A Case Study of Parent-Child Interaction Therapy: Flexible Client-Centered Adaptation of an EST

The authors present a case study of Katie, a 4-year-old girl diagnosed with oppositional defiant disorder (ODD). Treatment was conducted with Katie and her family using Parent-Child Interaction Therapy (PCIT). However, client-centered adaptations were made to improve the feasibility of the treatment and its ecological validity in a community setting. Katie demonstrated marked reduction in ODD symptoms during treatment and no longer met criteria for ODD at discharge and throughout follow-up periods. A hybrid model was utilized whereby PCIT components were delivered in both clinic and in-home settings. Client-centered adaptations and the benefits of treatment in the in-home setting are discussed. The authors contend that use of appropriate client-centered clinical flexibility, when implementing a manualized, empirically supported, and evidence-based treatment, can assist in bridging the science-practice gap allowing for appropriate flexibility and individualization, while also promoting the use of empirically supported and validated treatment approaches.