Exploring the feasibility and acceptability of novel "re-implementation" supports for clinicians who have been trained in Parent-Child Interaction Therapy (PCIT).

INTERVENTION: All participants: All participants will undertake a two‐day Parent‐Child Interaction Therapy (PCIT) refresher training, the content of which is informed by PCIT International's 'recalibration' training, and previous research into implementation barriers encountered by PCIT‐trained clinicians in Aotearoa / New Zealand. This complimentary, catered training will be delivered outside of typical working hours, to facilitate clinician attendance regardless of their current employment context. It will delivered by a senior PCIT trainer in Tamaki Makaurau / Auckland. Incorporated within the two training days, all participants will receive the following enhanced supports: • A collection of resources to support delivery, including detailed virtual delivery resources and demonstration of these. Access to a Dropbo Xwith all resources and materials. • A complimentary pack of 25 Eyberg Child Behaviour Inventory (ECBI; Eyberg & Pincus, 1999) questionnaires to use with future PCIT clients, and a complimentary PCIT treatment protocol in the event that this has been misplaced since their initial PCIT training. • Facilitated discussion and problem‐solving sessions around using PCIT in various contexts including private practice, should participants choose to do this. For example, what to charge for PCIT, how to obtain referrals, and where suitable clinic rooms are located. • Discussion, facilitated by a Maori PCIT provider, relating to how to deliver PCIT in a culturally responsive way. After the two training days, all participants across both the intervention and control groups will be offered optional complimentary weekly 1hr group PCIT‐oriented consultation sessions with a senior PCIT clinician, for the si Xmonth trial period. Participants may atten CONDITION: Childhood conduct problems; ; Childhood conduct problems Mental Health ‐ Other mental health disorders Public Health ‐ Health service research PRIMARY OUTCOME: (2) Trial procedures will be evaluated by assessing the number of clinicians who complete the trial, as determined by an audit of study logs. Where a clinician withdraws from the study, the point of withdrawal and reason for withdrawal will be recorded.[End of trial (six months post randomisation).] The primary objective of this pilot study is to assess the feasibility of conducting a RCT. In future, this fully‐powered RCT will assess the effects of provision of a re‐implementation intervention on adoption of PCIT by clinicians who are not – or are rarely – using PCIT in their practice. The current feasibility trial will identify any factors that may detract from our ability to achieve this aim in the full trial. ; ; Primary outcomes are (1) number of clinicians who enrol in the trial and (2) number of clinicians who complete the trial. ; ; (1) Recruitment processes will be evaluated by assessing the number of clinicians who provide consent to participate in the trial ‐ this will be determined by an audit of study enrolment logs. ; ; ; [Baseline (beginning of Day 1 of PCIT refresher training).; ; ] SECONDARY OUTCOME: Acceptability of each aspect of the re‐implementation intervention will be assessed by participant uptake of the components. As an online booking system will be used to co‐ordinate the loan of (1) the audiovisual equipment, (2) the time‐out cubicle, and (3) the mobile co‐worker, a frequency count of weekly bookings will be used as a proxy measure for the acceptability of these items. ; ; Also, in a post‐trial semi‐structured phone interview, participating clinicians will be asked to rate the acceptability of the components of the re‐implementation package on a series of Likert scales. [Audit of booking system data: Weekly for the six‐month trial period. ; Semi‐structured interview: End of trial. ; ] Acceptability of group consultation sessions will be assessed by participant attendance rates, measured by an audit of session attendance registers. [Weekly attendance rates, for the six‐month trial period. ] Acceptability of the monthly surveys as a data collection method, and the timing and frequency of these, will be measured by response rates. ; Also, a post‐trial semi‐structured phone interview will incorporate Likert scales and seek participants’ ratings of the acceptability of the monthly surveys as a data collection method.[Response rates assessed following each monthly survey, for the six‐month period. ; Post‐trial phone interview at six‐months post randomisation. ] Acceptability of the recruitment and trial processes to Maori clinicians will be assessed by multiple‐choice items within a study‐specific questionnaire following the pre‐trial information session and at the end of the trial. Maori clinicians choosing not to enrol in the trial will also be offered the opportunity to speak kanohi‐ki‐te‐kanohi (face to face) or via phone with a Maori research team member, to discuss their impressions and any concerns about trial recruitment processes and/or methodology that contributed to their decision not to participate, and this qualitative data will be recorded.[Pre‐trial information session, end of trial (si Xmonths post randomisation). ] Acceptability of trial processes to participants will be measured by a study‐specific survey following the pre‐trial information session, and at the end of the trial. Those who choose *not* to enrol in the trial following the information session will also be asked to complete the study‐specific survey as to their reasons for non‐participation, and a frequency count of responses to these multiple‐choice items will be undertaken. ; ; ; [Pre‐trial information session, end of trial (i.e., si Xmonths post randomisation). ] Clinician adoption of PCIT will be assessed by clinician self‐report of the number of unique families to whom PCIT was delivered in the most recent representative one‐week period at si Xmonths post‐randomisation and compared to baseline (via the study‐specific monthly survey). Given that PCIT sessions are typically held weekly, this is expected to provide a valid measure of clinician PCIT adoption. ; [Baseline (beginning of Day 1 of PCIT refresher training), and end of trial (si Xmonths post randomisation). ] Clinician self‐reported Capability, Opportunity and Motivation to use PCIT (drawn from COM‐B theory; Michie et al., 2014) will be measured by Likert scale items within a monthly self‐report survey, developed for the purposes of this trial, and delivered via Qualtrics. [Monthly for the six‐month trial period. ] INCLUSION CRITERIA: Clinicians must have completed a recognised 40‐hour initial training in PCIT within the past 10 years and be registered to practise in Aotearoa / New Zealand at the time of participation in the trial. Having been eligible for the PCIT initial training implies that included clinicians will be allied health and medical clinicians with a Masters degree or equivalent (i.e. psychologists, psychiatrists, social workers, psychotherapists, occupational therapists, and nurses). Eligible clinicians are not required to be employed in a clinical role, and may be in an administrative or managerial role, as it is possible that they may elect to adopt PCIT in a part‐time private practice context. Where the clinician is already seeing a full caseload of PCIT clients, they will remain eligible for inclusion as we are interested in whether provision of additional supports might influence the nature and quality of implementation. For example, the PCIT treatment protocol recommends use