![Back to Play
YEA!
Labeled Praise
The Warning ...
Obey Disobey
(UH-OH!)
If you don’t [original command],
you’ll have to go to the time out chair](https://image.slidesharecdn.com/3pcit07-240514050826-5f4488fb/85/Parent-Child-Interaction-Technique-PCIT07-ppt-41-320.jpg)
![Are you ready to
[obey original command]?
Child stays on chair
3 min plus 5 sec quiet
Or doesn’t
(OH-OH!)
Obey
Acknowledge
The Chair
Command
No](https://image.slidesharecdn.com/3pcit07-240514050826-5f4488fb/85/Parent-Child-Interaction-Technique-PCIT07-ppt-43-320.jpg)
![Yes
Are you ready to
[Obey Original Command]?
Obey
Acknowledge
The First Obey
Child Stays
on Chair
3 Min plus 5 Sec Quiet
No](https://image.slidesharecdn.com/3pcit07-240514050826-5f4488fb/85/Parent-Child-Interaction-Technique-PCIT07-ppt-45-320.jpg)
Parent Child Interaction Technique PCIT07.ppt
- 1. Parent-Child Interaction Therapy Courtney Ingalls, MS University of Florida
- 2. Parent-Child Interaction Therapy (PCIT) • Designed for young children (3-6) and their parents/caretakers • Work with parents and child together • Live coaching of skills • Emphasis on restructuring parent- child interaction patterns
- 3. What families might benefit from PCIT? • Children with conduct problem behavior • Preschool age (3-6) • At least one parent able to attend weekly sessions with child • Parent(s) willing to practice skills at home
- 4. Child-Directed Interaction Parent-Directed Interaction Parents follow Play therapy skills Differential attention Increase warmth of parent-child relationship Parents lead Limit-setting Consistency Predictability Follow through
- 5. Structure of PCIT • Assessment – Measures that guide treatment • Parent Report • Observation
- 6. Parent Negative Behavior • Critical Talk • Smart Talk • Yell • Physical Negative Child Negative Behavior • Critical Talk • Smart Talk • Yell • Physical Negative • Whine • Non-Compliance Child: (Hits parent) physical negative Parent: You’re mean critical talk Child: AHHHHHHHH yell DPICS Dyadic Parent-Child Interaction Coding System
- 7. Structure of PCIT • Assessment – Measures that guide treatment • Teaching sessions – Presentation of skills – Modeling and role-playing • Coaching sessions – Check in – Therapist codes and coaches – Assign homework
- 8. How does coaching work? • Parent wears a Bug-in-the-Ear receiver while playing with child in playroom (therapist can coach while in the room with the parent) •Therapist coaches specific skills •Spouses take turns playing and observing
- 9. What families might benefit from PCIT? • Children with conduct problem behavior • Preschool age (3-6) • At least one parent able to attend weekly sessions with child • Parent(s) willing to practice skills at home
- 11. Effect Size Interpretations • Small = 0.20 - 0.40 • Medium = 0.40 - 0.60 • Large = 0.60 - 0.80 • Very large = 0.80 – 1.00 • Astronomical = > 1.00
- 12. Child Problem Behavior and 2-Year Effect Size 178 104 112 121 80 100 120 140 160 180 200 Pre Post 1 Year 2 Year Intensity Score 2.32 Eyberg et al.
- 13. Eyberg Child Behavior Inventory Weekly Intensity Score 90 100 110 120 130 140 150 160 170 1 3 5 7 9 11 13 15 17 19 21 23 25 Dropouts (n = 36) All combined (n = 99) Normative mean Clinical cutoff Criterion to end treatment Completers (n = 63)
- 14. Child Compliance and 2 Year Effect Size 50 60 70 80 90 100 Pre Post 1 Year 2 Year Percent .85 Eyberg et al.
- 15. School Observation Coding System Compliance 40 50 60 70 80 90 100 Pre Post 12 Mo 18 Mo Percent of Commands Obeyed Funderburk et al., 1998
- 16. Child Deviant Behavior Composite and 2 Year Effect Size 0 10 20 30 40 50 60 Pre Post 1 Year 2 Year Frequency in 30 Minutes .54 Eyberg et al.
- 17. DPICS Parent Verbal and Physical Negative 0 5 10 15 20 25 30 35 40 Pre Post 1 Year 2 Year Frequency in 30 Minutes 1.11 Eyberg et al.
