Describes interim results of a study examining the effectiveness of parent-child interaction therapy (PCIT) with families of preschool-age children with oppositional defiant disorder. Following an initial assessment, 64 clinic-referred families were randomly assigned to an immediate treatment (i.t.) or a wait-list control (WL) condition. Results indicated that parents in the IT condition interacted more positively with their child and were more successful in gaining their child's compliance than parents in the WL condition. In addition, parents who received treatment reported decreased parenting stress and a more internal locus of control. Parents in the IT group reported statistically and clinically significant improvements in their child's behavior following PCIT. All families who received treatment reported high levels of satisfaction with both the content and process of PCIT. Preliminary 4-month follow-up data showed that parents maintained gains on all self-report measures.
In light of the persistent nature of conduct problem behavior in children, and its enormous cost t o families and society, the importance of developing effective interventions that foster lasting changes i s discussed. Parent-management training (PMT) and studies of its associated long-term gains are reviewed. Although studies have demonstrated short-term gains for PMT, evidence for the long-term maintenance of treatment gains is limited. Strategies designed to promote the maintenance of treatment gains are drawn from both the adult and child treatment liierature and applied to parent training. The need to reduce dropout and t o examine the content and timing of booster sessions using randomized control group designs is emphasized.Future research must address the course of children's conduct problem behaviors, as well as the behaviors of parents and others (e.g., peers, teachers) who influence the child following treatment.
The implantable cardioverter defibrillator (ICD) may be associated with some degree of psychological maladjustment, especially in patients experiencing high rates of discharge. This article reviews the psychological literature related to ICDs and presents two case examples illustrating common psychological complications related to multiple discharges. A brief, psychological intervention can be implemented to improve patient adjustment. To explain possible processes by which psychological complications may develop in ICD patients, two well-established psychological theories of learning and behavior, classical conditioning and learned helplessness, are reviewed. Multidisciplinary teams that include consultation with clinical psychologists are suggested for the routine care of ICD patients.
This article focuses on Parent-Child Interaction Therapy (PCIT), a treatment program for young children with conduct problem behavior and their families. In Part One, PCIT is presented as an interactional approach to parent training and discussed in the context of other behavioral parent training programs. In Part Two, PCIT is described and empirical support for the program's effectiveness is presented. Given the importance of adapting programs to meet the needs of individual families and demonstrating treatment efficacy, Part Three is devoted to the presentation of strategies for modifying PCIT and measuring treatment outcome.
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