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Chapter 7: Progressing through the Discipline Program

Chapter 7: Progressing through the Discipline Program. Competence to Mastery. Six step progression to mastery levels Usually, there is an advance of one step every 1-2 weeks Coaching becomes less directive Parents become more involved in problem solving

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Chapter 7: Progressing through the Discipline Program

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  1. Chapter 7:Progressing through the Discipline Program PCIT Chapters 7 and 8

  2. Competence to Mastery • Six step progression to mastery levels • Usually, there is an advance of one step every 1-2 weeks • Coaching becomes less directive • Parents become more involved in problem solving • Apply skills to new problems and situations A switch to internal locus of control PCIT Chapters 7 and 8

  3. Step 1: Minding Exercises • Fundamental skills taught in the teaching and coaching lessons • “Minding” exercises: • Child is highly compliant with good attitude • Parent is competent to give effective instructions with proper follow through • Child has learned to stay in Time Out Chair PCIT Chapters 7 and 8

  4. Step 2: “Real-Life” Directions • Apply discipline in a more stimulating and chaotic environment • Similar to the home environment • Establish Time Out chair in the open area • Homework: 3-5 carefully selected instuctions each day • Child is warned of the oncoming directives • Child should be minding more with fewer Time Outs PCIT Chapters 7 and 8

  5. Step 3: Applying skills throughout the day • Drastic drop in coaching by therapist • Parents experts in playing and discipline skills • Children complying near 100% when given two-choices statement • Incorporate age-appropriate siblings are brought into clinic PCIT Chapters 7 and 8

  6. Step 3: Applying skills throughout the day • Homework: Minding all day at home • “Biggies” and “Smallies”: Choosing of behaviours that are sufficiently important to warrant a firm directive • Discipline under time constraints • Transition periods are high rish times for disobedience • Timeout only used for disobedience of positively stated commands • Incorporate discipline into school environment PCIT Chapters 7 and 8

  7. Step 4: House Rules • Up to this point, only a child’s noncompliance has been addressed • Now it is time to deal with disruptiveness: doing what one is told not to do • Selection of high frequency behaviours that the parent wishes to reduce PCIT Chapters 7 and 8

  8. Step 4: House Rules • Again, there is full disclosure of House Rules • For older children, it may even be appropriate to write the rules down • Define specific behaviours that will not be allowed • Breaking of Rules leads to a Time Out with no warning • Children are reminded of Rule after the Time Out PCIT Chapters 7 and 8

  9. Step 4: House Rules • Can the behaviour be handled in a different way? • Selective ignoring • Strategic praise • Positively stated commands • Save house rules for a handful of disruptive behaviours • Difficult to enforce • Difficult for child to remember PCIT Chapters 7 and 8

  10. Step 5: Public Behaviour • Use of discipline outside of the clinic and home settings • Involves in vivo coaching in appropriate setting • Cognitive restructuring of parent’s feelings of embarrassment • Learn that “Time Out can travel” • Problem solving: generate appropriate Time Out environments PCIT Chapters 7 and 8

  11. Step 6: Remaining Problems • This is the point in the therapy that co-morbid developmental concerns can be addressed • Language, motor, social, self-help skills • Many language development issues may be addressed by play therapy • Reflections with elaborations • Descriptive statements PCIT Chapters 7 and 8

  12. Step 6: Remaining Problems • Time to address (parent) individual and marital problems that were no apparent at pretreatment • Taking advantage of therapist rapport and the reduction in parental stress • Referral to “adjunctive” treatments PCIT Chapters 7 and 8

  13. Chapter 8:The Last Session:Posttreatment Feedback and Follow-up Planning PCIT Chapters 7 and 8

  14. Posttreatment Evaluation • Review of therapy progress, discuss remaining problems, schedule maintenance and “booster” sessions • Emphasize parental improvements • Recognize magnitude of progress • Link progress to therapy • Bolster parent’s sense of confidence PCIT Chapters 7 and 8

  15. Posttreatment Evaluation • Repeat all pretreatment procedures • Generation of written report documenting child’s posttreatment level of behavioural and emotional functioning • Forms filled for the Feedback Session PCIT Chapters 7 and 8

  16. Posttreatment Feedback • Recognition and celebration of accomplishments • “Before” and “After” PCIT • May include extended family members • Tangible rewards are given • Posttreatment video show which includes pre-treatment footage • Potent reminder of progress PCIT Chapters 7 and 8

  17. Posttreatment Feedback • Emphasize to parent that they are the architect of the plan for future improvements • Use of tools • Scheduling of Booster Sessions PCIT Chapters 7 and 8

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