How to apply behavior modification and family therapy dealing with children and adolescents
Dr VIMAL KUMAR S V
MPHIL CLINICAL PSYCHOLOGY (NIMHANS)
MPHIL LEARNING DISABILITIES
PHD(PSYCHOLOGY) NET
2. Expectations and queries
1. Im a psychologist, working in a child
clinic and a mother too.. so I think
this will be a fruitful one to my
interest. Expecting a session on
mental health of children.
2. Effective parenting
3. Therapies to improve the
relationship between parents and
child
4. Home remedies for behavioural
problems………….
3. Overview of the webinar
Mental health problems in children and adolescents
Parenting styles
Parent and child relationship
Management
Practical aspects
5. Diana Baumrind’s Parenting Styles
Families play an important part in a child’s
overall development.
Diana Baumrind states that parents should
develop rules for children while at the same
time being supportive and nurturing.
Inadequate Parenting may lead to
different abnormal behaviour and emotions
of the children.
6. Diana Baumrind’s Parenting Styles
Authoritarian parenting: restrictive and punitive
parenting style in which there is little verbal
exchange between parents and children; children
socially incompetent.
Authoritative parenting: positive parenting
style; parents encourage children to be
independent yet enforces rules and restrictions;
verbal exchange allowed; children socially
competent.
7. Neglectful parenting: parenting style of uninvolvement;
children socially incompetent.
Indulgent parenting: parenting style of involvement with
few rules or restrictions on child; children socially
incompetent.
Diana Baumrind’s Parenting Styles
8. Family System model
This model highlights the role of characteristics of family systems, broader
social network systems in the etiology and maintenance of childhood
psychopathology.
Elimination problem(Enuresis & encopresis) may be due to living in a
chaotic family environment. Elimination problem may be maintained by
coercive ,triangulating interaction patterns with parents or caregivers(
White,1984;Kelly,1996).
9. • Conduct Problems occur in Disorganized families which lack
communication and problem-solving skills, clear rules, roles( Barton &
Alexander,1981).
• Parents socialize children through modelling and reinforcement to
interpret ambiguous situation in a threatening manner and to cope
with fear through avoidance behavior.
• Parental Psychological problems such as depression, over intrusive
parenting during infancy and coercive parent – child interactions in
childhood have been found to be associated with ADHD(
Hinshaw,1994).
10. • Autistic withdrawal was the child response to unemotional and
inadequate parenting. (Bettelheim,1967).
• Families may maintain eating disorders like anorexia. These include rigidity,
triangulation, blame shifting, unclear communication( Minuchin et al,1978).
• Depression may occur when the family prevent the child from completing
age-appropriate developmental tasks( Asarnow et al , 1993).
11. Learning Model
It is a learning theory based on the ideas that psychopathology is a learned phenomenon.
Operant conditioning is simply learning from the consequences of subjects' own behavior.
Reinforcement is any procedure that increases the response
Punishment is any procedure that decreases the response
Types of reinforcers:
Primary: e.g. food or water
Secondary: money or power
13. Chocolate Bar Electric Shock
Excused from Chores
No TV
privileges
POSITIVE
NEGATIVE
REINFORCEMENT PUNISHMENT
Operant Conditioning
14. Insufficient , inadequate and maladaptive reinforcement
contributes to the development and maintenance of
psychopathology ( Mash & Dozois,2003).
Psychopathology due to maladaptive Reinforcement
& punishment
15. Psychopathology due to negative reinforcement
In the development of the OCD, an obsessive thought (eg concern as to
whether an alarm clock was set) results in anxiety. If the child checks
the clock and determines that the alarm was indeed set this will
immediately relieve anxiety and thus reinforce the child to continue
engaging in compulsive checking behaviors in the future.(Barrett &
Healy, 2003)
16. Behavior problems due to punishment
Eg. Excessive prolonged punishment from the teachers who beat children
harshly may have a direct link to violent behaviour ,conduct disorder and
Oppositional disorder .
17. Parent Management Training
• Negative parenting practices and
negative child behavior contribute to
one another in a "coercive cycle", in
which one person begins by using a
negative behavior to control the other
person's behavior. That person in turn
responds with a negative behavior,
and the negative exchange escalates
until one person's negative behavior
"wins" the battle.
18. Parent Management Training
• The therapist works from a social learning model in a structured paradigm with
parents to remediate parenting skill deficiencies.
• Parents are trained to encourage prosocial rather than antisocial behavior in
their children.
19. • Psychotherapy is most
effective when the family’s
psychosocial situation is
promising and the family
is willing to support
treatment (Mattejat and
Remschmidt, 1991)
20. • Skills in PMT:
• Tracking and classifying problem behaviors
• Ignoring trivial coercive events
• Using effective backup consequence when punishment is necessary
21. Oregon Social Learning Centre Approach
• Trained parents to use mild punishment in contingent manner to encourage
prosocial behavior and discourage antisocial behavior
• Identify, define, and observe problem behavior in new ways
• Taught social learning principles
• Techniques used: Mild punishment, Positive reinforcement, Negotiation,
Contingency contracting
22. Basic Elements
• Pinpointing and accurate labeling of child behavior
• Daily tracking of specific child behavior
• Administering tangible social reinforcement
• Using alternatives to physical punishment (i.e., time-out)
• Communicating effectively (e.g., clear commands, undiluted praise)
• Learning to anticipate and solve new problems
23. Applications
• PMT is one of the most extensively studied treatments for childhood disruptive
behaviors.
• ADHD
• Improvement in parental mental health (depression, stress, irritability, anxiety,
and sense of confidence)
24. Practical sides
• Quality time with children
• Addressing sibling rivalry
• Identifying parenting styles and changes
• Dispute between parents
• Impact of grandparents and other significant relatives
• Lack of exposure
• Underlying academic difficulties or disabilities
