V.4 #2 Counseling/School Psychology - Parent Management Training
Behavioral problems are correlated with academic difficulties (Todd, Horner, Sugai, & Colvin, 1999). Children with anti-social behaviors often experience a high co-occurrence with academic and social deficits. Although learning disabilities may be the cause for students to engage in maladaptive behaviors, often disruptive behaviors can be the cause for deficiencies in academic achievement, grade retention, placement in a more restrictive setting and poor interpersonal relations among peers and adults (Kazdin, 2003).
Treatments and Format
Two treatments have consistently shown empirical evidence in the treatment of anti-social and behavior problems: parent management training (PMT) and problem-solving skills training (PSST). These treatments have been designed by Alan Kazdin (2003) at the Yale Child Conduct Clinic. Parent management training involves procedures that train a parent to affect changes and alterations in their child’s behavior in a home environment. PSST focuses on the cognitive processes involved when dealing with interpersonal situations.
Both PSST and PMT are provided by a trained professional in the mental health profession, often a psychologist, but it can also be from a social worker or counselor on an individual basis to children and families (Kazdin, 2003). Both can be provided as a systemic approach in reducing the maladaptive behaviors and are not mutually exclusive. PSST has been discussed in the previous publication (see Benhar SSL, 4(1), October 2010) and this article will address PMT.
Parent Management Training (PMT)
PMT focuses on changing a child’s behavior in the home setting by educating parents (Kazdin, 2003). For example, aggression and other conduct problems can develop and may be maintained due to ineffective parent-child interactions. There are several reasons for this including a lack of positively reinforcing appropriate behaviors by a parent or a parent reinforcing inappropriate behaviors along with providing ineffective commands and severe punishment.
PMT is derived from behavior theory that focuses on the relationships and interactions between behaviors and the environmental events that influence behavior and is called contingencies of reinforcement (Kazdin, 2003). These contingencies of reinforcement consist of three components: antecedents (A), behaviors (B), and consequences (C). Antecedents refer to the triggers in the environment that occur before the behavior is manifested by the child. This may include commands or instructions, verbal and non-verbal actions, such as remarks or gestures by others, along with physical acts, such as hitting. Behaviors refer to the actions of individuals that are often in response to the triggers that precede them. Consequences refer to the events that follow the behavior that will either increase or decrease the behaviors, such as being rewarded with what the child wants after having a temper tantrum or being punished by having something taken away, such as television privileges.
PMT consists of altering the current ineffective parent-child interactions and promoting prosocial behavior (Kazdin, 2003).
The parent or parents are the focus of treatment by the therapist and not the child.
Parents are educated by the therapist to observe, identify and define disruptive behaviors in a more systematic manner by describing them so that they are clearly delineated for the implementation of the intervention. For example, saying that a child is aggressive is not as helpful as describing when, where and how often the child engages in hitting behaviors.
Treatment employs teaching parents about the principles of operant conditioning, such as positive reinforcement, shaping procedures, prompting prosocial behaviors, behavior contracts, and the use of mild punishment, such as loss of computer privileges.
Treatment usually combines modeling by the therapist, practice by the parents at home, role-playing and rehearsal in the sessions, along with reviewing the behavior intervention program that is implemented in the home for its effectiveness.
Description of Yale Child Conduct Clinic PMT Training (Kazdin, 2003)
Below is a short description that details some of the specifics involved in PMT training that gives a clearer idea of the allotted time a parent will need to devote in undergoing this training.
PMT consists of 12-16 weekly sessions with the parent lasting 45-60 minutes.
Parents are taught operant conditioning techniques that include specific skills for the parent to implement in their interactions with their child.
The initial step is a discussion of general operant conditioning concepts, such as positive reinforcement and how the parent correctly implements it in the home setting using specific examples.
The PMT therapist focuses on situations that the parent actually encounters with the child.
The application of the steps to specific situations brought to the session by the parent is modeled by the PMT therapist.
Then the parent and therapist practice by role playing that solution.
Throughout the role playing, the therapist prompts the parent verbally and nonverbally to guide performance, provides reinforcement (smiles and praise), specific corrective feedback, and models improved ways of performance.
Homework assignments are designed by the therapist to help generalize skills learned in the sessions to other settings.
Reward charts are implemented in the home environment as a means to reward the child for appropriate behavior. Tokens used for the charts may consist of stickers, points or coins that are based on practical concerns, such as the age of the child and the ability of the parent to consistently implement the program. The reward chart is used as a means to shape not only the child's behavior but to also shape the parents' child rearing practices.
PMT also focuses on promoting prosocial behaviors in the school setting.Teachers are contacted to discuss behavioral concerns and the reward system used in the home environment as a means to connect the program at home to the child';s school performance.
Behavioral problems often co-occur with learning difficulties (Todd, Horner, & Sugai, 1999). Frequently, it is unclear when a student is disruptive in the classroom is it primarily due to a learning or a behavioral problem. Since challenging behaviors may often lead to learning difficulties and visa-versa, it is prudent for teachers to refer students with chronic disruptive behaviors who do not respond well to typical good classroom management techniques.
PMT has been shown to be highly effective in teaching more prosocial responses. However, only a trained professional in PMT should conduct this as an intervention. Teachers should refer a child with anti-social behavior to their school psychologist, counselor or social worker.
Kazdin, A. E. (2003). Problem-solving skills training and parent management training for conduct disorder. In A. E. Kazdin & J. R. Weisz (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 241-262). New York: Guilford Press.
Todd, A. W., Horner, R. H., Sugai, G., & Colvin, G. (1999). Individualizing school-wide discipline for students with chronic problem behaviors: A team approach. Effective School Practices, 17, 72-82.
Michael David Benhar, Ph.D. is an Assistant Professor in the Social Sciences Department at Suffolk County Community College. Dr. Michael David Benhar teaches undergraduate and graduate courses in Developmental Psychology, Exceptional Child, Classroom Management, and Assessment. He has co-authored a chapter on students with disabilities. In addition, he has worked as a school psychologist in a preschool for children with special needs.