|Parent-Child Interaction Therapy in Outpatient Clinical Settings; Modifications and Extensions
|Sunday, May 30, 2010
|9:00 AM–10:20 AM
|Texas Ballroom Salon C (Grand Hyatt)
|Area: CBM/CSE; Domain: Service Delivery
|Chair: Jennifer L. Crockett (Kennedy Krieger Institute)
|CE Instructor: Caio Miguel, Ph.D.
|Abstract: Parent-Child Interaction Therapy, or PCIT, is an empirically-supported parent training model for children with conduct and behavior problems. Training occurs across two phases, Child Directed Interaction (CDI) and Parent Directed Interaction (PDI). The goals of CDI are to increase positive parenting skills. The goals of PDI are to increase parental behavior management skills. The overall goals of PCIT are to increase child compliance and decrease problem behavior. Therapists use behavioral skills training techniques and live coaching throughout the course of the criterion-based intervention. This symposium will describe four separate extensions or modifications to the PCIT methodology. The first presentation will provide an overview of the PCIT model and discuss how PCIT is used in an inner-city outpatient clinical setting. The second presentation will describe the treatment progression across two very different parent child dyads, including one parent with a history of drug abuse and a child with autism. The next presentation will discuss modifications to PCIT for children with severe language delays. The final presentation will discuss the extension of PCIT for families in which both parent and child have a disability.
|Implementation of Parent-Child Interaction Therapy in a Community Outpatient Clinic: Challenges and Rewards
|SUSAN K. PERKINS-PARKS (Kennedy Krieger Institute), Andrew Scherbarth (Kennedy Krieger Institute)
|Abstract: Child noncompliance accounts for some 80-90% of the referrals to treatment clinics for children ages 4 to 7 (McMahon and Forehand, 2003). Parent-Child Interaction Therapy (PCIT) has a strong evidence base for treatment of child disruptive behavior and noncompliance in this age group and draws upon operant theory in addition to child psychotherapy and early child development (Eyberg, 1988), yet poses implementation challenges in community mental health settings. This presentation will provide a brief introduction and overview of the PCIT treatment model and will discuss how PCIT may be used in an outpatient setting with primarily inner city families. The many strengths of the model including among others the developer’s commitment to dissemination and reliance upon behavioral skills training and skill mastery will be delineated as will the obstacles community practitioners may encounter during service delivery. The presentation will include case examples with sample data for parent and child participants (data to be collected) and will seek to raise awareness among child treatment providers regarding PCIT’s implementation problems and solutions and offer support for the efficacy of the approach in outpatient settings despite some of the barriers that may arise.
|Comparison of Parent-Child Interaction Therapy Treatment Effects With Two Families, One With a History of Drug Abuse
|EMILY D. SHUMATE (Kennedy Krieger Institute), Jennifer L. Crockett (Kennedy Krieger Institute)
|Abstract: This presentation will discuss the use of Parent Child Interaction Therapy (PCIT) with two families. PCIT is an empirically-supported treatment based on the principles of applied behavior analysis used to decrease disruptive behaviors and increase compliance with children with conduct disorders. New areas of research include evaluating the use of PCIT with children with autism, intellectual disabilities, and other behavioral disorders. Little research has evaluated the use of PCIT with parents with a history of drug abuse, involvement with child protective services, history of domestic violence, or with suspected intellectual disabilities. A comparison between two families who completed the PCIT program will be discussed. One dyad includes a single mother with a history of drug abuse and involvement with child protective services with a 5-year-old son with autism. The other dyad includes a single mother working on a graduate degree and a 5-year-old son with a conduct disorder. Data show that both families were able to meet criterion on all parenting skills, but the time in treatment prior to meeting criteria and maintaining the skills varied. These two clinical cases will be discussed regarding considerations and modifications when using PCIT as a behavioral treatment for diverse populations.
|Modifications of Parent-Child Interaction Therapy for Young Children With Severe Language Delays
|NATALIE A. PARKS (Marcus Autism Center), M. Alice Shillingsburg (Marcus Autism Center), Nathan A. Call (Marcus Autism Center)
|Abstract: Parent-Child Interaction Therapy (PCIT) is an empirically-supported intervention that has been shown to be effective at decreasing problem behavior and producing qualitative changes in interactions between parents and their typically developing children (Edwards, et al., 2002; Eyberg & Ross, 1978). Recently researchers have begun to evaluate the effectiveness of PCIT with children with developmental disabilities (Brinkmeyer & Eyberg, 2003). Initial studies have discussed possible modifications to the PCIT procedures that are necessary adaptations for children with language delays (McDiarmid & Bagner, 2005) or autism spectrum disorders (Bagner & Eyberg, 2007; Solomon, Ono, Timmer, & Goodlin-Jones, 2008). However, to date this empirically-supported intervention has not been adapted for children with severe language delays. This talk will discuss a modification to the traditional PCIT model that incorporates parents teaching their children to request preferred items. Data indicate that children engage in higher rates of spontaneous utterances after parents are trained to teach their children to request.
|Application of Parent-Child Interaction Therapy When Both the Parent and Child Have a Disability
|KRISTEN M. KALYMON (Kennedy Krieger Institute), Emily D. Shumate (Kennedy Krieger Institute)
|Abstract: This study investigated the use of Parent-Child Interaction Therapy in reducing problem behavior in a child diagnosed with autism and a parent with a suspected intellectual disability. PCIT is an empirically-supported treatment for children with conduct-disorders that emphasizes improving the quality of parent-child relationships and changing interaction patterns. The current study used a single-case design to explore changes in the child’s disruptive behaviors as well as changes in parental skills. The participant, Kyle, was a 10-year-old boy who was diagnosed with autism and exhibited aggression, self-injurious behavior and disruptive behavior. The participant’s mother, Judy, was 46-years-old with suspected cognitive impairments. Weekly sessions were conducted in therapy rooms equipped with one-way mirrors and an adjoining observation room. Judy was taught to describe and praise Kyle’s behaviors and use only correct commands through direct coaching, modeling and role-playing. Current data include the first half of the treatment package (Child-Directed Interaction). Results, thus far, indicate decreases in Kyle’s self-injurious and aggressive behaviors, increases in total duration of in-seat behavior and toy engagement, along with increases in positive verbal behaviors and decreases in non-directive statements, by Judy, over the course of treatment. Additional data, including results from Parent-Directed Interaction phase, will be collected.