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Research
Karitane’s dedicated research team partners with universities and other organisations to improve clinical practice and outcomes for children and families.
Karitane conducts research to inform the evidencebase of our clinical service delivery, contribute to wider knowledge and scholarship, and to ensure families receive the best interventions, advice and support available. The Karitane research department is led by Dr Jane Kohlhoff, Senior Lecturer in Perinatal and Infant Mental Health, School of Psychiatry at the University of New South Wales, and Research Fellow at Karitane. In 2018-2019, Dr Kohlhoff was supported by a team of researchers including Post-Doctoral fellow Dr Nancy Wallace and four part-time research assistants. The team also collaborates widely with researchers and clinicians from across Australia and internationally.
Innovative clinical research
Internet–parent child interaction therapy
Karitane was awarded a NSW Health Mental Health Innovation Fund grant to conduct a pilot trial of Parent Child Interaction Therapy (PCIT), delivered via Telehealth to families in rural and remote NSW throughout 2018. This program represents the first translation of PCIT via the internet into a real-world setting in Australia. Research and evaluation were key components of the pilot, with evidence showing statistically significant reductions in disruptive child behaviours, increases in child compliance and increases in positive parenting skills after I-PCIT treatment. I-PCIT received widespread positive qualitative feedback from clients. Results have been disseminated in a number of peer-reviewed publications and conference presentations, both in Australia and internationally.
Parent-child interaction therapy – toddler (under two’s adaptation)
Clinicians at the Karitane toddler clinic have developed an adaptation of PCIT for children aged 12-24 months. Pilot research at Karitane has demonstrated the efficacy of the program in terms of improved parenting skills and sensitivity, decreases in child behaviour problems, and shifts from insecure and disorganised to secure infant attachment patterns (Kohlhoff and Morgan, 2014; Kohlhoff et al., 2019). In 2018 the model was formalised in a treatment manual in collaboration with colleagues from the United States (Girard, Wallace, Kohlhoff, Morgan and McNeil, 2018) and described in an invited book chapter in the most recent PCIT International Handbook (Kohlhoff and Morgan, 2018). In May 2018, a large randomised controlled trial was commenced at the Karitane Toddler Clinic to further evaluate the program. In recognition of this ground-breaking international work, clinicians and academics from around the world have visited the Karitane Toddler Clinic to learn about and receive training in PCIT-T, and the team was awarded first place in the 2018 SWSLHD Quality Awards, in the ‘Health Research and Innovation’ category.
Development and validation of the Karitane family outcomes tool (KFOT)
The lack of available parent-report tools to evaluate outcomes and monitor the quality of Australian Early Parenting Centres (EPCs) kick-started the development of a new parent-report measure by Karitane. The new measure will evaluate clinical outcomes of parents attending Australian EPC and similar services worldwide. The specific aim is to develop a tool that is brief, userfriendly, and easy to score and interpret, and that measures multiple intervention target domains (e.g., parent wellbeing, child behaviour, and parent-child relationship quality). The project is now nearing completion with the assistance of over 2000 parents from the community and Karitane. The new KFOT questionnaire will be rolled out across Karitane services in 2020.
Volunteer family connect – results from ROI and RCT
At the end of 2012, a collaborative relationship was formed between researchers and three leading Australian nongovernment organisations – Good Beginnings Australia (now part of Save the Children), The Benevolent Society and Karitane. This group came together to conduct rigorous research that would answer questions about the extent to which volunteer home visiting programs were effective in supporting;
• Positive outcomes for families
• Positive outcomes for the volunteers who delivered the service
• A significant social return on investment
The collaboration conducted a randomised controlled trial of volunteer home visiting.
Volunteer Family Connect (VFC) is an evidence-based program combining current best practice and clinical expertise to provide social and practical support to families with children under five years of age. Trained volunteers visit families in their homes or other safe place, on a weekly basis for up to two hours, for 3-12 months. The volunteer works in partnership with the family to offer information, friendly support and encouragement in a non-threatening, non-directive, non-judgmental manner. VFC is intended to complement and work in conjunction with professional services, providing a community-based early intervention model that focuses on the importance of parent-child bonding and providing bridges between families and their local communities.
Research partnerships
Karitane has continued to be a partner on a number of major research initiatives throughout 2018-2019, including; Early Life Determinants of Health clinical academic group within the Sydney Partnership for Health Education, BestSTART-SW (System Transformation and Research Translation) within the South West Sydney Academic Unit for Child Health Research.
Karitane continues to be a member of the South West Sydney Research Hub, with Karitane CEO Grainne O’Loughlin sitting as a member of the SWS Research Executive Committee. Karitane partners with a number of health, community and university-based organisations to conduct specific translational research projects including those focused on refugee health, home visiting for Culturally and Linguistically Diverse (CALD) families, postnatal depression and infant directed speech, and PCIT. Partners include:
Successful Research Grants
• Tooke, S & Kohlhoff, J 2019-2020, The Pre- admission Midwife Appointment Program at the Mater: ‘A qualitative investigation of consumer satisfaction and impact’, Friends of the Mater Foundation grant.
