CBT Parenting Interventions Webinar March 14 2018 Parenting

CBT & Parenting Interventions Webinar March 14, 2018

Parenting Interventions The vast majority of Evidenced Based Interventions for Parenting involve the principles of CBT Specifically, Behavior Principles guide most parenting programs One size does not fit all – parents may need different programs for different kids!

Programs…. There are so many parenting programs – it is hard to choose which one is best for your client and family – most target aggressive behaviors Most are for very young children (<8) and are used by child welfare services to improve parenting practices of families referred for child maltreatment

When do you need to work with Parents/Caregivers? All the time! Aggressive behaviors ADHD Anxiety OCD School Refusal Managing Technology

With or without kids present? First, invite everyone “What did your parents tell you about coming today? ” “Can you tell your child why he/she is here and what you would like to get out of this experience? ”

Key Components (CDC 2009) 1) Emotional Communication Active listening Identifying and labeling emotions Express and manage/cope with emotions Reduce criticism and sarcasm Allowing and accepting the child’s voice

2) Positive parent-child interactions Engaging in child centered activities Attending to the activity (mirroring) Positive play and activities Creativity and humor

3) Requiring Parents to practice in session! The most effective programs practiced the skills in session rather than just teach them! Teach, role-play, practice, in-vivo Use your sessions to model and demonstrate the skills and then ask parents what they observed Be brave, honest, and show mistakes

Negative Reinforcement (Parent) Meltdown Giving In Relief Negative Reinforcement

Decreasing Externalizing problems Attention to behavior Rewarding Positive behavior Ignoring Negative behavior Effective use of directions/instructions Using Time-Out correctly Consistency, Consistency

Clinical Examples Increases the likelihood of the behavior Decreases the likelihood of the behavior Something Added Sticker Chart > Compliance Spanking > Non-compliance Something Taken Away Whining > Give Candy Bar Car keys > Breaking Curfew

Less effective programs…. Teach parents how to problem-solve child behaviors Teach parents how to promote academic and cognitive skills Talk about the problems instead of practicing the necessary skills (behavioral)

Challenges “I don’t want to bribe my kid” “They know how to do it, they should just do it!” “Why should I reward them when they already have everything!” “I was spanked as a kid and I turned out just fine!”

Examples of Programs Parent Child Interaction Therapy (PCIT) Helping the Noncompliant Child Triple P (Positive Parenting Program) Incredible Years Training Series Functional Family Therapy (combines relational and CBT) Multi-System Family Therapy (MST)

What about older kids? As children get older, we must be developmentally sensitive. By age 7/8, classic attention, praise, and time out strategies become “aged-out” Need to engage the child in the process and internalize Critics of behavioral programs have argued they are too focused on extrinsic vs. intrinsic motivation

Here comes the (C)BT… Ross Greene – Collaborative Problem Solving approach now Collaborative and Proactive Solutions As children get older, they need to take ownership in the process – these strategies are non-punitive, non-adversarial, collaborative, proactive, skill-building, relationship-enhancing interventions.

“Basket-Case” Child is not complying not because they are intentionally being difficult but because they lack the skill to cope Basket A – hard and fast rules Basket B - collaboratively problem solve Basket C – Let it Go…(pick and choose your battles)

Developing Trends… Behavioral Principles are necessary but not sufficient CBT + trauma focused – TF-CBT + attachment – examples CBT + emotions – Whole Brained Child