Tag

disruptive behaviors

PCIT: Improving Child Behavior, Transforming Parent-Child Relationships

By | NESCA Notes 2018

photo from pcit.org

 

By: Ryan Ruth Conway, Psy.D.
Clinical Psychologist, NESCA

First developed in the 1970’s by Sheila M. Eyberg, Ph.D., Parent-Child Interaction Therapy (PCIT) is a scientifically proven treatment program for young children (ages 2-7) who display challenging behaviors (e.g., noncompliance, defiance, temper tantrums, aggression) and difficulty regulating their emotions. PCIT therapists work with both the child and the parent together. Goals of treatment are to develop warmth and positivity in the parent-child relationship and teach parents how to effectively deal with behavioral problems both at home and publicly. While this efficacious treatment has been around for almost 50 years and is practiced both nationally and internationally, it is not widely known amongst parents and professionals in Massachusetts.

 

The video above provides brief illustrations of the treatment in action at the University of Miami’s PCIT program. Watching the video, you will see clips of a PCIT therapist “coaching” the parent through a one-way mirror, as the parent listens to the therapist’s instructions about interacting with his or her child through an earpiece while they play. PCIT is unique in that it is “in vivo,” or in real time, which helps the therapist directly observe parent-child interactions and also greatly enhances the caregiver’s learning of new skills that promote positive behaviors in children.

The video depicts the first phase of PCIT treatment called Child-Directed Interaction (CDI), which is the relationship enhancement phase. In CDI, parents follow the child’s lead in play while practicing specialized parenting skills. One of the skills applied by the parents in the video is praise. But not just any praise – this is labeled praise (e.g., “Great job playing gently with the toys”). Labeled praise communicates to the child specifically what it is that they did well, which increases the likelihood that this behavior will happen again, bolsters the child’s self-esteem and also promotes positive feelings between the parent and child. Praise feels good to give and to receive! Another skill practiced in CDI is reflection, or repeating what the child says during the play (e.g., Child says “The kangaroo is jumping”; Parent says “He is jumping very high!”) Reflections show that the parent is listening to the child, that the parent approves of what the child is doing and has also been shown to improve speech. Labeled praise and reflections are just two of the many skills taught to parents in CDI.

While positive behaviors are reinforced in CDI, inappropriate behaviors (e.g., whining, crying, talking back) are intentionally ignored to reduce their occurrence. While ignoring disruptive behaviors, parents are coached to use distraction and redirection skills. CDI then sets the foundation for the next phase of PCIT, called Parent-Directed Interaction (PDI), which continues to encourage appropriate play while also focusing on a structured and consistent approach to discipline.

There have been numerous studies documenting the effectiveness of PCIT (http://www.pcit.org/literature.html). Results have shown improvements in child behavior as well as reduced stress and increased confidence amongst caregivers. In addition to these outcomes, we see a stronger, happier parent-child bond!

NESCA is thrilled to announce that we are now offering PCIT! If you or someone you know might be interested in this treatment, please contact Dr. Ryan Ruth Conway at rconway@nesca-newton.com or (617) 658-9831.

To learn more about PCIT, visit http://www.pcit.org/

 

About the Author: 
Conway

Ryan Ruth Conway, Psy.D., is a licensed clinical psychologist who specializes in Cognitive Behavioral Therapy (CBT), behavioral interventions, and other evidence-based treatments for children, adolescents and young adults who struggle with mood and anxiety disorders as well as behavioral challenges. She also has extensive experience conducting parent training with caregivers of children who present with disruptive behaviors and Attention-Deficit/Hyperactivity Disorder. Dr. Conway has been trained in a variety of evidence-based treatments, including Parent-Child Interaction Therapy (PCIT), Dialectical Behavior Therapy (DBT), and Exposure with Response Prevention (ERP). Dr. Conway conducts individual and group therapy at NESCA utilizing an individualized approach and tailoring treatments to meet each client’s unique needs and goals. Dr. Conway has a passion for working collaboratively with families and other professionals. She is available for school consultations and provides a collaborative approach for students who engage in school refusal.

