The Added Value of Parents Practicing in Virtual Reality to Illustrate the Use of Innovative Methods in Parent-Child Interaction Therapy: Single-Case Experimental Design
VR rehearsal gives PCIT parents a small skill polish but does not speed child compliance or cut stress.
01Research in Context
What this study did
Researchers added a VR practice module to standard PCIT. Parents wore headsets and rehearsed skills like labeled praise and reflection in a virtual playroom.
The team used a multiple-baseline design with a small group of parents whose children had mixed clinical needs. They tracked parent behavior, child compliance, and parent stress.
What they found
Regular PCIT still worked. The VR add-on gave a tiny, uneven boost to positive parenting moves and cut parent questions a bit.
Child compliance and parent stress improved at the same slow pace as regular PCIT. VR practice did not speed those up.
How this fits with other research
Lee et al. (2024) and Factor et al. (2022) also ran parent training over screens. They saw clear child gains, while this VR version did not. The difference: Lee and Factor taught parents new skills; VR here only let parents rehearse skills they already learned.
Gayle et al. (2025) used VR directly with autistic kids and saw big, lasting skill jumps. Anonymous (2025) aimed VR at parents instead, with smaller payoff. Targeting the child, not the parent, may give VR its punch.
Parsons et al. (2019) added a tablet app to therapy and found only a slim language edge. Like the VR add-on, the tech helped a little but did not beat good old coaching.
Why it matters
If you run PCIT, keep the core live coaching. A VR headset can give parents extra reps, but don’t expect faster child progress or less stress. Save VR time (and cost) for families who want more practice after they master the basics. Track child and parent data yourself; if gains stall, add more live coaching instead of more tech.
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02At a glance
03Original abstract
Throughout years of research, the well-known behavioral parent training program, Parent-Child Interaction Therapy (PCIT), has been adapted and enhanced to tailor the treatment to the needs of families in community-based clinical care. This study wished to evaluate an add-on to PCIT that could be engaging for parents. As a way to enlarge practice opportunity and potentially allow parents to achieve positive treatment effects sooner, this study added virtual reality (VR) to PCIT. This study aimed to increase positive parenting skills at a faster pace with the use of PCIT-VR, on the basis that practicing positive parenting skills in the VR tool would increase parents’ overall practice time, thus leading to more confidence in their skills, which could consequently increase the pace of skill acquisition. Furthermore, we hypothesized that due to the overall increase in positive parenting skills, PCIT treatment effects such as diminishment of child disruptive behavior and parenting stress would decrease at a faster pace when VR was introduced. Families were recruited from a specialized child and adolescent psychiatry clinical practice in the Netherlands. Using a single-case experimental design, 11 families, equating to 18 participants, signed informed consent forms and received the staggered introduction of VR to treatment. As is common with a single-case experimental design, visual inspection analyses and randomization tests were conducted. Group differences were evaluated with nonparametric tests and reliable change indices. Overall, our study reaffirmed that PCIT is an effective intervention for this population as there were positive treatment effects found in almost all cases. Nevertheless, there did not seem to be a clear relationship between the use of the VR tool and PCIT treatment effects, although positive parenting skills seemed to increase when VR was introduced to treatment for some parents. For all parents, questions and comments decreased with the introduction of VR. These findings tentatively suggest that practicing with VR could potentially increase positive parenting skills and also have an impact on other treatment-related outcomes, such as child disruptive behavior and parenting stress. This was the first time that PCIT has been supplemented with VR. We provide preliminary evidence of its added value. We cautiously suggest that VR could provide added value to PCIT and increase confidence in parenting skills for certain parents, although there are complex factors that play into treatment success that must simultaneously be considered. These factors include parents having the motivation and mental capacity to change and the complex psychological problems some families face. Although promising, we believe that due to the novelty of our VR practice tool and the variety of results from our study, more research is necessary into PCIT-VR to draw further conclusions on its effects.
JMIR Pediatrics and Parenting, 2025 · doi:10.2196/60752