Parent-Child Interaction Therapy (eBook)

Cheryl Bodiford McNeil, Ph.D., is a Professor of Psychology in the Clinical Child Program at West Virginia University. She received her Ph.D. from the University of Florida. Dr. McNeil's clinical and research interests are focused on program development and evaluation, specifically with regard to abusive parenting practices and managing the disruptive behaviors of young children in both the home and school settings. She has authored two books (Parent-Child Interaction Therapy and Short-Term Play Therapy for Disruptive Children), a continuing education package (Working with Oppositional Defiant Disorder in Children), a psychotherapy DVD for the American Psychological Association (Parent-Child Interaction Therapy), and a classroom management program (The Tough Class Discipline Kit). In addition, Dr. McNeil has published numerous research articles and chapters related to the importance of intervening early with young children displaying disruptive behaviors. She is the wife of Dr. Daniel McNeil, a Professor of Psychology, and the mother of two school-aged boys.Toni Hembree-Kigin, Ph.D., is a licensed psychologist in independent practice in Mesa, Arizona. She received her Ph.D. from the University of Florida. Dr. Hembree-Kigin's clinical and research interests are focused on young children with disruptive behavior problems and those in shelter and foster care. She has authored three books (Mental Health Interventions with Preschool children, Parent-Child Interaction Therapy, and Short-Term Play Therapy for Disruptive Children) and a continuing education package (Working with Oppositional Defiant Disorder in Children). Dr. Hembree-Kigin designed the therapeutic milieu in the group home and shelter care for the Child Crisis Center East Valley based on the PCIT model. In addition, Dr. Hembree-Kigin has published numerous research articles and chapters related to the importance of intervening early with young children displaying disruptive behaviors. She is the wife of Dr. Timothy Kigin, school psychologist, and mother of three school-aged children.

Preface 6
Why a Second, Expanded Clinical Edition? 6
Organization of the Second Edition 7
Contributors to the Book 8
Acknowledgments 9
Reference 9
Contents 10
Part I Fundamentals of Parent-Child Interaction Therapy 17
1 Overview of Parent-Child Interaction Therapy 18
What Is PCIT? 19
Typical Course of Treatment 20
Theoretical and Historical Underpinnings 21
Key Features of PCIT 22
Using the Second Edition 29
References 30
2 Research on PCIT 32
Early PCIT Research 32
Recent Research Initiatives 32
Suggestions for Future Research 38
References 41
3 Intake Assessment and Therapy Orientation Session 45
Who Should Attend the Intake Session? 46
Flexible Battery Approach 47
Semi-structured Intake Interview 48
Eyberg Child Behavior Inventory (ECBI) 49
Sutter-Eyberg Student Behavior Inventory Revised (SESBI R) 50
Dyadic Parent-Child Interaction Coding System III (DPICS III) 50
Joining with and Motivating Parents 54
Sharing Test Results with Parents 57
Explaining Specialized Parenting 57
Introducing PCIT to Parents and Children 58
Expectations for Attendance 59
Reducing Barriers to Treatment 60
Explaining the First Homework Assignment 61
Summary 61
References 62
4 Teaching Child-Directed Interaction 63
Overview of Teaching Session 63
Review Homework 65
Presenting the Goals of Child-Directed Interaction 65
Explaining the Five Minutes of Homework Each Day 65
Selling CDI to Skeptical Parents 67
Explaining the Overriding Rule of Letting the Child Lead 69
Teaching the Avoid Skills of Child-Directed Interaction 70
Teaching the Do Skills of Child-Directed Interaction 73
Using Strategic Attention 80
Using Selective Ignoring 81
Handling Disruptive Behaviors That Cannot Be Ignored 85
Modeling Skills in Combination 85
Role-Plays of Child-Directed Interaction 85
Appropriate Toys for Child-Directed Interaction 86
