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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
    • 1. interaction patterns are learned
    • 2. interactions are maintained in present relationships
    • 3. interaction patterns can be changed
    • 4. 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”
    • 5. 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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