Family therapies Flashcards
Parent Management Training (PMT)
testing
Group training (weekly sessions)
- Based on behavioural & social learning principles (skinner and Bandora) eg reinforcement, time out, shaping, attending and ignoring, antecedents, behaviour, and consequences
- Emphasis is on positive reinforcement
- Parents taught to: shift focus to new desired behaviour, +R new behaviour, limit punishment & focus on effective procedures eg time out
- Promoting warmth, +R, emotional management including eye contact
PMT and coercive cycle
- Train to change the coeicive cycle model (rewarding for both)
Child problem behaviour > parent responds emotionally > child escalates > parent escalates > parent withdraws or gives in
Child problem behaviour > child responds differently > child de-escalates > parent stays engaged
PMT and CU + research
- Promote warmth
- +R
- Eye contact/ emotional engagement btwen P+C
- Research = CU poorer outcomes but still benefit (curve instead of / even if small difference statistically big impact on their lives clinically)
Research for PMT
most promising of treatments,
marked improvement and maintence,
better if longer treatment, younger children (higher ES),
therapist more supportive than confrontational
Cons of PMT
Less effective for single parents + low SES (?other priorities, stress)
parent has to buy in and actually do this = drop out
Problem Solving Skills Training (PSST) pro and con
Problem Solving Skills Training (PSST)
- Focuses on cognitive distortions and interpersonal situations
* Generating alternative solutions to interpersonal problems
* Investigating attributions to cues in interactions (tend to attribute hostile intentions to others)
- 5 problem-solving steps: 1) Identify thoughts, feelings and behaviours in social situations, 2) Appraise the situation, 3) Identify self-statements/reactions, 4) alter their attributions and motivations, 5) learn to be more sensitive to others
- Need to have metacognitive skills
- Foster pro-social behaviours
- The therapist models self-statements “I could ignore and walk away”, “I could go talk to the teacher”
- Develop step by step approach to solving problems
- Use games (catch ball without hand for problem solving) and stories
- Problem solving sheet I gave Chloe
- Use reinforcement and mild punishment with tokens
PSST and Dodges social information processing model
- learn to process info so don’t behave based on their faulty attributions (eg hostile) - able to reappraise and decide how want to proceed (change “casual attributions from “they bumped into me because their a jerk to maybe their in a rush”)
Multisystemic Treatment pro and con
- Intensive family and community-based approach
- For teens with severe conduct problems who are at risk for out-of-home placement and other negative consequences
- Attempts to empower caregivers to improve youth and family functioning
- Effective in reducing long-term rates of criminal behaviour, Reduces association with deviant peers
- Based on Bronfenbrenners model
Prevention assumptions
- conduct problems can be treated in younger children (start early),
- involves counteracting risk factors/strengthening protective factors (a buffer) to prevent escalation of problem behaviours,
- cost effective in the long run not short run
Incrediable years
what is it
what are the 3 stages
How does monitoring work?
group based
- Programme based on cognitive social learning for teachers and parents
- Replace critical and physically violent discipline with positive strategies (ignoring, use of natural and logical consequences, redirecting, monitoring, and problem-solving).
Basic
(from 3-10 year olds)
- Targets parenting skills:
- play/involvement: to allow them to learn,
- praise/rewards: make it tangible, and verbal,
- limit setting,
- handling misbehaviour: avoiding and ignoring it
- Use video modelling, role plays, home work activities
Advanced
(targets interpersonal skills):
- Problem solving
- Anger management (emotions <-> behaviour link)
- Communication (e.g. Active listening and speaking up, communicating more positively to oneself and to others)
- Emotion control (e.g., Learning coping strategies to stop negative self-talk and increase positive self-talk)
- Giving and getting support (e.g., Knowing how to get feedback from others, Learning how to be more supportive of others)
Education
(academic skills to increase attachment):
- Make learning enjoyable through play
- Set routine after school (how tv interferes with learning)
- HW support – how to show an active interest in childs learning
- How to read to children
- How to follow through with limits
- Involvement with school (how to work with teachers/not blame them)
Monitoring
- Parent/leader evaluation weekly
- Leader help with hw for a parent, assess skills informally, and build relationship with a parent
- Parent buddies assigned support to each other
Early start
- Early start (chch) - provide quality support to Christchurch families with newborn babies who may have risks to their health and wellbeing
- Found small but consistent benefits
Challenges of the programme
- Matching intervention level
- difficulties interfere with delivery (depression, isolation, diverse, low ses)
- reasons people come through is what becomes barriers to tx
- High demand on parents (drop out)
- Developed for middle class
- Group can lead to deviant peers)
Pro to prevention
Efficient, effective, parents can provide peer support to each other, - research shows positive outcomes for children, parents, and teacher-parent relationship – greater effect when need is greater (more room to get better).
Factors influencing practice
- Theraputic alliance important
my presentation boundary setting
- consistent rules and consequences are frequent targets of MST.
- USE POSITIVE REINFORCEMENT TO shift focus to new behaviour, practice new behaviour, positively reinforce new behaviour, limit punishment
1. Write down rules
2. Communicate limits: You can use your computer for 30 minutes tonight,” or “You’ll need to clean your room before you can go outside.”
3. Warning: in 5 mins if….
4. Offer choices: Not forcing can either come home now and see friends on weekend or you can stay and not see them on weekends
5. Logical consequences; RELATED TO BEHAVIOUR – too long gaming take away game
