Theoretical Perspective
Theoretical Perspective
Parent-Child Interaction Therapy is an intervention founded on social learning and attachment theories (Allen, Timmer, Urquiza, 2014). Parent-Child Interaction Therapy uses the overview of attachment theory that states that “sensitive and responsive parenting provides the foundation of the child’s sense of knowing that he or she will be responded to when necessary” (Theoretical Underpinnings of PCIT, 2010). Therefore, the warmth, responsiveness, and sensitivity that Parent-Child Interaction Therapist teach and model when working with caregivers increases the chance that children will develop a sense of security in their interactions and relationship with their caregivers.
Parent-Child Interaction Therapy also utilizes …show more content…
concepts of social learning theories. According to Herchell, Calzada, Eyberg, and McNeil (2002) social learning theory asserts that “child behavior problems are inadvertently established or maintained by dysfunctional parent-child interactions” (pg. 10). Therefore, Parent-Child Interaction Therapy focuses on effective commands and meaningful play in an attempt to correct dysfunctional interactions between the child and the caregiver in order to combat the child’s problem behaviors.
Age Range and Treatment Modality PCIT is an intervention designed for the treatment of younger children who are diagnosed with disruptive behavior disorders, as well as children who are presenting with a broad range of behavioral, emotional, and family problems (Cohen, Heaton, Ginn, & Eyberg, 2011). Treatment is typically recommended for children between two and seven years of age (Zisser & Eyberg, 2010). It is suggested that children engaging in PCIT should either live with their caregiver, have liberal visitation with their caregiver, and/or will be returned to their caregiver within eight to ten weeks of beginning treatment (Rae & Zimmer-Gembeck, 2011). With regard to modality, PCIT is a family-based intervention that typically transpires in an outpatient setting (Zisser & Eyberg, 2010). Modifications to modality may be made, depending on the availability of necessary materials or accessibility to the required space.
Stage of Treatment and Rationale PCIT is a therapeutic intervention that occurs across all stages of treatment. PCIT is composed of three phases that implement strategies for parent-child engagement and interaction at the beginning, middle, and end stages. In the first phase, clients participate in pre-assessment and orientation, as the children’s behaviors and interactions with their caregivers are assessed and discussed. In the second phase, clients engage in Child-Directed Interaction (CDI), as children lead their caregivers in play activities. In the final phase, clients engage in Parent-Directed Interaction (PDI), as caregivers direct their children’s activities using appropriate PCIT skills and techniques. PCIT is an ongoing therapeutic process that occurs from the initiation of treatment until termination.
Treatment Goals
Several studies have shown that PCIT results in significant improvements in child behavior functioning as well as improvements in parenting skills and attitudes.
(Prat, n.d.). Parent Child Interaction Therapy aims to accomplish several different goals. One of the goals is to improve the quality of the parent-child relationship (What is PCIT, 2012). Through PCIT, it is expected that the parent will establish a more positive relationship with their child. The next goal is to change negative parent-child interaction patterns (What is PCIT, 2012). It is expected that through the course of PCIT, caregivers will develop skills to help manage their child’s behavior so that the child’s negative behaviors will decrease. As a result, the child’s behavior will become more manageable and result in less distress for the caregiver. Another goal for PCIT is to teach specific skills to establish a nurturing and secure relationship between the parent and child (What is PCIT, 2012). It is expected that the parent will demonstrate improvements in reflective listening skills, learn to use more prosocial communication, as well as display a more positive attitude (Prat, n.d.). It is also expected that the parent will learn discipline techniques, which will help the child to listen and follow directions (Prat, n.d). Lastly, PCIT aims to increase the child’s prosocial behavior and decrease negative behavior (What is PCIT, 2012). This goal will be effective because children tend to model their parent’s behavior. Therefore, parents can use their modeling role to teach their children positive behaviors (Prat, n.d.). For example, when parents communicate with their child demonstrating manners, the child can learn from those behaviors and apply them in other environments such as
school.
Materials
Specific materials are needed in order to conduct PCIT. One of the important materials is the ear piece and microphone, which is used to coach parents along as they interact with their children (Eyberg, 1999). Age appropriate play materials are also needed to conduct PCIT. Some of the suggested toys include: building blocks, Legos, tinker toys, Mr. Potatoe Head, crayons and paper, chalkboard with colored chalk as well as constructo-straws (Eyberg, 1999). The therapist should avoid toys that encourage aggressive play, preset rules, discouraging conversation, or those that lead parent/child imagining they are someone else (Eyberg, 1999). Lastly, an observational room with a one-way mirror is needed so that the therapist can directly watch how the parent and child are interacting.
