Copyright 2006 Sheila Eyberg Parent-Child Interaction Therapy

Copyright 2006 Sheila Eyberg  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 A n Empirically Supported Treatment for Disruptive Behavior Disorders

Copyright 2006 Sheila Eyberg 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

Copyright 2006 Sheila Eyberg  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) Coding Coaching Parent & Child

Copyright 2006 Sheila Eyberg PCIT Parent 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

Copyright 2006 Sheila Eyberg 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 Coding Coaching Parent & Child

Copyright 2006 Sheila Eyberg 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

Copyright 2006 Sheila Eyberg 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)

Copyright 2006 Sheila Eyberg Not Time-Limited  Termination criteria – Parent-child observations parent mastery of CDI and PDI skills Child compliance > 75% – Parent ratings of disruptive behavior Child behavior within ½ SD of normative mean on the ECBI – Parent self-confidence in parenting Parents feel able to handle problems on their own  Termination = Success

Copyright 2006 Sheila Eyberg PCIT Dropouts and Completers (N = 100) Maintenance Study Eyberg & Boggs, 2005

Copyright 2006 Sheila Eyberg 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) Coding Parent & Child Coaching

Copyright 2006 Sheila Eyberg 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

Copyright 2006 Sheila Eyberg Child-Directed Interaction Parent- Directed Interaction  Parents follow Play therapy skills Nonverbal communication of affect Differential attention Parents lead Limit-setting Consistency Problem solving Reasoning

Copyright 2006 Sheila Eyberg  IGNORE annoying, obnoxious behavior  STOP THE PLAY for dangerous or destructive behavior Child-DirectedInteraction DON’T DON’T –Give Commands –Ask Questions –Criticize DO DO –Praise –Reflect – Imitate –Describe Enthusiasm Enthusiasm

Copyright 2006 Sheila Eyberg Parent-Directed Interaction 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

Copyright 2006 Sheila Eyberg T he Command... Command No Opportunity Whoops! (Start over) Obey Labeled Praise Disobey Back to Play YEA!

Copyright 2006 Sheila Eyberg 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

Copyright 2006 Sheila Eyberg You are sitting quietly. 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

Copyright 2006 Sheila Eyberg Back to chair Child goes to Time out room 1 min + quiet Child gets off again The Backup “You got off the chair before I said you could. If you get off again, you’ll go to the Time Out Room.” Child gets off chair

Copyright 2006 Sheila Eyberg Yes You’re sitting quietly. Are you ready to [Obey Original Command]? Obey Acknowledge The First Obey Child stays on chair 3 min Plus 5 sec quiet

Copyright 2006 Sheila Eyberg Obey Back to play!!! Finally! Explain Labeled Praise Command

Copyright 2006 Sheila Eyberg Generalization Training  House rules  Public behavior  Siblings