Parent-child therapy helps tame out-of-control children


Parent-child therapy helps tame out-of-control children

ARIEL SABAR Special To The Washington Post

The Columbia Daily Tribune




Friday, January 10, 2014 at 2:00 pm

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Edith, a retired Capitol Hill staffer from Washington, was at the end of her rope last year over the mayhem her 5-year-old great-grandson Wayne was causing at preschool. "I was on speed dial" at the school, said Edith, who is raising two of her great-grandchildren. "He was hitting kids, destroying the classroom, tearing the ABCs off the wall — just terrorizing the building."


The principal begged her to seek help, and Edith soon enrolled Wayne — and herself — in an emerging psychological treatment for out-of-control preschoolers called Parent-Child Interaction Therapy (PCIT). The program has been slowly making its way into clinics across the country after years of randomized trials that have won it recognition as one of the most effective treatments for young children prone to frequent and destructive meltdowns.

LOCAL CONNECTION

For information about the Parent-Child Interaction Therapy (PCIT) here in Columbia, call 777-8300.

Unlike traditional play therapy, in which a therapist plays with the child while the parent stays in a waiting room, PCIT takes aim at both child and parent — or chief caregiver — and at the day-to-day mechanics of their relationship. Its premise is simple: that the best way to help children with titanic tempers is to coach parenting in real time.

Parents who enroll in PCIT get their own personal trainer: a social worker or psychologist who dispenses guidance through a wireless earpiece. In a typical session, the therapist retreats behind a one-way mirror and instructs parents — sometimes even feeding them lines to say — as they play with and learn to discipline their children. The live feedback catches ineffective parenting habits in their tracks and helps parents hew to PCIT's somewhat rigid script, which combines effusive praise and attention for good behavior with a clear system of warnings and timeouts for bad behavior.

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"It gave me a sense of 'someone's got my back,' " said Edith, who entered PCIT with Wayne at a mental health clinic in August 2012.

Wayne is typical of children who benefit from the therapy, which researchers have found most effective for those ages 2 to 7. According to clinical studies, families who complete PCIT see lasting improvements in child behavior: less-frequent and less-intense tantrums, less crying and whining, and less hyperactivity and inattention. Parents had less stress and enjoyed parenting more and typically developed a closer relationship with their children.

Young children, taking the first steps toward independence, are in many ways naughty by nature. By one estimate, the typical preschooler disobeys 25 to 50 percent of his parents' commands. Psychologists advise professional intervention only once the defiance becomes so disruptive that it upends family life.

"It's when the frequency of the behavior reaches a point where it starts influencing relationships with peers, family and teachers," said Kelly O'Brien, a clinical psychologist. "It's when it becomes multiple times per day over routine requests like getting ready for bed or turning off the computer to go to dinner."

To determine whether PCIT is appropriate, a therapist interviews the family, administers a parent questionnaire and standard child behavior assessment, and watches the parent and child play. Although some children entering PCIT might have already received a diagnosis of attention deficit hyperactivity disorder or oppositional defiant disorder, a psychiatric diagnosis isn't necessary for treatment.

Because of PCIT's time demands, parents have to be motivated. "The parent has to be organized enough to make a weekly outpatient therapy appointment," Loya said. "That kind of sounds like a given. But for a lot of folks, that's not the case."

Psychologists said the consequences of untreated behavior disorders in children are not just glares at the grocery store or the playground: Research has found that such children are more apt later to have drug and alcohol problems, to drop out of school, to develop other mental illnesses and to spend time in prison.

Although stimulants such as Ritalin are often prescribed for behavioral problems, medicine alone is not seen as an effective treatment for young children with disruptive behavior disorders.

PCIT might also play a role in reducing child abuse. A 2004 study in the Journal of Consulting and Clinical Psychology found that 850 days after treatment, 19 percent of physically abusive parents who had undergone PCIT had been re-reported to child welfare authorities, compared with 49 percent of physically abusive parents who received conventional services. A new line of PCIT research also is showing promising results with autistic children.

This article was published in the Friday, January 10, 2014 edition of the Columbia Daily Tribune with the headline "Tempering tempers: Parent-child therapy helps tam out-of-control children."

© 2014 Columbia Daily Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

on

Friday, January 10, 2014 2:00 pm.


Topics:

Psychotherapy,


Attention Deficit Hyperactivity Disorder,


Parent Child Interaction Therapy,


Play Therapy,


Disruptive Behavior Disorders,


Temper Tantrums,


Child Behavior

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