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Parent Training

(6-30-11)

  • Evolution of child management training
    • Laboratory demonstrations of operant learning
    • From laboratory to clinic
    • From clinic to home/school
    • Tharp & Wetzel (1969) triadic model
      • Consultant Mediator Target
      • Getting change done in the real world: Group D
    • The (continuing challenge): generalization (maintenance)
  • Miller (1975) Systematic Parent Training
    • Pretreatment procedures: contact & screening
    • Pretreatment procedures: baseline
    • Intervention I: Social Learning Concepts
      • interaction patterns are learned
      • interactions are maintained in present relationships
      • interaction patterns can be changed
      • the “Law of Reciprocity”
        • “if you want a positive, give one; and if you give a negative, expect one”
        • nonparity of pos & neg exchanges: “neg input if far more likely to be reciprocated than a positive input”
      • Praise, Ignore, and Punish rules
        • a. praise rule: when behav/interaction occurs that a person likes and would like to see more of–respond with positive attention
        • b. ignore rule: behav/interaction occurs that a person does not like, but does not wish to punish, turn away and do not respond to other person
        • c. punish rule: if any attention is directed toward a person engaging in intolerable behavior, attention must be negative and function to reduce the future occurrence
    • Intervention II: Basic Discrimination Training
      • [assumes parents’ motivaton, cooperation, and potential to function consistently]
      • parents have only 3 ways of responding to children’s behavior: (1) pos attention, (2) negative attention, (3) no attention
      • goal of Intervention II is to ensure that parents are aware of when and how to respond positively, negatively, or not at all
      • Praise
        • 1. When to praise: discrimination skills
        • 2. How to praise: identify praisable behavior, turn toward child, establish eye contact, pleasantly deliver verabl and physical praise
          • spoiling praise, Patterson’s “zap”s
          • demonstration, rehersal, feedback
        • 3. What to praise:
          • compliance with parents’ directives
          • approximate compliance
          • age-appropriate play and task performance3
          • pro-social peer and sibling interaction
          • positive verbal interaction
          • self-initiated positive responses to others
          • conspicuous absence of unwanted behavior
        • 4. When to praise: immediately if possible, consistently, virtually every time in training
      • Negative Attention
        • 1. obtain child’s attention
        • 2. state the problem
        • 3. state feelings and interpersonal consequences of negative behavior
        • 4. elicitate or suggest alternatives
        • 5. ending with positive interaction
    • Intervention III: Home Contingency Program
      • Miller suggest date supports benefit of beginning day with positive, pleasant interctions; divides family’s day into 3 to 6 time periods in which there are several parent-child or child disruptuons; begins with earliest daily period that presents problems
      • simily faces/points
      • include children (if over 8 years old) in negotiation of contingencies
    • Intervention IV: Punishment Procedures
      • Time out
        • 1. specific terminating command
        • 2. warning signal:
          • a. clear statement of the transgression
          • b. the consequence of noncompliance with terminating command
        • 3. time out period
      • Response cost
        • fines in token economy
        • mismanaged activities lead to loss of opportunity
      • Patterson: work consequences for adolescents
    • Intervention V: Parent Counseling
      • Brief (1-2 sessions)
        • “overwhelmed parents”, minor family crises, parents’ indecision about treatment, negative influences from outside the family
        • emphasize the importance of continuity of the interventions
      • Intensive
        • time-limited number os sessions to focus on unresolved issues from brief parent counseling, deal with counter-productive parental attitudes and behavior
      • Concomitant
  • Barkley (1997) parent training model of defiant children
    • Step 1 Why Children Misbehave
    • Step 2 Pay Attention!
    • Step 3 Increasing Compliance and Independent Play
    • Step 4 When Praise is Not Enough: Poker chips & points
    • Step 5 Time Out! and other disciplinary methods
    • Step 6 Extending Time Out to other misbehavior
    • Step 7 Anticipating Problems: Managing Children in public places
    • Step 8 Improving School Behavior from Home: The daily school behavior report card
    • Step 9 Handling Future Behavior Problems
    • Step 10 Booster Session & Follow-Up Meetings
  • A general model
    • Assessment and education
    • Deliberate, selective, and effective positive reinforcement
    • Extension to a second goal
    • Negative consequences
    • Token economy
    • Extension of the home program
  • Parent training in groups
    • goals
    • textbooks
    • structure
  • “Parent training” with adolescent children
    • Children’s needs: warmth & structure
      • Behavior therapy in families with child management problems tend to focus on consistency and contingency (structure),
      • Some authors/clinicians have addressed need for parental positive emotional support (warmth) for the success of behavior modification programs in the home: Patterson, Barkley
    • Adolescents’ needs: warmth, structure, expression, contribution
      • Behavior therapy with families with adolescents shifts the focus onto clear patterns of communication, reciprocal relationships, and appropriate balances (of power, of responsibility, of decision making) within the family
      • Identification and highlighting of common interests/concerns: the overlap between “what’s in it for me?” and “what’s in it for us?”
      • Flexibility in response
      • Setting of limits
      • Celebration of successes
      • Use of functional consequences

References:

Barkley, R.A. (1997). Defiant Children, 2nd Ed. New York: Guilford.

Patterson, G.R. (1971). Families: Applications of social learning to family life. Champaign, IL: Research Press.

Patterson, G.R. & Gullion, M.E. (1968). Living With Children: New methods for parents and Teachers. Champaign, IL: Research Press.

Patterson, G. & Forgatch, M. (1987). Parents and Adolescents Living Together. Part I: The Basics. Eugene, OR: Castalia Press.

Patterson, G. & Forgatch, M. (1989). Parents and Adolescents Living Together. Part II: Family Problem Solving. Eugene, OR: Castalia Press.

Tharp, R.G. & Wetzel, R.J. (1969). Behavior Modification in the Natural Environment. NY: Academic Press.

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