简介
Over the past two decades, Parent-Child Interaction Therapy (PCIT) emerged as a leading-edge method for helping parents improve their children's disruptive and oppositional behavior. Today, PCIT has a robust evidence base; is used across the country in settings as diverse as hospitals, mental health centers, schools, and mobile clinics; and is rapidly gaining popularity in other parts of the world. In keeping with this increasing recognition of PCIT's effectiveness, the authors of Parent-Child Interaction Therapy present this expanded clinical edition to keep readers up to date on new practice developments, current treatment protocols, and the latest research findings. This update retains the fundamentals as detailed by PCIT's founder, Dr. Sheila Eyberg, including an overview of the therapy, detailed description of the course of treatment, and handout materials. The text goes further to explore the evolution of PCIT outside the original target ages of three-to-six (including preventive PCIT for very young children at risk) and examines the use of PCIT with special child populations, such as abuse victims and those with ADHD. Contributing experts discuss uses of the therapy in school, at home, with minorities, and with highly stressed families. But regardless of the population, setting, or topic covered, interventions remain faithful to basic PCIT principles and methods. New features of the expanded second edition include: Adaptations of PCIT for babies, toddlers, preteens, and siblings. Applications for abuse survivors, children with developmental disabilities, ADHD, and severe aggression problems. Uses of PCIT with separating or divorced parents. Culturally relevant PCIT for ethnic minority and international families. Teacher-child, staff-child, and home-based applications. PCIT training guidelines. A brand-new chapter summarizing current research supporting PCIT. As PCIT broadens its scope, Parent-Child Interaction Therapy, Second Edition, brings innovative ideas and proven techniques to clinical child psychologists, school psychologists, and other mental health providers working to enhance the lives of children and their families.
目录
Preface 7
Why a Second, Expanded Clinical Edition? 7
Organization of the Second Edition 8
Contributors to the Book 9
Acknowledgments 10
Reference 10
Contents 11
Part I Fundamentals of Parent-Child Interaction Therapy 18
1 Overview of Parent-Child Interaction Therapy 19
What Is PCIT? 20
Typical Course of Treatment 21
Theoretical and Historical Underpinnings 22
Key Features of PCIT 23
Using the Second Edition 30
References 31
2 Research on PCIT 33
Early PCIT Research 33
Recent Research Initiatives 33
Suggestions for Future Research 39
References 42
3 Intake Assessment and Therapy Orientation Session 46
Who Should Attend the Intake Session? 47
Flexible Battery Approach 48
Semi-structured Intake Interview 49
Eyberg Child Behavior Inventory (ECBI) 50
Sutter-Eyberg Student Behavior Inventory Revised (SESBI R) 51
Dyadic Parent-Child Interaction Coding System III (DPICS III) 51
Joining with and Motivating Parents 55
Sharing Test Results with Parents 58
Explaining Specialized Parenting 58
Introducing PCIT to Parents and Children 59
Expectations for Attendance 60
Reducing Barriers to Treatment 61
Explaining the First Homework Assignment 62
Summary 62
References 63
4 Teaching Child-Directed Interaction 64
Overview of Teaching Session 64
Review Homework 66
Presenting the Goals of Child-Directed Interaction 66
Explaining the Five Minutes of Homework Each Day 66
Selling CDI to Skeptical Parents 68
Explaining the Overriding Rule of Letting the Child Lead 70
Teaching the Avoid Skills of Child-Directed Interaction 71
Teaching the Do Skills of Child-Directed Interaction 74
Using Strategic Attention 81
Using Selective Ignoring 82
Handling Disruptive Behaviors That Cannot Be Ignored 86
Modeling Skills in Combination 86
Role-Plays of Child-Directed Interaction 86
Appropriate Toys for Child-Directed Interaction 87
Dealing with One-Parent and Two-Parent Families 88
Incorporating Siblings 89
Adjusting CDI to the Childs Developmental Level 89
Problem-Solving with Parents on Logistical Issues 89
Assigning Child-Directed Interaction Homework 90
References 91
5 Coaching Child-Directed Interaction 92
Overview of a Typical Coaching Session 93
