Innovate and enhance for impact Towards a tailored parenting intervention using working elements and virtual reality

This dissertation amounted to existing evidence of parenting interventions – specifically Parent-Child Interaction Therapy (PCIT), by exploring its different components. We aimed to: (1) explore sequential analysis of therapist coaching in PCIT; (2) examine long-term results of PCIT from the parents’ perspective; and (3) outline and evaluate the added value of virtual reality (VR) in PCIT quantitatively and qualitatively. Notably, findings confirmed that PCIT diminishes child disruptive behavior and parenting stress, while enhancing the parent-child relationship in a community-based clinical sample. Moreover, new insights showed that responsive therapist coaching has an immediate effect on parents’ use of positive parenting skills. This highlighted the impact therapists and feedback have in PCIT. Additionally, long-term effects of PCIT showed that parents gain confidence in parenting and skill use, but effects of learnt skills seem to fade over time. Continued longitudinal studies, including child follow-up interviews, could offer more insights into the lasting impact of parenting interventions. Lastly, we found preliminary evidence that our still pioneering VR tool added value to PCIT. Parents gained confidence in skills through VR practice, and in some cases, VR seemed to reduce leading behavior. Parents and therapists provided practical implications for continued development of VR, as we found that implementing a novel tool was difficult. In conclusion, we must further investigate how we can best tailor parenting interventions such as PCIT, by using working elements and technology to our advantage to reach families who need it most. In other words, we must continue to innovate and enhance for impact.