Parent-Child Interaction Therapy

Parent-Child Interaction Therapy

CDI The Child-Directed Interaction CHILD DIRECTED INTERACTION (PHASE 1 OF PCIT) The CDI Teaching Session One-hour session Parents alone Didactic presentation of skills

Rules Reasons Examples Modeling/demonstration Role-play with parents Wh th e r a ly t c a x at e

t? h g u a ey t CDI The Basic Rule Follow the Childs Lead CDI The Dont Rules No commands No questions No criticism

Child Directed Interaction The Dont Rules No Commands Direct Sit here Indirect Could you sit here? Commands attempt to lead Risk negative interaction

Child Directed Interaction The Dont Rules No Questions Questions ask for an answer Open Closed Often hidden commands Take lead from the child Can suggest disapproval

Can suggest not listening Child Directed Interaction The Dont Rules No Criticism Examples Youre a bad girl That doesnt go that way No Stop Quit Dont Points out mistakes rather than correcting them Thats wrong is a criticism It goes like this allows correction without criticism Lowers self-esteem

Creates unpleasant interaction Mothers Changes in the Dont Skills During CDI 20 18 16 Commands 14 Questions 12 10

Criticism 8 6 4 2 0 Pre Post . Maintenance Study n = 22 Whats left? CDI Do Rules The PRIDE

Skills Praise Reflect Imitate Describe Enthusiasm! Child Directed Interaction The Do Rules Praise Unlabeled praise is nonspecific Good!

That's great! Labeled praise tells child specifically what is good Thank you for using your indoor voice. Increases the behavior it follows Increases child's self-esteem Increases positive feeling between parent and child

Child Directed Interaction The Do Rules Praise - Unlabeled praise is nonspecific * Good! * Great! - Labeled praise tells child specifically what is good *Thank you for using your indoor voice. Increases the behavior it follows Increases child's self-esteem Increases positive feeling between parent and child Child Directed Interaction The Do Rules

Reflection Repeating or paraphrasing Mom, this is a funny thing on top of his head! Yes, his hat is very silly! t n e Pa r Child Allows child to lead the conversation Shows that parent is listening

Shows that parent understands Improves and increases childs speech Child Directed Interaction The Do Rules Imitation Doing the same thing the child is doing Parallel play Cooperative play

Lets the child lead Teaches parent how to play Shows approval of childs activity Teaches child how to play with others Sharing Taking turns Child Directed Interaction The Do Rules Description Telling the child exactly what he or she is doing

Youre drawing a sun. Lets the child lead Lets child know you are paying attention and are interested Shows approval of childs activity Models speech Teaches vocabulary and concepts Holds childs attention to the task Child Directed Interaction The Do Rules

Enthusiasm Conveying excitement by voice and gesture Wow!! You finished that SO quickly! Lets the child know the parent enjoys being with the child Makes the play more fun for the child (and parent) Adds a quality of warmth to the interaction Mothers Changes in PRIDE Skills in the CDI Situation Labeled Praise Unlabeled Praise Reflection Behavior Description

4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 Pre-1 Treatment Post-2 Treatment Efficacy Project ChildDirected

Interaction DO DONT Praise Reflect Imitate Describe Enthusiasm Give Commands Ask Questions Criticize

IGNORE annoying, obnoxious behavior STOP THE PLAY for dangerous or destructive behavior Lets watch the PRIDE skills all together Avoid the Donts and Ignore Annoying behavior Steve and Sheila role-play the Child Directed Interaction Homewor

k Special time 5 minutes a day Why just 5 minutes? Practice, play, and therapy Mastery of CDI DPICS coding for 5 minutes 10 labeled praises

10 behavior descriptions 10 reflections (And no commands, questions, or criticisms) Coachin g The Primary Method of Parent Training in PCIT Advantages of Coaching in the Session Allows therapist to provide

immediate feedback Prevents miscommunication about skill application Provides support to parents as they learn to be consistent Enables therapist to calm and reassure parent if needed Provides opportunity for

reframing parent attributions of child behavior Common Coaching Statements Labeled Praises Good ignoring! Gentle correctives Oops, a question.

Directives Can you reflect that? Observations He quiets down when you talk softly like that.

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