Dealing with One-Parent and Two-Parent Families 87
Incorporating Siblings 88
Adjusting CDI to the Childs Developmental Level 88
Problem-Solving with Parents on Logistical Issues 88
Assigning Child-Directed Interaction Homework 89
References 90
5 Coaching Child-Directed Interaction 91
Overview of a Typical Coaching Session 92
Setting Up for the Coaching Session 93
Check-In and Homework Review 94
Parental Non-compliance with CDI Homework 95
Observing and Recording Child-Directed Interaction Skills 99
Coaching the Do and Avoid Skills: Tips for Therapists 100
End of Session Debriefing and Homework Assignment 113
Progression of CDI Coaching Sessions 113
What if a Caregiver Does Not Reach CDI Mastery? 114
References 115
6 Teaching Parent-Directed Interaction 116
Rationale for Why Young Children Should Comply with Parental Commands 116
Structuring the PDI Teaching Session 117
Importance of Consistency, Predictability, and Follow Through 117
Importance of Memorizing PDI Diagrams (e.g., Using Exact Words) 119
Rationale for Use of Compliance Exercises 119
Giving Effective Instructions 120
Practicing How to Give Effective Instructions 125
Determining Compliance 126
Praising Compliance 128
Rationale for Disciplining Children with Time-Out in a Chair 129
The Time-Out Warning 131
Logistical Issues Associated with Time-Out 132
Getting the Child to Time-Out 132
What If the Child Agrees to Comply on the Way to Time-Out? 134
What if the Child Takes a Toy to Time-Out? 135
What if the Child Puts Himself in Time-Out? 135
Length of Time-Out 135
Common Misbehaviors in Time-Out that Should Be Ignored 136
Time-Out Does Not End Until the Original Instruction Is Obeyed 137
Use of a Second Instruction to Over-Teach Compliance 138
Use of Play Therapy to Decrease the Childs Anger Level 139
Three Time-Out Behaviors That Cannot Be Ignored 139
Using the Time-Out Room as the Back-Up for Time-Out Chair Behaviors that Cannot Be Ignored 140
Role-Playing and Wrap-Up 144
References 145
7 Coaching Parent-Directed Interaction 146
Overview of a Typical PDI Coaching Session 146
Preparing for PDI Coaching Sessions 147
Check-In and Homework Review 148
Observing and Recording Parent-Directed Interaction Skills 149
Criteria for Mastery of Parent-Directed Interaction Skills 150
General Guidelines for Coaching PDI 151
Debriefing Parents Following the Session 161
Homework 164
References 165
8 Progressing Through the Parent-Directed InteractionSessions 166
First PDI Coaching Session 170
Second PDI Coaching Session 178
Third PDI Coaching Session 179
Fourth PDI Coaching Session 182
Fifth PDI Coaching Session 185
Sixth PDI Coaching Session 188
Seventh PDI Coaching Session and Beyond 189
Graduation Session 191
Conclusion 194
Reference 195
Part II Adaptations of Parent-Child Interaction Therapy 196
9 Younger Children 197
Meaningful Differences in the Everyday Experience of Young American Children 198
Using Child-Directed Interaction with Infants 203
Adapting Child-Directed Interaction and Parent-Directed Interaction for Toddlers 204
Case Illustration 207
Parent-Child Interaction Therapy and Prevention 210
References 211
10 Older Children 212
Developmental Issues 212
University of Oklahoma Health Sciences Center Adaptations for Older Children 213
Concerns Raised by the SAMHSA Study Regarding PCIT with Older Children 213
Adapting CDI to Older Children 215
Adapting PDI to Older Children 219
Command Training (CT) Module 220
Time-out with Incentive Chart (TIC) Module 225
Time-Out with Suspension of Privilege (TSP) Module 230
Alternatives to the TSP Module for Children Who Are Extremely Aggressive and Defiant 232
Conclusion 233
References 234
11 Siblings 235
Including Siblings with Disruptive Behavior Problems 236
Including Siblings Without Behavior Problems 236
Coaching Older Siblings as Babysitters 237
Direct Coaching of Children to Decrease Sibling Conflict 237
Direct Coaching of Children to Improve Social Skills (e.g., Aspergers) 238