• Eapen, V, Lingam, R, Whitehall, J, Raman, S, Kemp, A, George, A, Page, A, Jalaludi, B, Teng- Liaw, S, Woolfenden, S, Kohlhoff, J, De Leeuw & E, Baker, J 2018-2022, System Transformation and Research Translation – South Western Sydney (BestSTART-SW). South Western Sydney Local Health District Academic Unit. Enhancement of an Academic Unit.
• Lam-Cassetari, C & Kohlhoff, J 2018, The impact of postnatal depression on infant-directed speech and early language outcomes, The MARCS Institute for Brain, Behaviour and Development Research Partner Incentive program.
• Kohlhoff, J 2017-2018, Internet Parent-Child Interaction Therapy. NSW Department of Health Mental Health Innovation Fund grant.
• Kemp, L, Kaplun, C, Kohlhoff, J, Blight, V, Varelis & K, Eagar, S 2017-2018, Sustained Health Home Visiting for Families with Culturally and Linguistically Diverse (CALD) backgrounds with Low English Proficiency (LEP): determining the efficacy of program delivery using interpreters or in-language community support. South West Sydney Research Small Grant Scheme.
• Baker, J, Kohlhoff, J, Eapen, V, George, A, Arora, A & Al-Shammari, A 2017-2018, Starting School Well: Optimising Refugee Children’s Health in Preparation of this Key Transition. South West Sydney Research Small Grant Scheme.
• Kohlhoff, J & Woolfenden, S 2017-2019,Evaluation of an innovative childhood developmental surveillance program in primary health care and community based early learning settings. Early Life Determinants of Health SPHERE seed funding ($50,000, 2017-2018).
• Kohlhoff, J 2017-2019, The neurobiology of parenting and Disruptive Behaviour Disorder subtypes in early childhood. Australian Research Council Discovery Early Career Researcher Award (DE170100413).
• Kohlhoff, J 2017-2019, The ‘Watch Me Grow’ app for identification of developmental and mental health problems in early childhood: a validation study. 2016 Ramaciotti Health Investment Grant (HIG2016/063).
Current Research Projects
Evaluation of PCIT-T: an attachment based intervention for toddlers with disruptive behaviours;
Investigators: Kohlhoff, J, Morgan, S.
Development of Karitane Family Outcomes Tool (KFOT);
Investigators: Kohlhoff, J, Lee, S, Jones, P, Khajehei, M.
The ‘Watch Me Grow’ app for identification of developmental and mental health problems in early childhood: a validation study;
Investigators: Kohlhoff, J, Eapen, V.
Neurobiology of parenting and disruptive behaviour disorders in childhood;
Investigators: Kohlhoff, J, Hawes, D, Eapen, V
The effect of postnatal depression on infant-directed speech and early parent-child communication;
Investigators: Lam-Cassetarri, C, Kohlhoff, J.
Retrospective chart review of the effectiveness of Parent Child Interaction Therapy for toddlers with developmental concerns;
Investigators: McInnis, P, Kohlhoff, J, Eapen, V.
Treating perinatal and infant mental health: a service evaluation;
Stuchbury, M, Kohlhoff, J, Jehne, A.
A qualitative inquiry into how to optimise refugee children’s developmental health and wellbeing in preparation of the key transitions into primary and secondary school;
Investigators: Baker, J, Raman, S, Kohlhoff, J, George, A, Kaplun, C, Dadich, A, Amora, A, Zwi, K, Schmied, V, Eapen, V.
Volunteer Family Connect;
Investigators: J Baker, J Kohlhoff, V Eapen, A George, A Arora, A Al-Shammari
Volunteer Family Connect (VFC) is a community-driven, research-based home-visiting program that mobilises volunteers to provide support for parents of young children who are isolated or feeling overwhelmed by their parenting role. See here for a summary of research findings and here for return on investment.
Volunteer Family Connect;
Investigator: Grace, R, Kemp, L.
Evaluation of the Karitane Internet PCIT program: A retrospective file review study;
Investigators: Kohlhoff, J,Kimonis, E, Fleming, G.
A Randomised controlled trial comparing PCIT-T, COS-P and waitlist controls in the treatment of disruptive behaviours in children aged 14-24 months;
Investigators: Kohlhoff, J, McNeil, S, McMahon, C, Morgan, S, Huber, A, Hawkins, E, Eapen, V.
Higher Degree Research Student Projects
Sara Cibralic, UNSW PhD candidate
Project title: ‘The impact of PCIT-T on parental emotion regulation, reflective functioning, and understanding of the role of emotions in parenting and toddler behaviour’
Supervisors: Dr Jane Kohlhoff, Prof. Valsamma Eapen, A/Prof C. McMahon.
Michelle Kenny, UNSW PhD candidate
Project title: ‘Evaluating the effectiveness of a trauma informed parenting intervention for Indigenous parents’ mental health and attachment quality’
Supervisors: Dr Jane Kohlhoff, Prof Valsamma Eapen, Dr Beth Mah, A/Prof Kym Rae.
Maddie Simpson, WSU PhD candidate
Project title: ‘Understanding the development of post- traumatic stress disorder following childbirth and its impact on women who access residential and day parenting services in NSW’
Supervisors: Professor Hannah Dahlen, Virginia Schmied, Cathy Dickson.
