Transcript Coaching PCIT

Sheila Eyberg, PhD
University of Florida
Parent-Child Interaction Therapy
Basic Coaching Guidelines
Introduction
The Coach’s Concrete Goals in the
Child-Directed Interaction
Increase
 Labeled
Praise
Decrease
 Reflection
 Commands
 Behavioral
Description
 Questions
 Criticism
IGNORE negative behavior
STOP THE PLAY for dangerous or destructive behavior
Copyright 2005 Sheila Eyberg
Coach’s Concrete Goals in
Parent-Directed Interaction
Direct parents
through the steps
– Direct command
– Labeled praise after comply
– Timeout chair after second
noncomply
– Warning after first noncomply
– Direction to stay in chair
– Timeout room if chair escape
– Return to chair after room
– Ask for readiness
– COPE
– Return to CDI
Copyright 2005 Sheila Eyberg
Have parents
correct mistakes
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Indirect commands
Repeated commands
Questions
Criticism
Dawdling
Extra words in COPE
Conceptualizing Coaching
 Principles similar to treatment principles
 Coaching principles differ in CDI and PDI
CDI principles (coach lets parent lead)*
Differential Social Attention
PDI principles (coach leads parent)
Operant Conditioning
*Attachment theory explains what
happens in CDI but doesn’t tell us
what to do in coaching
Copyright 2005 Sheila Eyberg
Principle of
Differential Social Attention
CDI
Parents perform behaviors that gain greatest
support/approval from the therapist
Therefore therapist responds differentially to
correct and incorrect parenting skills
Give more attention to correct parent behaviors
Praise enthusiastically
Describe the effect on the child
Explain the reason it was good
Give less attention to incorrect parent behaviors
Copyright 2005 Sheila Eyberg
Operant Principles
Social Learning Theory
PDI
 Coaching begins with a command
 “Okay, give a very simple direct command”
 Coach rewards parent compliance
 “Good direct command!”
 Coach does not ignore noncompliance
 “Make it direct – hand me…”
Coach requires compliance to the PDI steps
Copyright 2005 Sheila Eyberg
Bottom Line
Effective coaching requires
a basic understanding of
behavioral principles
Behavior principles lead to
the behavior change in PCIT
Copyright 2005 Sheila Eyberg
The Basics of
Coaching the
Basics
Keep one eye
always on the
mastery goals…
Copyright 2005 Sheila Eyberg
Mastery Criteria
(Proxies for Attachment and Consistency)
 4 commands
 10 Behavioral
 75% effective
descriptions
 Direct
 10 Reflections
 Single
 10 Labeled praises
 <3
 Questions
 Commands
 Criticisms
 Positive (do)
 Alpha (opportunity)
 75% correct follow-through
 Labeled praise after comply
 Warning after noncomply
 If timeout, correct follow-through
Copyright 2005 Sheila Eyberg
Coaching to Reach CDI Criteria
 The basic rule (follow the child’s lead)
PR
DC
CR
 Good following!
 Describe what she’s doing. Good description!
 Let’s wait till she’s finished to praise it. Yes!
 The following skills (the PRIDE skills)
LP
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

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Great reflection!
Good labeled praise!
Nice behavioral description.
Excellent describing what she’s doing.
Copyright 2005 Sheila Eyberg
Coaching to Reach PDI Criteria
 Leading (the basic rule)
 Help parent stay in control
 “Nice command to get her back to the table.”
 “Just ignore everything but her obey.”
 Using the exact words
 If close, reflect their words correctly
 If not close, have them re-do it
“Make it direct, Give me…”
 Make it direct. Good.
 Whoops.
Copyright 2005 Sheila Eyberg
General Coaching Guidelines
 Be brief (rarely more than 5 words at a time)
 Be quick (comment on behavior immediately)
 Be positive (focus on the half-full glass)
 Be enthusiastic (usually)
 Be supportive (when needed)
 PAY ATTENTION (ALWAYS)
 Be one step ahead...
Copyright 2005 Sheila Eyberg
What Exactly Do Coaches Say?
Labeled Praises
 Good following
 Great behavior
description
 Nice answering his
question
 Great timing on ignoring
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Good direct command
Great labeled praise
Nice fast follow-through
Excellent ignoring
Perfect timing
Good matter-of-fact
tone
Excellent idea to [parent independent good judgment]
Copyright 2005 Sheila Eyberg
Observations/Descriptions
Describing components of theory
 He loves your attention
 He doesn’t like to be ignored
 She doesn’t like time out
Describing changes in the parent
 Your praises seem very natural
 You said that with certainty
Describing changes in the child
 He’s accepting your reflections today
 He’s handling frustration better this time
Copyright 2005 Sheila Eyberg
Directives
Direct commands
 Reflect what she just said.
 Tell her why it’s good.
 Just ignore that.
 Go back to CDI now.
 Think what you’ll say when he finishes.
Indirect commands
 Thank-you for what?
 He deserves a big hug for that.
 Time’s up.
 You can help him if you want.
Copyright 2005 Sheila Eyberg
Gentle Correctives (rarely)
Oops, a question.
A little leading…
Might be better to say . . .
Looks like a frown.
You don’t want to give him
attention for that.
Be careful he understands.
Was that a command!?! (humor)
Copyright 2005 Sheila Eyberg
Explanations
that Teach the Principles
 Explaining effects of parent’s behavior
 Your praise makes her want to please you more.
 She’s talking more because of your reflections
 Explaining reasons for child’s behavior change
 She hasn’t been bossy today – your ignoring worked
 He’s calmer now – CDI really calms him down
Copyright 2005 Sheila Eyberg
Interpretations that Reframe Child
Motivation
 Negative behavior is attention seeking
(not hateful, not evil)
He’s doing that to get your attention
He thinks if he keeps going you’ll give in
He’s not used to not getting his way
Copyright 2005 Sheila Eyberg
Coaches do say STOP!
If a parent is hurting a child
or hurting looks imminent
Immediately command the parent to stop
– then go in and talk about it
Copyright 2005 Sheila Eyberg
Coaching Defines PCIT
Let’s watch coaching in action!