Using the Cooperation Game 239
Conclusion 245
12 Autism Spectrum Disorders 246
Theoretical Similarities of PCIT and Empirically Supported Treatments for ASD 248
Child-Directed Interaction 249
Working with Stereotyped, Repetitive Behavior During CDI 250
Parent-Directed Interaction 251
Time-Out Concerns 253
Clinical Limitations 254
Adapting PCIT: Communication and Social Skills Component 256
Case Study 259
Conclusion 261
References 261
13 Child Physical Abuse 264
Understanding the Population 265
Typical Referral Concerns 266
Adaptations and the Unique Treatment Needs of Families with a History of CPA 270
General Therapeutic Issues 271
Assessment 274
Treatment 279
Incorporating Additional Coaching Targets 279
Tailoring and Adaptations Specific to PDI 281
Case Illustration 283
Conclusion 290
References 291
14 Anxiety Disorders 294
Separation Anxiety Disorder 294
CARD Protocol for Adapting PCIT for Treatment of SAD 296
Treatment Outcome Research 299
Generalized Anxiety 300
Enhancing PCIT for Young Children with Generalized Anxiety 300
The Case of Alexander H 302
References 308
15 Attention Deficit Hyperactivity Disorder 310
Conducting PCIT with Children Diagnosed with ADHD 311
References 326
16 Extremely Aggressive and Explosive Children 327
The Case of Mario 327
CDI Pitfalls with Explosive Children 328
CDI Adaptations for Explosive Children 329
PDI Adaptations 333
Conclusion 335
Reference 335
17 Marital Conflict 336
Encouraging Both Parents to Attend Treatment 337
Assessment Techniques 337
Integrating Marital Therapy Within PCIT 340
Termination of Treatment 346
References 347
18 Parents with Major Life Stressors 348
Strategies for Working with Multi-stressed Families in PCIT 350
Divorce 351
Substance Abuse 355
Intimate Partner Violence 358
Low-Income Families 364
Parting Words 367
References 368
19 Ethnic Minority Children and Families 370
Parent Training, PCIT, and Application to Ethnic Minorities 370
PCIT with Hispanics 371
PCIT with Native Americans 375
PCIT with African-Americans 378
Examining Social Validity 380
Conclusion and Final Recommendations for Therapists 381
References 382
20 Staff-Child Interaction Therapy 384
Baseline 387
SCIT Video on Child-Directed Play 388
Didactic Child-Directed Interaction Session with Trainer 388
Coding and Coaching of Child-Directed Interaction 388
SCIT Video on Staff-Directed Interaction 389
Didactic Staff-Directed Interaction Session with Trainer 389
Coding and Coaching of Staff-Directed Interaction 389
Coaching Sessions on the Milieu (Two-Way Radio with Earpiece for Staff) 389
Post-intervention Findings 391
Conclusion 391
References 391
21 Teacher--Child Interaction Therapy for Preschool Classrooms 392
Research Underpinnings 392
Establishing Rapport with the Teacher 392
Format of Training 393
Coaching TCIT 393
Child-Directed Interaction in TCIT 393
TCIT Mastery Criteria 395
Teacher-Directed Interaction Phase 395
Follow-Up Consultation 397
References 397
22 School Consultation 399
Assessment 400
Establishing Rapport and Credibility with the Teacher 401
Conclusion 417
References 417
23 Home-Based PCIT: From the Lab to the Living Room 419
Clinical Advantages 419
Clinical Tips 421
Concluding Remarks 425
References 425
24 PCIT Around the World 426
Adapting PCIT for New Countries 427
International Issues with PCIT 429
Conclusion 431
References 432
25 Training Issues 433
PCIT National Advisory Board 433
Minimum Professional Qualifications to Conduct PCIT 434
Becoming a PCIT Therapist: Minimum Training Requirements 435
Becoming a PCIT In-agency Trainer: Minimum Training Requirements 438
Becoming a PCIT Master Trainer: Minimum Training Requirements 438
Costs of Starting a PCIT Program 438
References 441
Appendices 442
Appendix 1 442
Appendix 2 443
Appendix 3 444
Appendix 4 446
Appendix 5 447
Appendix 6 448
Appendix 7 450
Appendix 8 451
Appendix 9 452
Appendix 10 453
Appendix 11 454
Appendix 12 455
Appendix 13 457
Appendix 14 458
Subject Index 461