THURSDAY 26 DECEMBER 2013 • [email protected] • www.thepeninsulaqatar.com • 4455 7741 inside Lone Surviver depicts WHEELS US Navy SEALs camaraderie • Akeed: Toyota unveils new in Afghan tragedy brand tagline P | 4 P | 8-9 CAMPUS • The Next Generation School celebrates Annual Day For parents of young P | 5 children with severe behaviour problems, MARKETPLACE Parent-Child • Nokia Lumia 1520 hits Interaction Therapy Qatar stores offers tools to help manage conduct. P | 6 HEALTH • Many with diabetes unaware of vision loss P | 11 TECHNOLOGY • Which type of SD card MANAGING to buy? P | 12 TEMPER Learn Arabic • Learn commonly used Arabic words TANTRUMS and their meanings P | 13 2 PLUS | THURSDAY 26 DECEMBER 2013 COVER STORY How to tame an out-of-control kid Larissa Niec, a PCIT therapist and psychology professor at Central Michigan University, practises coaching a mother and son at a university clinic. By Ariel Sabar mental health clinic in August 2012. (Like other par- son comes from a pretty cushy middle-class lifestyle. ents quoted in this article, Edith asked that only her I felt very ashamed, like I’m not a good parent.” dith, a retired Capitol Hill staffer from first name be used.) Most families complete PCIT after 10 to 20 weekly, Washington, was at the end of her rope last Wayne is typical of children who benefit from the hour-long sessions. In the first phase of PCIT — Eyear over the mayhem her 5-year-old great- therapy, which researchers have found most effective called child-directed interaction (CDI) — the par- grandson Wayne was causing at preschool. “I was on for those ages 2 to 7. According to clinical studies, ent is taught to notice and praise even the briefest speed dial” at the school, says Edith, who is raising families who complete PCIT see lasting improve- moments of good behaviour (“Thank you for sharing two of her great-grandchildren. “He was hitting kids, ments in child behaviour: less-frequent and less- your toys!”), while mostly ignoring defiance. In the destroying the classroom, tearing the ABCs off the intense tantrums, less crying and whining, and less second phase — called parent-directed interaction wall, just terrorising the building.” hyperactivity and inattention. Parents had less stress (PDI) — the parent is taught to issue calm and con- The principal begged her to seek help, and Edith and enjoyed parenting more, and typically developed crete commands (“Put the crayons in the box” rather soon enrolled Wayne — and herself — in an emerging a closer relationship with their children. than simply “Clean up your mess”) and to respond to psychological treatment for out-of-control preschool- To one degree or another, nearly every preschooler noncompliance with predictable, immediate conse- ers called Parent-Child Interaction Therapy (PCIT). has an inner Dennis the Menace. But families who quences (a warning, followed by escalating timeouts). The programme has been slowly making its way into enter PCIT have typically reached a crisis. Their The sequence is not accidental: The idea is that the clinics across the America after years of randomised kids have been expelled from day care or preschool. discipline becomes effective — and, ideally, unneces- trials that have won it recognition as one of the most Parents, demoralised by one too many public melt- sary — only once the child discovers he can get as effective treatments for young children prone to fre- downs, have grown isolated from friends and emo- much attention for good behaviour as for bad. The quent and destructive meltdowns. tionally withdrawn from their children. therapy does not end until the parent has demon- Unlike traditional play therapy, in which a thera- A common refrain is: I love my child, but I no strated — live, with the child — that he or she has pist plays with the child while the parent stays in longer like her. mastered the CDI and PDI skills. a waiting room, PCIT takes aim at both child and “I have had folks come in and say, ‘What I need Parents maintain the skills at home by establishing parent (or chief caregiver) and at the day-to-day is Supernanny,’ “ says Teresa Loya, a clinical social a timeout room and having at least five minutes a day mechanics of their relationship. Its premise is sim- worker who is the PCIT coordinator at the Kennedy of “special time” with their child. That often means ple: that the best way to help children with titanic Krieger Institute’s Family Center in Baltimore. playing together with toys and using the relation- tempers is to coach parenting in real time. “More than that, though, they often say, ‘I need to ship-building techniques learned in CDI. If a child Parents who enroll in PCIT get their own per- get rid of this kid.’ “ misbehaves in public, parents are instructed to find sonal trainer: a social worker or psychologist who “At our darkest moments, we thought, ‘This child a makeshift timeout area; a stairwell landing or a dispenses guidance through a wireless earpiece. In a can’t live with us anymore; he’s going to have to go to restroom alcove will do. “Immediate consequences typical session, the therapist retreats behind a one- a home,’ “ says Jennie, a 30-year-old mother of three are hands-down the important thing,” says Steven way mirror and instructs parents — sometimes even in Auburn, New York, who once locked herself and Kurtz, a child psychologist who conducts PCIT at the feeding them lines to say — as they play with and her newborn in a bathroom for safety from her rag- Child Mind Institute. learn to discipline their children. The live feedback ing 5-year-old son, Alex. Jennie tried everything — Once parents graduate from the programme, ther- catches ineffective parenting habits in their tracks play therapy, medication, a gluten-free diet — before apists schedule a follow-up phone call a few months and helps parents hew to PCIT’s somewhat rigid she and Alex began making a weekly six-hour drive later — and, if necessary, a “booster” session. script, which combines effusive praise and attention last year to the PCIT programme at the Child Mind Edith finished the programme after three months. for good behaviour with a clear system of warnings Institute in Manhattan. Now, she says, Wayne is a seemingly different child, and timeouts for bad. “I always thought that kids with [behaviour dis- sitting still in class, advancing a level in reading, “It gave me a sense of ‘someone’s got my back,’ orders] came from abusive households or really sad, trusted by teachers to help out in class. “I feel like I “ says Edith, who entered PCIT with Wayne at a poor conditions where they witnessed violence. My can live now,” Edith says. PLUS | THURSDAY 26 DECEMBER 2013 3 disorders in children are not just to discuss their child’s behaviour Jennifer Wyatt Kaminski, a devel- glares at the grocery store or the problems and develop responses. opmental psychologist at the Centers playground: Research has found that Parent and child were rarely with for Disease Control and Prevention, such children are more apt later to the therapist at the same time. As led a meta-analysis of 77 published To determine whether have drug and alcohol problems, to a result, the child associated the studies on evidence-based treatments drop out of school, to develop other calming effects of play therapy with for early childhood behavior problems. PCIT is appropriate, mental illnesses and to spend time the therapist, not her own parents. The results, published in 2008 in the in prison. Parents, meanwhile, struggled to apply Journal of Abnormal Child Psychology, a therapist interviews Though stimulants such as Ritalin the therapist’s lessons at home. found that one of the most successful the family, administers are often prescribed for behavioural Eyberg’s insight was, in essence, to strategies was to increase the number problems, medicine alone is not seen cast parents as play therapists to their of positive everyday interactions a parent questionnaire as an effective treatment for young own children. The professional therapist between parents and children. children with disruptive behaviour still had an important role but was PCIT’s live coaching and laserlike and standard disorders. behind the scenes, performing a kind of focus on the parent-child relationship child behaviour PCIT may also play a role in ventriloquism through an earpiece until make it distinctive, but the therapy reducing child abuse. A 2004 study in parents internalised the therapist’s voice. shares many of the same goals as other assessment, and the Journal of Consulting and Clinical Eyberg won federal money for a highly regarded interventions, such as Psychology found that 850 days after pilot study in the mid-1970s; over the the Incredible Years and the Triple P: watches the parent treatment, 19 percent of physically next three decades, randomized clini- Positive Parenting Program. abusive parents who had undergone cal trials began finding large, lasting “You’re relationship-building and and child play. PCIT had been re-reported to child improvements in child behaviour and providing children with positive atten- welfare authorities, compared with 49 in parents’ skills, attitudes and stress. tion in such a way that it reduces their percent of physically abusive parents But PCIT remained largely confined to need to seek out attention through” who received conventional services. university settings where Eyberg and undesirable behaviors, Kaminski says. Jennie reported similar results after A new line of PCIT research is also her former graduate students taught. For parents who have built emotional graduating from PCIT. Tantrums that showing promising results with autistic The therapy met resistance from some defenses against their children’s had drawn blood and lasted for hours children.