Advanced Preparation
Before beginning PCIT sessions, the room must be set up prior to CDI and PDI with the materials mentioned above. In order to prepare clients and caregivers for the therapy, a brief overview about the structure of therapy and course of treatment should be given. The overview will also include talking with the child about therapy, explaining why the family is coming, and describing what the sessions will be like. The room and materials such as the ear bug, microphone, and one-way mirror will also be explained. If two parents are involved, their roles will be explained as well as that each of the parents will take turns in the playroom while the other parent observes (Eyberg, 1999). In addition, confidentiality, boundaries, and attendance will also be explained to the clients and caregivers.
Training
In order to become a certified PCIT therapist, one must complete sufficient PCIT training as well meet a range of criteria. One must be a mental health professional, with a master’s degree or higher in psychology, social work or related field (PCIT Training Guidelines, 2009). In addition, the person must be licensed or under the supervision of a licensed mental health service provider such as a licensed psychologist, marital and family therapist or a licensed clinical social worker (PCIT Training Guidelines, 2009). A person can also be a psychology doctoral student who has completed the 3rd year of training and completing clinical work under the supervision of a licensed mental health service provider (PCIT Training Guidelines, 2009). Initial Training requires 40 hours of direct training with ongoing supervision and consultation for about 4-6 months (PCIT Training Guidelines, 2009). However, ten hours of the training can also be conducted online with 30 hours of face-to-face contact (PCIT Training Guidelines, 2009). Throughout the supervision and consultation, commitment to the model is assessed (PCIT Training Guidelines, 2009). After the initial training, continuous training is required in which the trainee is required to complete live training and serve as a therapist with a minimum of two real PCIT cases (PCIT Training Guidelines, 2009). The continuous training will focus on case experience and skill review (PCIT Training Guidelines, 2009). During this time, trainees are required to remain in regular contact with a PCIT trainer twice a month until the cases are completed which could take up to a year (PCIT Training Guidelines, 2009).
Overview of the Intervention
PCIT is an assessment driven model that uses play therapy techniques. After the pre-assessment, PCIT is divided into two sections: Child-Directed Interaction (CDI) and Parent-Directed Interaction (PDI), both sections are typically 7-10 sessions. However, termination with the family is determined when certain success criteria are met. The termination requirements will be discussed later in the paper. The CDI part of PCIT involves the parents alone at first in order for the therapist to present and teach skills required to successfully complete PCIT. CDI is the portion of PCIT that teaches parents to use traditional play therapy techniques such as parents following their child’s lead in play by describing their activities and praising their positive behavior. (What is PCIT, 2012).
During CDI, the therapist, or coach, lets the parent’s lead and provides praise to the parent for correct behaviors; therefore, increasing the chances that they will repeat this correct behavior with their children. In the learning portion of CDI, parents learn skills known as PRIDE: praise, reflect, imitate, describe, and enthusiasm. Parents also learn that it is not effective to give commands, ask questions and criticize. Parents are taught that during play you do not want to give children commands because it can be perceived as an attempt for the parent to take the lead and it may also increase the chance of negative interactions (What is PCIT, 2012). CDI also teaches parents that the use questions in play can also be a way for the parent to hide commands, it takes the lead from the child, and it can portray to the child that the parent is not listen.
In the PDI portion, parents are taught how to give clear and concise commands and how to appropriately use the time out chair and time out room; therefore, increasing the chance of child compliance to commands and providing a plan that outlines steps to handle child’s inappropriate behavior. Parents are taught commands should be direct, positive, single, specific, age-appropriate, given in a normal tone of voice, polite, and used only when necessary (What is PCIT, 2012). Lastly, termination from PCIT is determined when parents have a session that shows mastery of CDI and PDI skills, child’s compliance is more than 75%, or within typical range of functioning, and parents feel confident managing child’s behaviors.
Discussion
Throughout Parent-Child Interaction Therapy, the main focus continues to be on the parent-child interaction. It is hoped that by improving the parent and child interaction that the child’s problem behaviors will decrease and be more manageable for the caregiver. During the PDI portion, parents are given direct feedback during their interaction with their child. This interaction is known as coaching. This intervention is perfect for foster parents who may need to learn how to appropriately interact with foster children who may exhibit problem behavior. This intervention may also prove beneficial for mothers of children in foster care whose treatment goal is reunification. Furthermore, any time that an individual’s treatment goals focus on improving child parent interactions or reducing problem behaviors such as verbal aggression, fighting, and defiant behavior; then Parent-Child Interaction Therapy would be beneficial and ideal.