- 19. CDI The Basic Rule Follow the Child’s Lead
- 20. CDI: The DON’T Rules • No commands • No questions • No criticism
- 21. Direct : Sit here Indirect : Could you sit here? • Commands attempt to lead • Risk negative interaction No Commands CDI: The DON’T Rules
- 22. Questions ask for an answer • Often hidden commands • Take lead from the child • Can suggest disapproval • Can suggest not listening No Questions CDI: The DON’T Rules
- 23. • Examples You’re a bad girl That doesn’t go that way No Stop Quit Don’t Points out mistakes rather than correcting them “That’s wrong” is a criticism “It goes like this” allows correction without criticism • Lowers self-esteem • Creates unpleasant interaction No Criticism CDI: The DON’T Rules
- 25. CDI: The DO Rules The PRIDE Skills Praise Reflect Imitate Describe Enthusiasm!
- 26. Praise Unlabeled praise is nonspecific – Good! – That's great! Labeled praise tells child specifically what is good – Thank you for sitting so quietly. • Increases the specific behavior • Increases child's self-esteem • Increases positive parent-child interaction CDI: The DO Rules
- 27. Reflection “The moo-moo is in the barn.” “Yes, the cow is in the barn.” • Allows child to lead the conversation • Shows that parent is listening • Shows that parent understands • Improves and increases child’s speech • Repeating or paraphrasing CDI: The DO Rules
- 28. Imitation Doing the same thing the child is doing Lets the child lead Teaches parent how to “play” Shows approval of child’s activity Teaches child how to play with others – Sharing – Taking turns CDI: The DO Rules
- 29. Description • Telling the child exactly what he or she is doing – “You’re drawing a sun.” • Lets the child lead • Lets child know you are paying attention and are interested • Shows approval of child’s activity • Models speech • Teaches vocabulary and concepts • Holds child’s attention to the task CDI: The DO Rules
- 30. Enthusiasm • Conveying excitement by voice and gesture – “Wow!! You finished that SO quickly!” • Lets the child know the parent enjoys being with the child • Makes the play more fun for the child (and parent) • Adds a quality of warmth to the interaction CDI: The DO Rules
- 31. IGNORE annoying, obnoxious behavior STOP THE PLAY for dangerous or destructive behavior Child-Directed Interaction DON’T – Give Commands – Ask Questions – Criticize DO – Praise – Reflect – Imitate – Describe Enthusiasm
- 32. “Special time” 5 minutes a day Practice, play, and therapy Homework
- 33. Homework Good activities: Toys with no rules Construction toys Play sets Creative Toys Not-so-good activities: Board games Messy activities (like fingerpaint) Aggressive toys (like guns or action figures) Pretend-talk toys
- 35. COACHING
- 36. Why Coach? – Parents think they already do these things – Verbal habits are ingrained – Coaching (therapist feedback) makes parents aware of what they say – Coaching (child’s feedback) makes parents aware of the immediate effects – Coaching heightens parent’s attention and motivation
- 37. Why Coach? – Coaching provides parent support in actual difficult situations – Coaching demonstrates to parents (convinces parents) that change is possible – Coaching can help parents not to give up – Coaching is efficient -- makes it possible to address relevant problem areas and not spend time on areas that are not problems
- 39. PDI: Effective Commands • Direct (telling, not asking) • Positive (what to DO, not stop doing) • Single (one at a time) • Specific (not vague) • Age-appropriate • Given in a normal tone of voice • Polite and respectful (Please... ) • Explained before given or after obeyed • Used only when really necessary
- 40. The Command ... Command No Opportunity Whoops! (Start over) Obey Labeled Praise Disobey Back to Play YEA!
- 41. Back to Play YEA! Labeled Praise The Warning ... Obey Disobey (UH-OH!) If you don’t [original command], you’ll have to go to the time out chair
- 42. The Chair
- 43. Are you ready to [obey original command]? Child stays on chair 3 min plus 5 sec quiet Or doesn’t (OH-OH!) Obey Acknowledge The Chair Command No
- 44. BACK TO CHAIR CHILD GOES TO TIME OUT ROOM 1 MIN + QUIET CHILD GETS OFF CHAIR CHILD GETS OFF AGAIN The Backup ROOM WARNING “You got off the chair before I said you could. If you get off again, you’ll go to the Time Out Room .”
- 45. Yes Are you ready to [Obey Original Command]? Obey Acknowledge The First Obey Child Stays on Chair 3 Min plus 5 Sec Quiet No
- 47. Further Information… • PCIT website: www.pcit.org – Literature – Measures – Other material
- 48. Questions?