Setting Up for the Coaching Session 94
Check-In and Homework Review 95
Parental Non-compliance with CDI Homework 96
Observing and Recording Child-Directed Interaction Skills 100
Coaching the Do and Avoid Skills: Tips for Therapists 101
End of Session Debriefing and Homework Assignment 114
Progression of CDI Coaching Sessions 114
What if a Caregiver Does Not Reach CDI Mastery? 115
References 116
6 Teaching Parent-Directed Interaction 117
Rationale for Why Young Children Should Comply with Parental Commands 117
Structuring the PDI Teaching Session 118
Importance of Consistency, Predictability, and Follow Through 118
Importance of Memorizing PDI Diagrams (e.g., Using Exact Words) 120
Rationale for Use of Compliance Exercises 120
Giving Effective Instructions 121
Practicing How to Give Effective Instructions 126
Determining Compliance 127
Praising Compliance 129
Rationale for Disciplining Children with Time-Out in a Chair 130
The Time-Out Warning 132
Logistical Issues Associated with Time-Out 133
Getting the Child to Time-Out 133
What If the Child Agrees to Comply on the Way to Time-Out? 135
What if the Child Takes a Toy to Time-Out? 136
What if the Child Puts Himself in Time-Out? 136
Length of Time-Out 136
Common Misbehaviors in Time-Out that Should Be Ignored 137
Time-Out Does Not End Until the Original Instruction Is Obeyed 138
Use of a Second Instruction to Over-Teach Compliance 139
Use of Play Therapy to Decrease the Childs Anger Level 140
Three Time-Out Behaviors That Cannot Be Ignored 140
Using the Time-Out Room as the Back-Up for Time-Out Chair Behaviors that Cannot Be Ignored 141
Role-Playing and Wrap-Up 145
References 146
7 Coaching Parent-Directed Interaction 147
Overview of a Typical PDI Coaching Session 147
Preparing for PDI Coaching Sessions 148
Check-In and Homework Review 149
Observing and Recording Parent-Directed Interaction Skills 150
Criteria for Mastery of Parent-Directed Interaction Skills 151
General Guidelines for Coaching PDI 152
Debriefing Parents Following the Session 162
Homework 165
References 166
8 Progressing Through the Parent-Directed InteractionSessions 167
First PDI Coaching Session 171
Second PDI Coaching Session 179
Third PDI Coaching Session 180
Fourth PDI Coaching Session 183
Fifth PDI Coaching Session 186
Sixth PDI Coaching Session 189
Seventh PDI Coaching Session and Beyond 190
Graduation Session 192
Conclusion 195
Reference 196
Part II Adaptations of Parent-Child Interaction Therapy 197
9 Younger Children 198
Meaningful Differences in the Everyday Experience of Young American Children 199
Using Child-Directed Interaction with Infants 204
Adapting Child-Directed Interaction and Parent-Directed Interaction for Toddlers 205
Case Illustration 208
Parent-Child Interaction Therapy and Prevention 211
References 212
10 Older Children 213
Developmental Issues 213
University of Oklahoma Health Sciences Center Adaptations for Older Children 214
Concerns Raised by the SAMHSA Study Regarding PCIT with Older Children 214
Adapting CDI to Older Children 216
Adapting PDI to Older Children 220
Command Training (CT) Module 221
Time-out with Incentive Chart (TIC) Module 226
Time-Out with Suspension of Privilege (TSP) Module 231
Alternatives to the TSP Module for Children Who Are Extremely Aggressive and Defiant 233
Conclusion 234
References 235
11 Siblings 236
Including Siblings with Disruptive Behavior Problems 237
Including Siblings Without Behavior Problems 237
Coaching Older Siblings as Babysitters 238
Direct Coaching of Children to Decrease Sibling Conflict 238
Direct Coaching of Children to Improve Social Skills (e.g., Aspergers) 239
Using the Cooperation Game 240
Conclusion 246
12 Autism Spectrum Disorders 247
Theoretical Similarities of PCIT and Empirically Supported Treatments for ASD 249
Child-Directed Interaction 250
Working with Stereotyped, Repetitive Behavior During CDI 251
Parent-Directed Interaction 252
Time-Out Concerns 254
Clinical Limitations 255
Adapting PCIT: Communication and Social Skills Component 257
Case Study 260
Conclusion 262
References 262
13 Child Physical Abuse 265
Understanding the Population 266
Typical Referral Concerns 267
Adaptations and the Unique Treatment Needs of Families with a History of CPA 271
General Therapeutic Issues 272
Assessment 275
Treatment 280
Incorporating Additional Coaching Targets 280
