Chapter 1: Foundations of PCIT

1. Chapter 1:Foundations of PCIT PCIT Chapters 1 and 2

2. Why are we doing this? • Application of principles from the first term • A particular example of the multifaceted approach to behaviour modification • Consideration of the “unit of measurement”: monad vs. dyad • Targeting maladaptive behaviours that occur in childhood PCIT Chapters 1 and 2

3. About Parent-Child Interaction Therapy • “I love my child, but I just don’t like him very much” • Designed for parents with young children who are experiencing a range of behavioural, emotional and developmental problems • Children between 2 and 7 years PCIT Chapters 1 and 2

4. About Parent-Child Interaction Therapy • Developed by Dr. Sheila Eyberg, integrating operant methods with traditional play therapy • Conducted in the context of “dyadic play” for the development of problem solving skills • Behavioural Child Management Training PCIT Chapters 1 and 2

5. Behavioural Child Management Training • Recognizes that the individual (the child) may not be the appropriate unit of measurement • Rather there are maladaptive parent-child interactions • Teaching parents new, more adaptive skills PCIT Chapters 1 and 2

6. Behavioural Child Management Training Typical parental problems: • Vague or inconsistent instructions • Overuse of punishments (threats, anger) • Inconsistent or ineffective application of punishment • Little reinforcment for prosocial, desirable behaviours PCIT Chapters 1 and 2

7. Behavioural Child Management Training • Parents are taught (“direct” coaching”) to implement behavior modification principles (reinforcement, extinction) • Parents as therapists • Includes planned activity scheduling (differential reinforcement) taken in the form of play therapy • Can be taught to single families or to groups • Long term maintenance of training benefits PCIT Chapters 1 and 2

8. About normative behaviours… • Behaviour problems peak at 3 years • Related to developmental hurdles: independence, language development • Verbal negotiation (assertion) develops after this, aggression usually declines • Oppositional and aggressive behaviours that remain at this age tend to persist PCIT Chapters 1 and 2

9. Effectiveness of PCIT Almost exclusively based on parental demographics: • Participation and motivation • Marital Discord • Psychopathology and substance abuse • Intelligence (IQ) PCIT Chapters 1 and 2

10. Effectiveness of PCIT Child factors: • Loss of effectiveness in children over 7 years of age • More formal methods used for older children (contingency contracts, token economies) 2. Less favorable results in Autistic children PCIT Chapters 1 and 2

11. Steps in PCIT • Teaching and coaching of play therapy and discipline skills • Pre- and post-assessment • Follow-up and booster treatments as necessary PCIT Chapters 1 and 2

12. Chapter 2:The First Session PCIT Chapters 1 and 2

13. Assessment Environment • Parent(s) and child are present • Child allowed “free play” during parental assessments • Uses a series of parent, child, and teacher report measures, including direct observation of parent-child interactions PCIT Chapters 1 and 2

14. Dyadic Parent-child Interaction Coding System • Two way mirror, standard intercom, “bug-in-ear” microphone • Parents are assessed individually (out of sight of the other) • Session should be videotaped PCIT Chapters 1 and 2

15. Dyadic Parent-child Interaction Coding System Three situations (5 minutes each): • Child directed interaction • Parent directed interaction • Cleanup PCIT Chapters 1 and 2

16. Classroom observation • Multiple observations of children in daycare or school setting • Observations of: • Referred child • Child with “average” behaviour • Child with behaviour similar to referred child PCIT Chapters 1 and 2