Parent-Child Interaction Therapy is an intervention founded on social learning and attachment theories (Allen, Timmer, Urquiza, 2014). Parent-Child Interaction Therapy uses the overview of attachment theory that states that “sensitive and responsive parenting provides the foundation of the child’s sense of knowing that he or she will be responded to when necessary” (Theoretical Underpinnings of PCIT, 2010). Therefore, the warmth, responsiveness, and sensitivity that Parent-Child Interaction Therapist teach and model when working with caregivers increases the chance that children will develop a sense of security in their interactions and relationship with their caregivers.
Parent-Child Interaction Therapy also utilizes …show more content…
concepts of social learning theories. According to Herchell, Calzada, Eyberg, and McNeil (2002) social learning theory asserts that “child behavior problems are inadvertently established or maintained by dysfunctional parent-child interactions” (pg. 10). Therefore, Parent-Child Interaction Therapy focuses on effective commands and meaningful play in an attempt to correct dysfunctional interactions between the child and the caregiver in order to combat the child’s problem behaviors.
Age Range and Treatment Modality PCIT is an intervention designed for the treatment of younger children who are diagnosed with disruptive behavior disorders, as well as children who are presenting with a broad range of behavioral, emotional, and family problems (Cohen, Heaton, Ginn, & Eyberg, 2011). Treatment is typically recommended for children between two and seven years of age (Zisser & Eyberg, 2010). It is suggested that children engaging in PCIT should either live with their caregiver, have liberal visitation with their caregiver, and/or will be returned to their caregiver within eight to ten weeks of beginning treatment (Rae & Zimmer-Gembeck, 2011). With regard to modality, PCIT is a family-based intervention that typically transpires in an outpatient setting (Zisser & Eyberg, 2010). Modifications to modality may be made, depending on the availability of necessary materials or accessibility to the required space.
Stage of Treatment and Rationale PCIT is a therapeutic intervention that occurs across all stages of treatment. PCIT is composed of three phases that implement strategies for parent-child engagement and interaction at the beginning, middle, and end stages. In the first phase, clients participate in pre-assessment and orientation, as the children’s behaviors and interactions with their caregivers are assessed and discussed. In the second phase, clients engage in Child-Directed Interaction (CDI), as children lead their caregivers in play activities. In the final phase, clients engage in Parent-Directed Interaction (PDI), as caregivers direct their children’s activities using appropriate PCIT skills and techniques. PCIT is an ongoing therapeutic process that occurs from the initiation of treatment until termination.
Treatment Goals
Several studies have shown that PCIT results in significant improvements in child behavior functioning as well as improvements in parenting skills and attitudes.
(Prat, n.d.). Parent Child Interaction Therapy aims to accomplish several different goals. One of the goals is to improve the quality of the parent-child relationship (What is PCIT, 2012). Through PCIT, it is expected that the parent will establish a more positive relationship with their child. The next goal is to change negative parent-child interaction patterns (What is PCIT, 2012). It is expected that through the course of PCIT, caregivers will develop skills to help manage their child’s behavior so that the child’s negative behaviors will decrease. As a result, the child’s behavior will become more manageable and result in less distress for the caregiver. Another goal for PCIT is to teach specific skills to establish a nurturing and secure relationship between the parent and child (What is PCIT, 2012). It is expected that the parent will demonstrate improvements in reflective listening skills, learn to use more prosocial communication, as well as display a more positive attitude (Prat, n.d.). It is also expected that the parent will learn discipline techniques, which will help the child to listen and follow directions (Prat, n.d). Lastly, PCIT aims to increase the child’s prosocial behavior and decrease negative behavior (What is PCIT, 2012). This goal will be effective because children tend to model their parent’s behavior. Therefore, parents can use their modeling role to teach their children positive behaviors (Prat, n.d.). For example, when parents communicate with their child demonstrating manners, the child can learn from those behaviors and apply them in other environments such as
school.
Materials
Specific materials are needed in order to conduct PCIT. One of the important materials is the ear piece and microphone, which is used to coach parents along as they interact with their children (Eyberg, 1999). Age appropriate play materials are also needed to conduct PCIT. Some of the suggested toys include: building blocks, Legos, tinker toys, Mr. Potatoe Head, crayons and paper, chalkboard with colored chalk as well as constructo-straws (Eyberg, 1999). The therapist should avoid toys that encourage aggressive play, preset rules, discouraging conversation, or those that lead parent/child imagining they are someone else (Eyberg, 1999). Lastly, an observational room with a one-way mirror is needed so that the therapist can directly watch how the parent and child are interacting.
