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Explore the success and challenges of implementing PCIT in Hong Kong, including barriers, training models, and the role of praise. Discover the ongoing relationship between PCIT trainers and trainees in Hong Kong.
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Parent-Child Interaction Therapy: International Spotlight Anthony Urquiza, Ph.D. 6th Annual PCIT Conference University of Florida Gainesville, FL
PCIT in Hong Kong But PCIT in Hong Kong is the end of the story, this is our most recent international training agency. I think it is best to start at the beginning When we started training, these were the questions… What are the barriers to overcome? What training model is most effective? What leads to leads to success? (What is training success?)
What are the barriers to overcome? • Therapists wouldn’t like PCIT because of it’s behavioral theoretical foundation • Therapists wouldn’t like a protocol-driven treatment • Therapists as technicians • Manual/protocol rigid, can’t adjust to change • Non-authentic interactions with clients • Protocol undermines the therapeutic relationship • Protocols rule out clinical judgment, innovation • Therapists would refuse to do 5-minute coding • PCIT was too difficult to learn
What are the barriers to overcome? • Therapist instability • Therapists would get trained, then leave • Organizational instability/commitment • Administrators would not see the value • Agency would accept a new treatment • That ‘Effect Size’ thing
EBPs have ‘medium’ to ‘large’ effect sizes ‘EBP treatment works’ Specific tx better than broad-based tx Tx effect sustains over time This is really a good thing… right? Well, yes, except these are mostly university-based treatment outcome studies (including PCIT) ES in community MH clinics are not as good Estimating the Effect Size:X4 meta-analyses on child therapy
What do we need to do to effectively train? Successful training = adherence to protocol + fidelity (Competence) Good Training Model Good Trainers/Training Committed Trainees Ongoing Relationship Agency Support $
Good Training Model Parent is to Therapist as Therapist is to Trainer And PCIT is very robust! Information Theory/content Skill Acquisition/Practice Role plays Mastery Coached coaching Generalization How many clients? InformationSkill Acquisition/Practice Mastery Generalization
Good Training Model The role of praise in Hong Kong… Give me the model! ------------------------------------------------------------------------------- Hong Kong February 2004 (multiple days of training) March/April 2004 (case consultation) Sacramento February 2005 (multiple CA site visits) Hong Kong June 2005 (Symposium and additional training) It’s good that it is hard
Good Training Model – Hong Kong Identified three Tung Wah staff to be TOTs Heung Yin Kwan(Kitty)Choi Ka Yan(Trian) Chan Kai Wai(Monique)
Good Trainers/Training Because we have good trainers… Training Staff Tanda Almont Alissa Porter Michelle Culver Shalila Douglas Georganna Sedlar Lareina Ho Susan Timmer Jean McGrath Lisa Ware Leslie Whitten Nancy Zebell UCDavis CAARE Center: 100-112 clients/week
Committed Trainees UCDMC-trained staff at PCIT6 Russ Decker Emma Girard Cheryl Goldberg-Diaz Audra Hirsch Mary Linscomb Tiffany Masson Sharon Mellar Elisa Nevius Lori Pack Mary Pratt Naomi Perry Erica Pearl Ryan Quist Araceli Salazar Janae Tucker +Agency Stability (OES stable funding) +Leadership within the agency You are not normal!
+Strong institutional support TOTs Heung Yin Kwan (Kitty) Choi Ka Yan (Trian) Chan Kai Wai (Monique) Committed Trainees: Hong Kong
+Ivan Yi – Administrative Leadership +Heung Yin Kwan – Program Leadership TOTs Heung Yin Kwan (Kitty) Choi Ka Yan (Trian) Chan Kai Wai (Monique) Committed Trainees: Hong Kong
Ongoing Relationship Because we’ve maintained contact… • Conferences (PCIT conferences 1 through 5) • Frequent site visits • Advanced training seminars • Web-based information (www.pcittraining.tv) • Refinements in program development • Ongoing consultation (‘Dear Nancy’) • Training products • Handouts, sample tx objectives, etc. • Training video series • The Spanish PDI video is just now done!
Ongoing Relationship: Hong Kong All of the regular training materials and connections We’re continuing our relationship with Hong Kong And you will see Hong Kong present at a future PCIT conference
Tung Wah Group of Hospitals Heung Yin Kwan, Kitty Centre Supervisor Lui Wing Cheung Children Centre Parent-Child Interaction Therapy Pilot Project in Hong Kong(Sharing & Demonstration) Presented for Symposium on New Initiatives of Child Abuse PreventionJune 23, 2005 Tung Wah Group of Hospitals
Hong Kong PCIT Protocol The Chinese Version of PCIT treatment & DPICS
The treatment result of PCIT pilot project in H.K. Change of Children’s behavior problem (ECBI pre & post score) ECBI intensity clinical cut 131 ECBI problem clinical cut off 15
The result of PCIT pilot project in H.K. Change of parents’ stress level (PSI pre & post score) Clinical range 85% or above 99% less 85%
The result of PCIT pilot project in H.K. Change of Parenting Behavior (DPICS: pre & post score) mastery criteria: 25 mastery criteria 15 mastery criteria less than 3
Issues and Key Learning from the Project • Extra-counseling sessions (eg. Telephone counseling & home visit) are provided for individual mental health problems and family crisis to avoid non-attendance and attrition rate. • Liaison with school professionals to facilitate the case progress. • Regular professional meetings to enhance treatment integrity and PCIT skill mastery. • Ongoing staff-training to enhance staff competencies.
Future Development of PCIT Project at TWGHs • Train of Trainer (TOT) scheme to respond to the increased number of referrals. • Provide PCIT training to pre-school & primary teachers. • Expand services to different child clinical problems. • Conduct research on the project.
