Parent-Child Interaction Therapy
Blueprints Program Rating: Promising
A 12 week treatment for young children with emotional and behavioral problems, with one-half hour parent-child sessions, that places emphasis on improving the parent-child relationship, teaching effective parenting skills, and encouraging effective discipline.
As a form of therapy, PCIT is commonly funded by Medicaid. Some interested communities struggle to find a source for start-up funds. The child welfare block grant funds (Title IV-B) as well as the Community Mental Health Services block grant are both potential sources of support for start-up and for services and populations not covered by Medicaid. In addition, because Parent Child Interaction Therapy requires fairly significant start-up funding and once established can be supported with a relatively stable funding source (Medicaid), debt financing could be considered for start-up costs.
Improving the Use of Existing Public Funds
Studies document that PCIT reduces conduct disorder in children and improves the quality of parenting and parent-child interactions. State child welfare agencies that support implementation of PCIT may do so as part of a strategy to prevent costly out-of-home placements, and/or to help support children in successfully transitioning home from out of out-of-home placements. State dollars saved on out-of-home placements and reentries into the system can be redirected toward expanding and sustaining the intervention.
Allocating State or Local General Funds
State funds are needed to provide the required Medicaid state match. In addition, some state agencies have provided grant funds to cover start-up costs for PCIT.
Maximizing Federal Funds
Entitlements: Medicaid is the primary funder of PCIT. It is billed as mental health therapy, either individual or family. Recipients must be Medicaid eligible. Medicaid managed care organizations can use administrative dollars and/or reinvestment funds to support start-up and fidelity monitoring.
Formula Funds: Formula funds could potentially be used for start-up costs associated with PCIT. Because the intervention is generally targeted to children with behavioral health challenges and their parents/ caretakers, behavioral health or child welfare funding streams are likely most relevant.
- The Community Mental Health Services Block Grant (MHSBG) can fund a variety of mental health promotion and intervention activities and is a potential source of support for Parent Child Interaction Therapy programs.
- Title IV-B, Parts 1 & 2 provides fairly flexible funding to state child welfare agencies for child welfare services including prevention and family preservation activities.
Discretionary Grants: Relevant discretionary grants are administered by the Substance Abuse and Mental Health Services Administration (SAMHSA) or the Children's Bureau within the Department of Health and Human Services.
Foundation Grants and Public-Private Partnerships
Foundations should be considered as a source of start-up funding. Developing a public-private partnership with foundations and corporate partners could enable a locality to leverage the private investment to help support start-up costs and ongoing quality monitoring efforts that may not be fully covered with Medicaid support.
Because Parent Child Interaction Therapy requires fairly significant start-up funding and once established can be supported with a fairly stable funding source (Medicaid), debt financing could be considered for start-up costs. Social Impact Bonds, or Program-Related Investments from Foundations, can be considered for start-up expenses, with repayment being made from a portion of the Medicaid payment generated from delivery of the service.
All information comes from the responses to a questionnaire submitted by the developer of the program, Sheila Eyberg, PhD., to the Annie E. Casey Foundation.