Coaching children (and their parents)

Four-year-old boys aren’t usually bastions of model behavior, but Erik Olsen is getting close.

Erik was having some trouble minding his preschool teacher, and would often get down on himself. But in the past four months, with a little effort and coaching, Erik is less anxious and more responsive to his teacher and parents, says his mother, Cadie Olsen.

Parent-Child Interaction Therapy (PCIT), an intensive treatment program designed to improve family relationships and teach parents skills to help manage children’s behavior, has been the key to Erik’s success, says his mom.

“We began coming (to PCIT) in October,” Cadie Olsen says. “We noticed an immediate change in how he was feeling about himself.”

Over the course of 12 to 15 one-hour sessions, parents are coached on effective skills to manage problem behavior and how to increase positive and supportive communication.

“It has helped me to have more fun with [Erik] because it is easier to talk with him and play with him because I know better ways to interact,” says Dave Olsen, Erik’s father.

But the way in which the Olsen parents and many others have acquired those skills is a bit unconventional.

Getting help Parent-Child Interaction Therapy, offered through both the Wellspring Counseling Center and Nevada County Behavioral Health, was developed in the early 1970s by Sheila Eyberg, a child psychotherapist at the University of Florida, Gainsville. For more information, contact Polly Ryan at the Wellspring Counseling Center at 582-4616, or Kirsten Livak with Nevada County Behavioral Health at 582-7789.

See and do

At the Joseph Center Government Center, where PCIT is offered, a one-way mirror separates a simple playroom from an observation room. On one side a parent will play with his or her child while a therapist feeds directions into an earpiece the parent is wearing.

“Dave, tell Erik that there are two rules for special play time,” Jennifer Hall, a therapist intern who is close to obtaining her license to be a clinical social worker, says into the father’s earpiece.

Dave Olsen relays the message to Erik.

“Tell Erik that he must stay seated in his chair and play gently with the toys, or you will turn away from him and play by yourself until he follows the rules,” she says.

Again, Dave Olsen relays the message.

This back-and-forth continues for the entire one-hour session. Dave is reminded to praise Erik, and is himself praised when he does so.

A stuffed animal — Mr. Bear — also interacts during play time as a sort of role model.

During her time to play with Erik, Cadie Olsen holds Mr. Bear in her lap and uses him in her interaction.

“Mr. Bear, please give [the toy] to Erik,” she says.

She then shakes the bear’s head, as if it is saying “No.”

“Uh, oh!” says Erik, acknowledging that Mr. Bear is not following directions.

“Mr. Bear, you must go in time-out,” says Cadie, placing him in the corner.

“Oh, no!” responds Erik.

“Sometimes Mr. Bear doesn’t make good decisions,” Cadie says.

Everybody wins

While Erik’s problem behaviors are mild, PCIT is most commonly geared toward children between the ages of 2 and 8 who exhibit aggressive behaviors, throw frequent temper tantrums, are on behavior management medications, or are in foster care, says supervising therapist Polly Ryan.

“We had one 7-year-old who was absolutely terrorizing his mother,” Ryan recalls. “But after a few sessions he was cooperating and his tantrums decreased to a minimal level — like, instead of four or five a week, just one a month.”

Improvements can also be seen in parents’ stress levels, child compliance, and family communication, say the therapists.

“It is very complicated to change behavior, and this is really an amazing thing,” Ryan says. “A lot of couples say that we have saved their marriages, too, because they fought so much about their children.”

The key to success is PRIDE Parents and other care providers who work with young children can adopt Parent-Child Interaction Therapy PRIDE skills to better their relationships with youngsters and build disciplinary techniques. Praise appropriate behavior: Praise increases positive behavior, builds self-esteem, and betters the parent-child relationship. Reflect appropriate talk: Repeating what your child says allows the child to direct conversation, improves speech, and shows that you are listening. Imitate appropriate play: Imitation shows that you approve of your child’s choice of play, it shows that the parent is involved, and it teaches the child how to play with others. Describe appropriate behavior: Describing teaches concepts, improves attention and speech patterns, and organizes a child’s thoughts about play. be Enthusiastic: Enthusiasm demonstrates an interest in the child and strengthens a positive relationship. <i>— Source: marriage and family therapist Polly Ryan</i>