer the possibility of reaching more families and building resilience prior to the onset of debilitating mental health issues. This chapter reviews research on existing PCIT-based prevention models across the continuum from universal to indicated prevention and describes in detail Family Camp, a selective prevention model designed to be implemented by natural helpers (i.e., lay health workers or other community members). Key adaptations of the Family Camp model include (1) reducing the intensity of the intervention for children with subclinical problem behaviors, (2) user-friendly materials that facilitate implementation by natural helpers, (3) increased focus on fathers and the importance of the father-child relationship, (4) intentional discussion about heritage and culture to address acculturation-related challenges, and (5) guidelines to increase the portability of the intervention within community settings. Finally, we offer recommendations for the future directions in the development, research, and implementation of PCIT prevention models, with a focus on developing a continuum of care.