Advanced Preparation
Before beginning PCIT sessions, the room must be set up prior to CDI and PDI with the materials mentioned above. In order to prepare clients and caregivers for the therapy, a brief overview about the structure of therapy and course of treatment should be given. The overview will also include talking with the child about therapy, explaining why the family is coming, and describing what the sessions will be like. The room and materials such as the ear bug, microphone, and one-way mirror will also be explained. If two parents are involved, their roles will be explained as well as that each of the parents will take turns in the playroom while the other parent observes (Eyberg, 1999). In addition, confidentiality, boundaries, and attendance will also be explained to the clients and caregivers.
Training
In order to become a certified PCIT therapist, one must complete sufficient PCIT training as well meet a range of criteria. One must be a mental health professional, with a master’s degree or higher in psychology, social work or related field (PCIT Training Guidelines, 2009). In addition, the person must be licensed or under the supervision of a licensed mental health service provider such as a licensed psychologist, marital and family therapist or a licensed clinical social worker (PCIT Training Guidelines, 2009). A person can also be a psychology doctoral student who has completed the 3rd year of training and completing clinical work under the supervision of a licensed mental health service provider (PCIT Training Guidelines, 2009). Initial Training requires 40 hours of direct training with ongoing supervision and consultation for about 4-6 months (PCIT Training Guidelines, 2009). However, ten hours of the training can also be conducted online with 30 hours of face-to-face contact (PCIT Training Guidelines, 2009). Throughout the supervision and consultation, commitment to the model is assessed (PCIT Training Guidelines, 2009). After the initial training, continuous training is required in which the trainee is required to complete live training and serve as a therapist with a minimum of two real PCIT cases (PCIT Training Guidelines, 2009). The continuous training will focus on case experience and skill review (PCIT Training Guidelines, 2009). During this time, trainees are required to remain in regular contact with a PCIT trainer twice a month until the cases are completed which could take up to a year (PCIT Training Guidelines, 2009).
Overview of the Intervention
PCIT is an assessment driven model that uses play therapy techniques. After the pre-assessment, PCIT is divided into two sections: Child-Directed Interaction (CDI) and Parent-Directed Interaction (PDI), both sections are typically 7-10 sessions. However, termination with the family is determined when certain success criteria are met. The termination requirements will be discussed later in the paper. The CDI part of PCIT involves the parents alone at first in order for the therapist to present and teach skills required to successfully complete PCIT. CDI is the portion of PCIT that teaches parents to use traditional play therapy techniques such as parents following their child’s lead in play by describing their activities and praising their positive behavior. (What is PCIT, 2012).
During CDI, the therapist, or coach, lets the parent’s lead and provides praise to the parent for correct behaviors; therefore, increasing the chances that they will repeat this correct behavior with their children. In the learning portion of CDI, parents learn skills known as PRIDE: praise, reflect, imitate, describe, and enthusiasm. Parents also learn that it is not effective to give commands, ask questions and criticize. Parents are taught that during play you do not want to give children commands because it can be perceived as an attempt for the parent to take the lead and it may also increase the chance of negative interactions (What is PCIT, 2012). CDI also teaches parents that the use questions in play can also be a way for the parent to hide commands, it takes the lead from the child, and it can portray to the child that the parent is not listen.
In the PDI portion, parents are taught how to give clear and concise commands and how to appropriately use the time out chair and time out room; therefore, increasing the chance of child compliance to commands and providing a plan that outlines steps to handle child’s inappropriate behavior. Parents are taught commands should be direct, positive, single, specific, age-appropriate, given in a normal tone of voice, polite, and used only when necessary (What is PCIT, 2012). Lastly, termination from PCIT is determined when parents have a session that shows mastery of CDI and PDI skills, child’s compliance is more than 75%, or within typical range of functioning, and parents feel confident managing child’s behaviors.
Discussion
Throughout Parent-Child Interaction Therapy, the main focus continues to be on the parent-child interaction. It is hoped that by improving the parent and child interaction that the child’s problem behaviors will decrease and be more manageable for the caregiver. During the PDI portion, parents are given direct feedback during their interaction with their child. This interaction is known as coaching. This intervention is perfect for foster parents who may need to learn how to appropriately interact with foster children who may exhibit problem behavior. This intervention may also prove beneficial for mothers of children in foster care whose treatment goal is reunification. Furthermore, any time that an individual’s treatment goals focus on improving child parent interactions or reducing problem behaviors such as verbal aggression, fighting, and defiant behavior; then Parent-Child Interaction Therapy would be beneficial and ideal.