Selection and training of paraprofessionals in core parent-child interaction therapy skills

Families in need of behavior parent training (BPT) to address childhood conduct problems face numerous barriers to accessing evidence-based programs. An alternative delivery format with the potential to reduce service disparities involves training non-credentialed helpers (e.g., paraprofessionals, natural helpers) to administer BPTs with a prevention approach. This alternative has received little attention for the coaching-based BPT parent–child interaction therapy (PCIT). We sought to (a) identify selection factors that would predict PCIT therapist skills in a sample of non-credentialed helpers and (b) evaluate uptake of skills of non-credentialed helpers after a brief training. In Study 1, 62 undergraduate students with an interest in working with families provided information on their general learning ability, empathy, natural helping tendency, and knowledge of behavior principles. These constructs were used to predict performance on core PCIT therapist skill domains, including child-centered interaction skills, behavior observation coding, and parent coaching. In Study 2, 21 individuals from Study 1 were selected based on their knowledge of behavior principles (high, moderate, & low scores) to participate in a brief training in foundational PCIT therapist skills and again complete performance measures. Results revealed that learning ability and knowledge of behavior principles were the most consistent predictors of initial PCIT therapist skills. Non-credentialed helpers showed significant improvements in their PCIT therapist skill use with brief training, which has important implications for the potential implementation of a prevention model of PCIT by paraprofessionals. Preliminary recommendations for selection and training are provided.