Tailoring and Adaptations Specific to PDI 282
Case Illustration 284
Conclusion 291
References 292
14 Anxiety Disorders 295
Separation Anxiety Disorder 295
CARD Protocol for Adapting PCIT for Treatment of SAD 297
Treatment Outcome Research 300
Generalized Anxiety 301
Enhancing PCIT for Young Children with Generalized Anxiety 301
The Case of Alexander H 303
References 309
15 Attention Deficit Hyperactivity Disorder 311
Conducting PCIT with Children Diagnosed with ADHD 312
References 327
16 Extremely Aggressive and Explosive Children 328
The Case of Mario 328
CDI Pitfalls with Explosive Children 329
CDI Adaptations for Explosive Children 330
PDI Adaptations 334
Conclusion 336
Reference 336
17 Marital Conflict 337
Encouraging Both Parents to Attend Treatment 338
Assessment Techniques 338
Integrating Marital Therapy Within PCIT 341
Termination of Treatment 347
References 348
18 Parents with Major Life Stressors 349
Strategies for Working with Multi-stressed Families in PCIT 351
Divorce 352
Substance Abuse 356
Intimate Partner Violence 359
Low-Income Families 365
Parting Words 368
References 369
19 Ethnic Minority Children and Families 371
Parent Training, PCIT, and Application to Ethnic Minorities 371
PCIT with Hispanics 372
PCIT with Native Americans 376
PCIT with African-Americans 379
Examining Social Validity 381
Conclusion and Final Recommendations for Therapists 382
References 383
20 Staff-Child Interaction Therapy 385
Baseline 388
SCIT Video on Child-Directed Play 389
Didactic Child-Directed Interaction Session with Trainer 389
Coding and Coaching of Child-Directed Interaction 389
SCIT Video on Staff-Directed Interaction 390
Didactic Staff-Directed Interaction Session with Trainer 390
Coding and Coaching of Staff-Directed Interaction 390
Coaching Sessions on the Milieu (Two-Way Radio with Earpiece for Staff) 390
Post-intervention Findings 392
Conclusion 392
References 392
21 Teacher--Child Interaction Therapy for Preschool Classrooms 393
Research Underpinnings 393
Establishing Rapport with the Teacher 393
Format of Training 394
Coaching TCIT 394
Child-Directed Interaction in TCIT 394
TCIT Mastery Criteria 396
Teacher-Directed Interaction Phase 396
Follow-Up Consultation 398
References 398
22 School Consultation 400
Assessment 401
Establishing Rapport and Credibility with the Teacher 402
Conclusion 418
References 418
23 Home-Based PCIT: From the Lab to the Living Room 420
Clinical Advantages 420
Clinical Tips 422
Concluding Remarks 426
References 426
24 PCIT Around the World 427
Adapting PCIT for New Countries 428
International Issues with PCIT 430
Conclusion 432
References 433
25 Training Issues 434
PCIT National Advisory Board 434
Minimum Professional Qualifications to Conduct PCIT 435
Becoming a PCIT Therapist: Minimum Training Requirements 436
Becoming a PCIT In-agency Trainer: Minimum Training Requirements 439
Becoming a PCIT Master Trainer: Minimum Training Requirements 439
Costs of Starting a PCIT Program 439
References 442
Appendices 443
Appendix 1 443
Appendix 2 444
Appendix 3 445
Appendix 4 447
Appendix 5 448
Appendix 6 449
Appendix 7 451
Appendix 8 452
Appendix 9 453
Appendix 10 454
Appendix 11 455
Appendix 12 456
Appendix 13 458
Appendix 14 459
Subject Index 462
Why a Second, Expanded Clinical Edition? 7
Organization of the Second Edition 8
Contributors to the Book 9
Acknowledgments 10
Reference 10
Contents 11
Part I Fundamentals of Parent-Child Interaction Therapy 18
1 Overview of Parent-Child Interaction Therapy 19
What Is PCIT? 20
Typical Course of Treatment 21
Theoretical and Historical Underpinnings 22
Key Features of PCIT 23
Using the Second Edition 30
References 31
2 Research on PCIT 33
Early PCIT Research 33
Recent Research Initiatives 33
Suggestions for Future Research 39
References 42
3 Intake Assessment and Therapy Orientation Session 46
Who Should Attend the Intake Session? 47
Flexible Battery Approach 48
Semi-structured Intake Interview 49
Eyberg Child Behavior Inventory (ECBI) 50
Sutter-Eyberg Student Behavior Inventory Revised (SESBI R) 51
Dyadic Parent-Child Interaction Coding System III (DPICS III) 51
Joining with and Motivating Parents 55
Sharing Test Results with Parents 58
Explaining Specialized Parenting 58
Introducing PCIT to Parents and Children 59
Expectations for Attendance 60
Reducing Barriers to Treatment 61