Reach out if you would like to work with Ryan: Email rconway@nesca-newton.com

 

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Catch Them When They’re Good!

By | NESCA Notes 2017

 

By:  Ryan Conway, Psy.D.
NESCA Clinical Psychologist

If your child’s go-to response to your requests is typically “no,” then keep reading…

Children who tend to disobey rules, become easily agitated, experience temper outbursts and argue with authority figures are known to display a pattern of behaviors called disruptive behaviors. These behaviors can cause significant family turmoil and become quite challenging for schools to manage. Children who have trouble regulating their emotions and behaviors may be pinned as “the bad kids.” This is unhelpful because it does not explain what exactly is underlying the acting out. This type of reputation can also impact a child’s self-esteem, resulting in feelings of inadequacy and self-doubt. Disruptive behaviors could be masking other issues that are not obvious to teachers and parents. Consider the possibility that the kindergarten student who shuts down and refuses to engage in class is not oppositional, but instead experiencing anxiety about being away from his mother or father. Maybe the second grader obtains his parents’ attention most often at home when she lashes out. In trying to control disruptive behaviors, children get a lot of attention from adults for what they are doing wrong, often times unintentionally.

One of the hallmarks in teaching caregivers how to effectively manage these kinds of behaviors is positive parenting, which comes from a behavior therapy approach. Among positive parenting techniques is “catching them when they’re good,” which shifts the focus away from what is problematic and towards the appropriate behaviors parents want to see continue. With this technique, parents become more mindful about the behaviors they attend to and seek out opportunities to let their child know when he or she is on the mark. It feels good for both the giver and the receiver, and can bring you closer to your child!

Positive feedback is a powerful tool at any age. For children, it comes in many forms – a sticker for helping to set the dinner table, a praise statement (“I’m so pleased that you are using gentle hands with your brother”), even a hug! As your child starts to recognize that you are giving more attention to appropriate behaviors, they will similarly shift from negative actions (e.g., sassing off, whining, crying, etc.) to positive ones.

Behavioral parent training empowers caregivers by teaching them specific skills to not only manage their children’s behavior at home, but also to improve communication, build warmth within the parent-child relationship and create a calmer household. The Society of Clinical Child and Adolescent Psychology (SCCAP), a group dedicated to disseminating information about evidence-based therapies for youth mental health problems, sites behavior therapy (individual parent and groups of parents with or without child participation) as the most efficacious treatment for disruptive behaviors in children. The SCCAP website, www.effectivechildtherapy.org, was recently updated and is a helpful resource for parents seeking information and guidance about treatment for children and teens.

NESCA is excited to be offering a new group for parents and children ages 7-10 who exhibit disruptive behaviors and/or ADHD symptoms. This group will have separate parent and child sections – with opportunities for combined parent-child sessions – and utilize both behavioral and cognitive-behavioral techniques. For additional information, visit http://www.nesca-newton.com/events.html.

Or visit our previous article about behavioral parent training and the research backing this approach: http://www.nesca-news.com/2017/04/parent-training-programs-101.html.

 

About the Author:

Conway

Ryan Ruth Conway, Psy.D., is a licensed clinical psychologist who specializes in Cognitive Behavioral Therapy (CBT), behavioral interventions, and other evidence-based treatments for children, adolescents and young adults who struggle with mood and anxiety disorders as well as behavioral challenges. She also has extensive experience conducting parent training with caregivers of children who present with disruptive behaviors and Attention-Deficit/Hyperactivity Disorder. Dr. Conway has been trained in a variety of evidence-based treatments, including Parent-Child Interaction Therapy (PCIT), Dialectical Behavior Therapy (DBT), and Exposure with Response Prevention (ERP). Dr. Conway conducts individual and group therapy at NESCA utilizing an individualized approach and tailoring treatments to meet each client’s unique needs and goals. Dr. Conway has a passion for working collaboratively with families and other professionals. She is available for school consultations and provides a collaborative approach for students who engage in school refusal.

 

If you are interested in working with Dr. Conway or have any additional questions about NESCA’s therapy services, please complete NESCA’s online intake form.

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.