Parent-Child Interaction Therapy
Parent-Child Interaction Therapy (PCIT) is an evidence-based treatment model backed by over 30 years of research. PCIT focuses on improving the quality of the parent-child relationship by changing parent-child interaction patterns. PCIT was developed for children ages 2–7 years with externalizing behavior disorders. In PCIT, parents are taught specific skills to establish or strengthen a nurturing and secure relationship with their child while encouraging pro-social behavior and discouraging negative behavior.
PCIT is designed to help both parents and children through skills training, observation, and live coaching. PCIT aims to empower parents to be their child’s therapist, which makes change happen faster and last longer than with traditional play therapy. Parents and children in the PCIT program work together to improve the quality of the parent-child relationship, to build the child’s self-esteem, to improve the child’s compliance and listening skills, and to teach parents the skills necessary to manage their child’s severe behavior problems.
Trauma-Focused Cognitive Behavioral Therapy
The goal of Trauma-Focused Cognitive Behavior Therapy (TF-CBT) is to help address the biopsychosocial needs of children with Post-traumatic Stress Disorder (PTSD) or other problems related to traumatic life experiences, and their parents or primary caregivers. TF-CBT is an evidence-based model of psychotherapy that combines trauma-sensitive interventions with cognitive behavioral therapy. Children and parents are provided knowledge and skills related to processing the trauma; managing distressing thoughts, feelings, and behaviors; and enhancing safety, parenting skills, and family communication.
Therapeutic elements of TF-CBT can be easily remembered, based on the “PRACTICE” acronym:
- Psychoeducation and Parenting skills
- Affective Expression and Regulation
- Cognitive Coping
- Trauma Narrative Development and Processing
- In Vivo Gradual Exposure
- Conjoint Parent-Child Sessions
- Enhancing Safety and Future Development
- Family Systems/Family-Based Therapy
The goal of family therapy is to help family members improve communication, solve family problems, understand and handle special family situations (for example, death, serious physical or mental illness, or child and adolescent issues), and create a better functioning home environment. For families with one member who has a serious physical or mental illness, family therapy can educate families about the illness and work out problems associated with care of the family member. For children and adolescents, family therapy most often is used when the child or adolescent has a personality, anxiety, or mood disorder that impairs their family and social functioning, and when structural changes within the home take place, or when a stepfamily is formed or begins having difficulties adjusting to the new family life.
Family therapy is based on family systems theory, in which the family is viewed as a living organism rather than just the sum of its individual members. Family therapy uses systems theory to evaluate family members in terms of their position or role within the system as a whole. Problems are treated by changing the way the system works rather than trying to fix a specific member.
Family Centered Treatment
Family Centered Treatment is part of Carolina Outreach’s continuum of care for at-risk children and their families. FCT is an evidence-based, in-home service that helps to preserve the family and prevent out-of-home placements.
FCT services are conducted in the family’s home and include:
- Individualized Service Plans
- Case management
- Counseling / behavioral therapy
- Skills training
- Resource coordination
- 24/7 Crisis interventions
For youth in therapeutic foster care and residential programs, we utilize the FCT model to help reunite them with their families when it is in the best interest of the child. For children and adolescents living at home, our skilled therapists bring FCT services into their home, where they and their parents/caregivers can learn the skills they need to succeed in their everyday lives.
The FCT model includes multiple contacts with the family each week, excluding the ramping up period (first month) and the slowing down period (last month of treatment). Lengthier and more frequent sessions are available based on assessed need.
On-call support is available 24/7/365. The average length of treatment is 6 months, but the length of treatment is driven by family need and progress and may be shorter or longer in duration.
FCT services are typically conducted in a(n):
- Adoptive home
- Birth family home
- Foster/kinship care
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a form of treatment that focuses on examining the relationships between thoughts, feelings, and behaviors. By exploring patterns of thinking that lead to self-destructive actions and the beliefs that direct these thoughts, people with mental illness can modify their patterns of thinking to improve coping. CBT is a type of psychotherapy that is different from traditional psychodynamic psychotherapy in that the therapist and the patient will actively work together to help the patient recover from their mental illness. People who seek CBT can expect their therapist to be problem-focused, and goal-directed in addressing the challenging symptoms of mental illnesses. Because CBT is an active intervention, one can also expect to do homework or practice outside of sessions.
Scientific studies of CBT have demonstrated its usefulness for a wide variety of mental illnesses, including mood disorders, anxiety disorders, personality disorders, eating disorders, substance abuse disorders, sleep disorders and psychotic disorders. Studies have shown that CBT actually changes brain activity in people with mental illnesses who receive this treatment, suggesting that the brain actually improves its functioning as a result of engaging in this form of therapy.
CBT has been shown to be as useful as antidepressant medications for some individuals with depression and may be superior in preventing relapse of symptoms. Patients receiving CBT for depression are encouraged to schedule positive activities into their daily calendars in order to increase the amount of pleasure they experience. In addition, depressed patients learn how to change (“restructure”) negative thought patterns in order to interpret their environment in a less negatively biased way. As regular sleep has been found to be very important in both depression and bipolar disorder, therapists will also target sleeping patterns to improve and regulate sleep schedules with their patients. Studies indicate that patients who receive CBT in addition to treatment with medication have better outcomes than patients who do not receive CBT as an additional treatment.
CBT is also a useful treatment for anxiety disorders. Patients who experience persistent panic attacks are encouraged to test out beliefs they have related to such attacks—which can include specific fears related to bodily sensations—and develop more realistic responses to their experiences. This is beneficial in decreasing both the frequency and intensity of panic attacks. Patients who experience obsessions and compulsions are guided to expose themselves to what they fear in a safe and controlled therapeutic environment. Beliefs surrounding their fears (of contamination, illness, inflicting harm, etc.) are identified and changed to decrease the anxiety connected with such fears.
The Modular Approach to Therapy for Children with Anxiety, Depression, Trauma or Conduct Problems (MATCH) is designed for children ages 6-15 years. Unlike most evidence-based treatments, which focus on single disorder categories (e.g. anxiety only), MATCH is designed for multiple disorders and problems encompassing anxiety, depression, trauma, and disruptive conduct, including the conduct problems associated with ADHD.
MATCH is composed of 33 modules, or specific treatment procedures derived from decades of research. These modules can be organized and sequenced flexibly to tailor treatment to each child’s characteristics and needs. In addition, MATCH can move easily from a focus on one disorder area to another (e.g. shift from anxiety to depression) if the child’s presentation should change during treatment.
Clinicians trained in this evidence-based approach can treat over 70% of typical problems presented in outpatient clinics. MATCH provides children and their families with a way to better understand their challenges and tools to help manage their difficulties and improve their functioning.