Parent-Child Interaction Therapy

1. Sheila Eyberg, Ph.D. Stephen Boggs, Ph.D. University of Florida Parent-Child Interaction Therapy

2. ODD (�No!) Refuse or defy adult requests Lose temper easily Annoy others on purpose CD (Against the Rules) Steal things Destroy things Start fights/Hurt others ADHD (Impulsive, Hyperactive, Inattentive) Have difficulty staying seated Have difficulty playing quietly Have difficulty awaiting turn An Empirically Supported Treatment for Disruptive Behavior Disorders

3. Disruptive Behavior Disorders in Preschoolers Highly persistent Worsen with time Strongest risk factor for adolescent delinquency and violent crime Prevalence up to 20% Costs to society very high Can be diagnosed reliably at age 3 Can be treated effectively if treated early

4. Parent and child together Theoretically grounded Emphasis on restructuring interaction patterns Not time-limited Assessment-driven Scientifically based Clinically validated Empirically supported Defining Features of Parent-Child Interaction Therapy (PCIT)

5. PCITParent and Child Together in Treatment Focus on changing behaviors of both parent and child Therapist tailors treatment based on observation of parent-child interactions during treatment Parent errors in application corrected on-the-spot Parents can be confident therapist understands their child Therapists can assess when parents ready to move to next step in treatment Allows accurate determination of treatment completion

6. Parent-Child Interaction Therapy (PCIT) Parent and child together Theoretically grounded Emphasis on restructuring interaction patterns Not time-limited Assessment-driven Scientifically based Clinically validated Empirically supported

7. Based on  Developmental Theory Baumrind�s Parenting Styles Authoritarian (high demandingness, low warmth) Permissive (high warmth, low demandingness) Authoritative (high warmth, high demandingness) Nurturance and firm limits both necessary for healthy adolescent outcomes PCIT draws from both attachment and social learning theory to achieve authoritative parenting

8. Parent and child together Theoretically grounded Not time-limited Emphasis on restructuring interaction patterns Assessment-driven Scientifically based Clinically validated Empirically supported Parent-Child Interaction Therapy (PCIT)

9. Not Time-Limited Termination criteria Parent-child observations parent mastery of interaction skills Child compliance > 75% Parent ratings of disruptive behavior Child behavior within � SD of normative mean Parent self-confidence in parenting Parents feel able to handle problems on their own Termination = Success

10. Completers and Dropouts

11. Parent and child together Theoretically grounded Emphasis on restructuring interaction patterns Assessment-driven Not time-limited Scientifically based Clinically validated Empirically supported Parent-Child Interaction Therapy (PCIT)

12. Structure of PCIT Assessment sessions Teaching sessions Describing Modeling Role-playing Coaching sessions Parent wears a Bug-in-the-Ear receiver while playing with child in playroom Therapist observes and codes parent and child behaviors at start of session Therapist coaches specific skills from observation room using microphone Spouses take turns being coached with child and observing spouse�s coaching

14. Discuss the E Discuss the E

15. Parent-Directed Interaction 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

16. The Command ...

17. The Warning ...

21. Finally!