Various strategies can be used to address these problem areas We

Various strategies can be used to address these problem areas. We have seen in our own practice that the decision of which intervention strategy to utilize is a process that is idiographic in nature. In order to address issues with deficits in parental knowledge, psychoeducation or clarification of misinformation of prior knowledge can be helpful. Problems with implementation of parenting strategies can often be addressed directly in session via methods such as role-playing, modeling, and teaching. When parent beliefs about the nature of a presenting concern may be contributing to

problematic child behaviors or present as barriers to treatment adoption, cognitive therapy, reframing, motivational interviewing, and values clarification can be effective strategies. In this next section, we describe ways in which our BHCs have provided PMT-based interventions for each of these areas. If the parent (a) has never Caspase inhibitor clinical trial implemented strategies to address the problem behavior, (b) has never implemented effective strategies, or (c) has had difficulties implementing effective strategies due to deficits in understanding effective strategies, the BHC would enhance parental knowledge by providing psychoeducation about RO4929097 datasheet a specific PMT strategy. This psychoeducation would include information about the principles of operant conditioning

(e.g., positive or negative reinforcement, positive or negative punishment), as appropriate for the strategy, that fits with the functional analysis

the BHC and parent have co-created during the “assessment” phase of the session. It may include some instruction about the PMT intervention (see, for instance, Video 1). For example, a brief assessment with a 7-year-old child referred to us by the pediatrician for sleep difficulties GBA3 revealed an inconsistent bedtime routine that was notable for high degrees of parental attention when the child would awake in the middle of the night. Although the child would fall asleep fairly quickly, during periods of nighttime waking she would come into her parents’ bedroom. They would then turn on the television or give her a snack until she reported feeling tired again. Over time, nighttime waking increased to the point that it began interfering with her ability to remain awake during the day. After completing the functional analysis, the BHC provided psychoeducation to the parents about how their attending behaviors were rewarding the child for waking (e.g., she would get to watch television in bed with the parents, or enjoy a favorite snack), thereby increasing the likelihood that nighttime waking would occur again. Armed with this information, the parents were able to modify their own behavior to minimize interactions during nighttime waking and quickly place the child back into her bed.

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