Group Parent Child Interaction Therapy

Parent-child Interaction Therapy (PCIT) is an interactive therapist-parent, parent-child evidence based treatment originally developed for use in young children (ages 2-7) with disruptive behaviors (Gurwitch 341). Today, PCIT is not only implemented for families with a wide-array of mental health problems including trauma, substance abuse, maltreatment, autism, and anxiety, but also across multiple cultures, with successful implementations in varying ethnic and cultural communities around the world (Lieneman 239). Since it’s development in 1974, both cross-sectional and longitudinal studies have shown significant positive outcomes of PCIT for children and their families including improved child behaviors, reduced parenting stress, and improved parent-child relationships (Gurwitch 341). To date, it is one of the most researched, highly regarded and effective evidence-based treatments in child psychology.

TED Talk stated that the greatest risk factors for children who are identified as having conduct problems are that they will end up in prison. 1 in 5 children that are diagnosed with conduct disorder from ages 5 to 6 years of age will cost over $1 million dollars. The book stated that they are often aggressive and psychological cruel to people. They will destroy people’s property, steal, skip school, and many more bad things if you treat it later it will be more difficult. Schools does use some of the strategies and resources that are recommended by The Virtues Project, because it helps to understand the how they should talk to children. I think that families and teachers do not integrate some strategies because sometimes it does not work,

Research is continually being conducted everyday with this common disorder. Many parents main concerns is the use of medication to treat their child. Many doctors nowadays show the parents the current research of studies being done and their effectiveness as well as providing papers for families for their willingness to participate in ongoing studies to better help understand their childs disorder and the best way to treat it ( Görtz-dorten, Breuer, Hautmann, Rothenberger, Döpfner, 2011).

It mainly focuses on developing a safe, stable, nurturing environment with positive interactions with caregivers (Shi, 2014). Individuals with reactive attachment disorder require change and the restructuring of the development process. Per United Behavioral Health (2016), possible therapeutic techniques include infant/parent psychotherapy and interaction guidance. The infant/parent psychotherapy focuses on “attachment, trauma, cognitive behavioral, and social learning theories” to treat traumatized children and families with a final goal to restore a sense of trust and safety within the relationship and family (United Behavioral Health, 2016). Whereas interaction guidance is a strength based intervention using positive reinforcement to reshape behavior and observable interactions within the relationship, which is comparable to behavioral therapy. In addition to those two types of therapy, psychoeducation for caregivers and inexperienced parents is important for them to learn that their abilities as a parent affects their child. Not much research has been done do to the ethical standards and “do no harm” to

“Behavior problems (e.g., aggression, oppositional behaviors, separation anxiety) in young children ages 5 years and younger are common and often begin in the toddler and preschool years” (Fung, Fox, & Harris, 2014 p.623; as cited in Fox & Holtz, 2009). Unfortunately, Fung et al. (2014) found that there are some at-risk young children whose behavior problems fail to dissolve. If not treated, these conduct issues frequently form into more serious psychiatric side effects as children advance into adolescence and adulthood, and regularly induce future cycles of violence (as cited in Campbell, 2002; Einfeld et al., 2006; Robert, Mazzucchelli, Studman, & Sanders, 2006). Fortunately, there are programs available to help at-risk young children with behavior problems. One of those programs is called Early Pathways (EP). EP is a therapy program that takes place in the home of the child and their parents (Fung et al., 2014). Fung et al. decided to incorporate the EP program into their study to find out if the program would be successful for the 447 at-risk children ages 5 and younger who were participating in the study. The article by Fung et al. offers direction for creating successful early-mediation for families of low-income to improve behavior results for their children.

This approach aim at providing parents with the skills to managed the adolescent’s behaviors. According to Centers for Disease Control and Prevention (2017) “parents work with a therapist to learn strategies to create structure, reinforce good behavior, provide consistent discipline, and strengthen the relationship with their child through positive communication”. Children behaviors that are diagnosed with a disruptive behavior disorder affects the entire family and peers. The parent behavior therapy approach is a way to include the child’s family in her care while providing the parents with the skills they need to manage the child’s symptoms. Cognitive Behavior Therapy would be used for the client on individual bases. Cognitive behavior therapy would be effective in teaching the client strategies for coping with her anger. Since the client is over the age of five, an atypical antipsychotic medication called risperidone would be used for treatment purposes. This medication was selected, because it is FDA approved to treat behavior problems in children. “Despite the widespread use, atypical antipsychotics are not FDA approved for children younger than five years old. Five atypical antipsychotics currently have FDA-approved indications for use in children and adolescents: aripiprazole, olanzapine, paliperidone, quetiapine, and risperidone” The Centers for Medicare & Medicaid Services (2013) . The expected outcome for this client is to provide treatment that help the client to cope with her behavior issues and to promote the client with a good quality of life. The ultimate goal, is that the client will be able to function in

Webster-Stratton and Reid (2003) presented the Dina Dinosaur Treatment Program to the targeted students with conduct problems and the comorbid problems related to ADHD and ODD diagnoses. Both parent and child participated in a 22-session program. Webster-Stratton and Reid (2003) stated intervention with both parent and child are necessary for success and consistency when learning the components of the program. The Dina Dinosaur program focused on topics such as: How to do your best in school, Understanding your feelings, Using Problem-Solving strategies and steps as well as helping both parties understand how to be friendly, and other social entities in proactive communication that lead to prosocial behaviors. The result of the research conducted

