PCIT Advanced Training in PCIT: Center Providing PCIT in ... · PDF filejeton hakeri Created...
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Advanced Training in PCIT: Providing PCIT in Home
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2015 UC Davis PCIT Conference Los Angeles, CA
PCIT Training Center
Tylene Cammack-Barry, UC Davis Jocelyn Clegg, Counseling4Kids
Horacio Diaz, ChildNet
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• Supporting an in-home PCIT program • How to conduct PCIT in clients’ homes • Testing different coaching strategies • In-home PCIT treatment integrity • The challenges of in-home PCIT and how to
handle them • The benefits of in-home PCIT
Goals for participants is to understand:
OBJECTIVES
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HOW TO SET UP YOUR PCIT SPACE
IN HOME PCIT
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CREATING A PCIT SPACE
IMPROVED FAMILY COMMUNITY FUNCTIONING
• Minimize noise • Minimize intrusions • Work with the
caregiver to decide how to handle others
CALM
• Introduce the routine of the treatment session
•Tell how the routine leads to the outcomes
• Stick to the routine
ROUTINE •Be on time and prepared •Document everything •Graph progress (DPICS &
behavior problems) •Carry a shadow file with
you- show graphs
PROFESSIONAL
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• Where is there empty space for playing?
• Are there many breakable or valuable items in or near this space?
• Will the child be easily contained in this area?
• Ask the question, “Where do you usually play with client?”
SETTING UP THE SPACE- THINGS TO CONSIDER:
Scan the living space quickly
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SETTING UP The dining room table
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SETTING UP Mobile home
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SETTING UP Mobile home
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SETTING UP The kitchen counter
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SETTING UP Living space
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SETTING UP School space
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SETTING UP School space
(view 2)
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SETTING UP
• Space limitations • Logistical barriers
• Age of client • Distractibility of client
• Caregivers need to hear you easily- check understanding
• Caregiver depressive symptoms- seeing you may help keep focus
• Less interruption of parent-child play is better
• Make sure you can see & hear easily
• Technology if you want to use it, make sure it works perfectly!
WHAT’S POSSIBLE CLIENT
CAREGIVER YOUR PREFERENCES & NEEDS
WHERE YOU SIT- THINGS TO CONSIDER
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SETTING UP Using FM receiver
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SETTING UP Sitting behind the child
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SETTING UP Sitting between the parent and child
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SETTING UP Sitting behind the parent
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SETTING UP DECIDING ON YOUR TIME-OUT SPACE
• Minimal stimulation
• Visible to the parent
• Out of the way of foot-traffic
• Explore parent’s current practices
• Avoid “the corner”
• Make space by using a rug, bean bag, kid sized chair
• Avoid tall chairs, stools – consider safety
Find a space with the following qualities:
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LET’S TRY IT OUT!!
ROLE PLAYING COACHING
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GROUP DISCUSSION • What setup did you like best? Why?
• How often did you coach?
• How much did you say?
• What kinds of things did you say?
(Level)
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• Behind the parent
• Across from parent
• Using an FM receiver
COACHING IN HOME PHYSICAL SET UP AND COACHING:
Where you sit will affect how you coach:
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• Less coaching
• Choosing moments best for giving feedback
• Setting up exercises for parent to practice specific skills
• Take good notes and share observations with caregiver following session
COACHING IN HOME TIMING YOUR COACHING:
When you coach changes in homes:
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• Keep it simple
• Keep it focused
• Keep coaching goals in mind
COACHING IN HOME HOW MUCH TO COACH:
How much you coach changes in homes:
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• When you teach
• Keep it short and simple
• Model and role play
• Give handouts
COACHING IN HOME TEACHING MOMENTS
Psychoeducation is best in little bits:
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MEANING OF “HOME” AND THERAPEUTIC ROLES
TREATMENT IN HOMES
• Home is safe • Your role in
keeping all safe & providing PCIT
SANCTUARY
• Caregivers’ roles in their homes
• Your social role & your professional role
THE HOST
• Variations in meaning of “home” by culture
• Need to be sensitive • Need to create
therapeutic space
CULTURE & HOME
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IN-HOME PCIT PROGRAMS
• Need to follow PCIT protocol: Assessment driven (5-5-5, ECBI, 5 min coding), coach toward CDI/PDI mastery, 30 min coaching per session
• Need to focus on the dyad, especially in CDI
• Need for coding accuracy
• Demands on therapists: documentation, preparation for session
MAINTAINING TREATMENT FIDELITY
Protocols and therapist autonomy
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• Know the protocol and what you need to accomplish each session
• Have parent & child goals going into the session
• Review accomplishments with the parent at the end of each session
COACHING IN HOME STAYING ON TRACK
Sticking to protocols can be challenging:
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CONTACT US Website: pcit.ucdavis.edu
Web Course: pcit.ucdavis.edu/pcit-web-course
www.facebook.com/UCDPCIT PCIT LinkedIn Group
THANK YOU!