Explaining the First Homework Assignment 62
Summary 62
References 63
4 Teaching Child-Directed Interaction 64
Overview of Teaching Session 64
Review Homework 66
Presenting the Goals of Child-Directed Interaction 66
Explaining the Five Minutes of Homework Each Day 66
Selling CDI to Skeptical Parents 68
Explaining the Overriding Rule of Letting the Child Lead 70
Teaching the Avoid Skills of Child-Directed Interaction 71
Teaching the Do Skills of Child-Directed Interaction 74
Using Strategic Attention 81
Using Selective Ignoring 82
Handling Disruptive Behaviors That Cannot Be Ignored 86
Modeling Skills in Combination 86
Role-Plays of Child-Directed Interaction 86
Appropriate Toys for Child-Directed Interaction 87
Dealing with One-Parent and Two-Parent Families 88
Incorporating Siblings 89
Adjusting CDI to the Childs Developmental Level 89
Problem-Solving with Parents on Logistical Issues 89
Assigning Child-Directed Interaction Homework 90
References 91
5 Coaching Child-Directed Interaction 92
Overview of a Typical Coaching Session 93
Setting Up for the Coaching Session 94
Check-In and Homework Review 95
Parental Non-compliance with CDI Homework 96
Observing and Recording Child-Directed Interaction Skills 100
Coaching the Do and Avoid Skills: Tips for Therapists 101
End of Session Debriefing and Homework Assignment 114
Progression of CDI Coaching Sessions 114
What if a Caregiver Does Not Reach CDI Mastery? 115
References 116
6 Teaching Parent-Directed Interaction 117
Rationale for Why Young Children Should Comply with Parental Commands 117
Structuring the PDI Teaching Session 118
Importance of Consistency, Predictability, and Follow Through 118
Importance of Memorizing PDI Diagrams (e.g., Using Exact Words) 120
Rationale for Use of Compliance Exercises 120
Giving Effective Instructions 121
Practicing How to Give Effective Instructions 126
Determining Compliance 127
Praising Compliance 129
Rationale for Disciplining Children with Time-Out in a Chair 130
The Time-Out Warning 132
Logistical Issues Associated with Time-Out 133
Getting the Child to Time-Out 133
What If the Child Agrees to Comply on the Way to Time-Out? 135
What if the Child Takes a Toy to Time-Out? 136
What if the Child Puts Himself in Time-Out? 136
Length of Time-Out 136
Common Misbehaviors in Time-Out that Should Be Ignored 137
Time-Out Does Not End Until the Original Instruction Is Obeyed 138
Use of a Second Instruction to Over-Teach Compliance 139
Use of Play Therapy to Decrease the Childs Anger Level 140
Three Time-Out Behaviors That Cannot Be Ignored 140
Using the Time-Out Room as the Back-Up for Time-Out Chair Behaviors that Cannot Be Ignored 141
Role-Playing and Wrap-Up 145
References 146
7 Coaching Parent-Directed Interaction 147
Overview of a Typical PDI Coaching Session 147
Preparing for PDI Coaching Sessions 148
Check-In and Homework Review 149
Observing and Recording Parent-Directed Interaction Skills 150
Criteria for Mastery of Parent-Directed Interaction Skills 151
General Guidelines for Coaching PDI 152
Debriefing Parents Following the Session 162
Homework 165
References 166
8 Progressing Through the Parent-Directed InteractionSessions 167
First PDI Coaching Session 171
Second PDI Coaching Session 179
Third PDI Coaching Session 180
Fourth PDI Coaching Session 183
Fifth PDI Coaching Session 186
Sixth PDI Coaching Session 189
Seventh PDI Coaching Session and Beyond 190
Graduation Session 192
Conclusion 195
Reference 196
Part II Adaptations of Parent-Child Interaction Therapy 197
9 Younger Children 198
Meaningful Differences in the Everyday Experience of Young American Children 199
Using Child-Directed Interaction with Infants 204
Adapting Child-Directed Interaction and Parent-Directed Interaction for Toddlers 205
Case Illustration 208
Parent-Child Interaction Therapy and Prevention 211
References 212
10 Older Children 213
Developmental Issues 213
University of Oklahoma Health Sciences Center Adaptations for Older Children 214
Concerns Raised by the SAMHSA Study Regarding PCIT with Older Children 214
Adapting CDI to Older Children 216
Adapting PDI to Older Children 220
Command Training (CT) Module 221
Time-out with Incentive Chart (TIC) Module 226
Time-Out with Suspension of Privilege (TSP) Module 231
Alternatives to the TSP Module for Children Who Are Extremely Aggressive and Defiant 233