Bryan Neo UNSW Masters candidate
Project title: ‘Validation of the Clinical Assessment of Prosocial Emotions (CAPE) in Pre-schoolers with Disruptive Behaviour’
Supervisor/Co-investigators: A/Prof. Eva Kimonis (UNSW), A/Prof. David Hawes (USyd), Prof. Valsamma Eapen (UNSW).
Research Output
July 2018 to June 2019
Book Chapters
• Cibralic, S, Owen & C, Kohlhoff, J 2019, ‘Autism Spectrum Disorder and Attachment: Is an Attachment Perspective Relevant in Early Interventions with Children on the Autism Spectrum?’ In McNeil, CB, Quetsch, LB, & Anderson, CM (Eds). ‘Handbook of Parent-Child Interaction Therapy for Children on the Autism Spectrum’, Springer.
• Kohlhoff, J & Morgan, S 2018, Parent-Child Interaction Therapy for Toddlers (PCIT-T) . In Niec, L (Ed) ‘Handbook of Parent-Child Interaction Therapy – Innovations and Applications for Research and Practice’, Springer
Peer Review Journal Articles
• Kohlhoff, J, Wallace, N, Morgan, S, Maiulo, M &Turnell, A 2019, Internet-delivered Parent Child Interaction Therapy (I-PCIT): Two clinical case reports. Clinical Psychologist, 1-12.
• Baker, J, Raman, S, Kohlhoff, J, George, A, Kaplun, C, Dadich, A, Amora, A, Zwi, K, Schmied, V & Eapen, E 2019, ‘Optimising Refugee Children’s Health/Wellbeing in Preparation for Primary and Secondary School: A Qualitative Inquiry’ BMC Public Health, 19: 812
• Brunton, RJ, Dryer, R, Krägeloh, C, Saliba, A, Kohlhoff, J & Medvedev, O 2019, ‘Women and Birth’, The initial development of the Pregnancy-Related Anxiety Scale Journal, vol 32, 118-130.
• Brunton, R, Dryer, R, Kohlhoff, J & Saliba, A 2019, Re- Examining Pregnancy-Related Anxiety: a replication study. ‘Women and Birth’, vol 32, 131-137.
• Brunton, R.J, Dryer, R, Krägeloh, C, Saliba, A, Kohlhoff, J & Medvedev, O 2018, ‘The Pregnancy-Related Anxiety Scale: a validity examination using Rasch analysis’. Journal of Affective Disorders, vol 236, 127-135.
Conference Presentations
• Kohlhoff, J, Evaluation of the Karitane Internet Parent Child Interaction Therapy (I-PCIT) program. Oral presentation at the SWSLHD 2019 Research Showcase, Sydney, June 2019.
• Kohlhoff, J, Early intervention for Toddlers with disruptive behaviours: Results of a waitlist controlled trial of Parent- Child Interaction Therapy for Toddlers (PCIT-T). Evaluation of the Karitane Internet Parent Child Interaction Therapy (I-PCIT) program. Oral presentation at the SWSLHD 2019 Research Showcase, Sydney, June 2019.
• Neo, B, Kimonis, E, R, Hawes & D, Eapen, V, Validation of the Clinical Assessment of Prosocial Emotions (CAPE) in Pre-schoolers with Disruptive Behaviour. Association for Behavioural and Cognitive Therapies, Washington DC, USA, November 2018.
• Neo, B, Kimonis, E. R, Hawes, D, & Eapen, V, Validation of the Clinical Assessment of Prosocial Emotions (CAPE) in Pre-schoolers with Disruptive Behaviour. Australian Association for Cognitive Behavioural and Cognitive Therapies, Brisbane, Australia, October, 2018.
• Lam-Cassetari, C & Kohlhoff, J, Mothers with postnatal depression are less affective and talk less to pre-linguistic infants. International Congress of Infant Studies. Philadelphia, July 2018.
“We’ve treated families from Armidale, Dubbo, Bega and Byron Bay, with all showing dramatic changes in the children’s behaviour, and parents reporting a reduction in disobedience, hurting parents and siblings and extreme tantrums."
Dr Jane Kohlhoff, Senior Lecturer in Perinatal and Infant Mental Health, School of Psychiatry at the University of NSW
Articles on Research Projects:
For More Information:
Contact Karitane Education & Research Department:
Postal Address: PO Box 241, Villawood NSW 2163
Street Address: 138-150 The Horsley Drive (entry and parking via Mitchell Street), Carramar, NSW 2163
Email: jane.kohlhoff@unsw.edu.au
Ph: (02) 9794 2344
Fax: (02) 9794 2323
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Our Services
Established in 1923, Karitane is a respected and trusted service leader in parenting services across NSW. Karitane delivers high quality, comprehensive, evidence-based parenting services for families and the provision of education and training to healthcare professionals and non-government organisation. Education and research underpins the delivery of our clinical care. We lead and disseminate the latest evidence-based research ensuring we provide the best advice to parents and educate health professionals, staff, students and academia.
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