Participants: M. Parker, Guidance Counselor, B. Michael, Social worker, Parent, D. Shaw Principal, S. Roberts, Behavioral Consultant, Classroom Teachers; D. Chemnitz and C. Ragusa

In addition, Parent-child interaction therapy (PCIT), has shown to be effective in child abuse victims and their parents. Improvements of parenting skills, less child behavioral problems, and better parent-child relationship are all outcomes of PCIT. In this therapy the parent and child have directed interaction. The parent is taught communication skills. After that the parent can play with the child while the therapist coaches the parent. Clear commands are taught to use at home and in public. In this activity the child must lead the activity and the parent mustn’t criticize the child to create a positive relationship. The study suggested that PCIT decreased reports of abuse and decreased behavior at school (Paul, Gray, Elhai, Massad, & Stamm, 2006).

After approximately four months of treatment, Bobby’s parents reported several weeks of regular compliance at home, no physical aggression at home or school, along with a teacher report of consistent engagement at school and significant improvement in overall compliance. Upon termination of therapeutic services, Bobby’s parents were given the Therapy attitude inventory (TAI) to inform the clinician of their therapeutic experience to help the clinician understand their perspectives and inform future practice. This therapeutic model is helpful in Bobby’s case to provide the parents with skills to facilitate prosocial behaviors in Bobby through the use of more effective communication and boundary setting through the use of PRIDE skills, direct commands, and time-out procedures. This therapeutic process helped to establish a secure relationship between Bobby and his parents, by replacing their authoritarian parenting style with an authoritative style to maintain structure and warmth. Through the therapeutic process, Bobby learned that his parents had consistent rules, responses to his actions, and would give him positive attention for good behavior. Bobby’s parents learned how to engage with Bobby more effectively to show him they were engaged and supportive, and still had boundaries. This healthier relationship dynamic between Bobby and his parents has also helped Bobby develop more functional relationships with other adults in his life including his teachers. As Bobby learned

According to Samoulis & Liddle (2006), observational ratings of therapist interventions have been used to predict outcomes at 6 and 12 months’ post-treatment for families receiving MDFT. The following outcome measures were as follows; Timeline Follow-Back Interview, which measures the quantity and frequency of daily consumption of drugs; using a calendar and the individual 's own memory in order to help them gather retrospective estimates; Child Behavior Checklist (CBC) and Youth Self-Report Externalizing and Internalizing dimensions, which is a widely used parent-report measure that assesses children’s behavioral problems and social competencies; the CBCL contains groupings of Externalizing (delinquent and aggressive)

According to Seligman and Reichenberg (2014), “therapists should have a solid understanding of the multiple casual factors that lead to the development of…disorder” (p.78). As discussed previously, therapists need to consider a child’s past traumatic experiences before moving into treatment. With the knowledge of a child’s early attachment trauma, family dynamics, and attachment style the therapist is better able to meet the child where they are at. It is also recommended that therapists working with children with conduct disorder related symptomology may be “called on to develop behavioral strategies for changing negative behaviors and provide training in social skills and problem solving. Therefore knowledge of behavior therapies, family therapy, and psychoeducation is needed” (Seligman & Reichenberg, 2014, p.79). In this excerpt, it seems that the therapist needs to be flexible to meet the needs of the child within a personal, family, social, and school-based setting. It also appears that working both within and in-between these domains of functioning are vital for positive therapeutic growth. Cognitive-behavioral therapy is also supported in research conducted by Copping et al. (2001) where this mode of therapy has been found to reduce conduct disorder related symptomology and overall social relations with peers. Within this framework, it is recommended that “therapists should not engage in win-lose battles, should not trust the adolescents’ portrayal of their own

It doesn’t stop there. Parent Child Interaction Therapy- Emotion Development has shown promising results. PCIT-ED is a 14-session psychotherapeutic treatment, where the primary caretaker is key to the implementation of treatment and serves as the "arm of the therapist." During this treatment the therapist observes the interaction between parent and child through a one-way mirror, through the use of a microphone and earbuds, he then coaches the parent to intervene more effectively on the child's behalf. The overall goal is to enhance the child capacity to identify emotions in self and in others, so homework is given. Nobody like homework, but this type is designed to enhance skill achievement between these weekly session. The key emotion-development element of treatment is essentially developmental and has relational components, because it identifies the caregivers strengths and weaknesses. This identification can result in the caregivers with affective disorders to be referred for their own treatments since there weaknesses and strengthens affect the child based on their own temperament, interpersonal and caregiving history, emotional maturity and even overt psychopathology. Remember a healthy environment is important. When emotion development programs aren't available, the use of behavioral activation strategies is worth trying before medication. It states "The use of antidepressant medications should be attempted only in circumstances in which very severe psychopathology is present with failures of appropriate psychotherapies" (Wehrwein). I agree I don’t think medication at such a young age is appropriate or helpful for the child. So at what age is

disruptive behaviors. BPT results in children’ s becoming not just compliant, but more compliant, than other children who do not have any significant behavioral problems, to their parents’ instructions. In addition to altering behaviors, BPT changes the parents-child interactions reduces parents’ stress. BPT is part of a multicomponent intervention for preventing serious conduct problems in school-age youth as well (Spiegler, 2016).

Santrock (2010) gives the advice for parents stating “ recognize that the quality of your parenting is a key factor in your child’s development…..parents should observe for themselves whether their children seen to be having behavior problems”. (p.372)