Conclusion 234
References 235
11 Siblings 236
Including Siblings with Disruptive Behavior Problems 237
Including Siblings Without Behavior Problems 237
Coaching Older Siblings as Babysitters 238
Direct Coaching of Children to Decrease Sibling Conflict 238
Direct Coaching of Children to Improve Social Skills (e.g., Aspergers) 239
Using the Cooperation Game 240
Conclusion 246
12 Autism Spectrum Disorders 247
Theoretical Similarities of PCIT and Empirically Supported Treatments for ASD 249
Child-Directed Interaction 250
Working with Stereotyped, Repetitive Behavior During CDI 251
Parent-Directed Interaction 252
Time-Out Concerns 254
Clinical Limitations 255
Adapting PCIT: Communication and Social Skills Component 257
Case Study 260
Conclusion 262
References 262
13 Child Physical Abuse 265
Understanding the Population 266
Typical Referral Concerns 267
Adaptations and the Unique Treatment Needs of Families with a History of CPA 271
General Therapeutic Issues 272
Assessment 275
Treatment 280
Incorporating Additional Coaching Targets 280
Tailoring and Adaptations Specific to PDI 282
Case Illustration 284
Conclusion 291
References 292
14 Anxiety Disorders 295
Separation Anxiety Disorder 295
CARD Protocol for Adapting PCIT for Treatment of SAD 297
Treatment Outcome Research 300
Generalized Anxiety 301
Enhancing PCIT for Young Children with Generalized Anxiety 301
The Case of Alexander H 303
References 309
15 Attention Deficit Hyperactivity Disorder 311
Conducting PCIT with Children Diagnosed with ADHD 312
References 327
16 Extremely Aggressive and Explosive Children 328
The Case of Mario 328
CDI Pitfalls with Explosive Children 329
CDI Adaptations for Explosive Children 330
PDI Adaptations 334
Conclusion 336
Reference 336
17 Marital Conflict 337
Encouraging Both Parents to Attend Treatment 338
Assessment Techniques 338
Integrating Marital Therapy Within PCIT 341
Termination of Treatment 347
References 348
18 Parents with Major Life Stressors 349
Strategies for Working with Multi-stressed Families in PCIT 351
Divorce 352
Substance Abuse 356
Intimate Partner Violence 359
Low-Income Families 365
Parting Words 368
References 369
19 Ethnic Minority Children and Families 371
Parent Training, PCIT, and Application to Ethnic Minorities 371
PCIT with Hispanics 372
PCIT with Native Americans 376
PCIT with African-Americans 379
Examining Social Validity 381
Conclusion and Final Recommendations for Therapists 382
References 383
20 Staff-Child Interaction Therapy 385
Baseline 388
SCIT Video on Child-Directed Play 389
Didactic Child-Directed Interaction Session with Trainer 389
Coding and Coaching of Child-Directed Interaction 389
SCIT Video on Staff-Directed Interaction 390
Didactic Staff-Directed Interaction Session with Trainer 390
Coding and Coaching of Staff-Directed Interaction 390
Coaching Sessions on the Milieu (Two-Way Radio with Earpiece for Staff) 390
Post-intervention Findings 392
Conclusion 392
References 392
21 Teacher--Child Interaction Therapy for Preschool Classrooms 393
Research Underpinnings 393
Establishing Rapport with the Teacher 393
Format of Training 394
Coaching TCIT 394
Child-Directed Interaction in TCIT 394
TCIT Mastery Criteria 396
Teacher-Directed Interaction Phase 396
Follow-Up Consultation 398
References 398
22 School Consultation 400
Assessment 401
Establishing Rapport and Credibility with the Teacher 402
Conclusion 418
References 418
23 Home-Based PCIT: From the Lab to the Living Room 420
Clinical Advantages 420
Clinical Tips 422
Concluding Remarks 426
References 426
24 PCIT Around the World 427
Adapting PCIT for New Countries 428
International Issues with PCIT 430
Conclusion 432
References 433
25 Training Issues 434
PCIT National Advisory Board 434
Minimum Professional Qualifications to Conduct PCIT 435
Becoming a PCIT Therapist: Minimum Training Requirements 436
Becoming a PCIT In-agency Trainer: Minimum Training Requirements 439
Becoming a PCIT Master Trainer: Minimum Training Requirements 439
Costs of Starting a PCIT Program 439
References 442
Appendices 443
Appendix 1 443
Appendix 2 444
Appendix 3 445
Appendix 4 447
Appendix 5 448
Appendix 6 449
Appendix 7 451
Appendix 8 452
Appendix 9 453
Appendix 10 454
Appendix 11 455
Appendix 12 456
Appendix 13 458
Appendix 14 459
Subject Index 462
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