Parent Management Training
Parent Management Training or Behavioral Parent Training treats challenging, oppositional, or disruptive behaviors in children. Behavioral training is based antecedent-behavior-consequence model, which includes the following concepts:
Behaviors are increased when followed by:
- Positive reinforcement (something desirable, which for children may include any kind of attention, even angry attention)
- Negative reinforcement (something undesirable disappears)
Behaviors are decreased when followed by:
- Punishment (something undesirable happens)
- Extinction (a desirable thing disappears)
Paying attention to problem behaviors increases the likelihood that they will recur. Even when the attention children get for their behaviors is subtle ("the look") or unpleasant (arguing, yelling), it can still be powerfully reinforcing.
By engaging problem behaviors, we may inadvertently be rewarding them with attention.
Parent Management Training is a type of time-limited, structured training or therapy that can be delivered individually or in groups. It provides strategies and skills to address common behavioral problems in children. It recognizes that parenting is not easy and is not always intuitive.
No matter how skilled parents are, some children are more challenging to parent than others, and so parents can often benefit from extra guidance. Key elements of parent management training are presented here. More detailed information is available in the Curriculum and in the Patient & Parent Handouts.
Attention, play, listening
The foundation of positive parenting are positive interactions. The core strategy is setting aside brief periods of child-centered time in which the parent pays attention to the child's play, interests, or conversation without trying to question, criticize, or direct the interaction. Parents often interject with question or guidance. This is not always wrong, but in the setting of this special time, the parent should just attend and show interest.
Praise & Positive Reinforcement
Reward desired behavior with positive attention.
Be clear - “I like it that you got dressed quickly” is better than “Good job!”
Be unconditional - “Thanks for putting away the Legos. Now the room looks great” is better than, “Thanks for putting away the Legos. Why can’t you do that all the time?”
Positive reinforcement can include tangible rewards, but it can also be warm attention, high fives, hugs.
Why? We all work for rewards
When and how to praise and reward
Make it natural, and part of the day.
- “Since you are ready for school on time, we can have pancakes for breakfast.”
- “You bumped into your sister and she fell and is crying. Please help her up"... "Thank you for helping her up. That was very kind of you.”
- “Thank you for bringing in the groceries. After we unpack them, let’s have some of those cookies we bought.”
Give effective instructions
Be direct - don’t say “let’s” if you mean “you”
Don’t phrase commands as questions - “Do you want to clean up the toys now?", "Will you put your clothes away?"
Be specific – what to do, not what to stop doing.
Give instructions one at a time
Keep explanations simple
Give kids time - 30 - 60 seconds should be good
Be close - be sure they can see and hear you
Follow through - Praise if compliant, consequence if not
Younger children, and children with ADHD really benefit from proximity and simple and single instructions. Most importantly, adults need to follow through on instructions, thanking the child for complying, or reminding them, helping them, or giving a consequence if they do not. Parents that don't follow through are eventually ignored.
Ignore, distract, redirect
- Ignore behavior that is annoying but not dangerous or destructive.
- Offer alternatives. rather than “Stop doing that!”, try “Come over here and help me with this.”
- As soon as the child starts behaving appropriately, praise him or her.
Ignoring, rather than scolding or punishing minor misbehaviors, is an effective strategy for several reasons. If the goal of the behavior is parental attention, ignoring it reduces positive reinforcement. Scolding is a resource that loses its power if applied too often, so you want to save it for more critical situations.
Distracting and redirection are techniques that complement ignoring. If a child is doing something you don't want him to do, invite him to do some other more appropriate activity. If the goal is attention, you are then giving attention as he engages in the appropriate activity.
Build a reward system
Rewards systems or Token Economies can be used to promote positive behaviors in homes, schools, and other settings. The point system is linked to desired privileges or items.
- Child earns points or tokens for positive behaviors
- Points can be cashed in for reinforcers, even just stickers on the chart
- Works best when
- There are only a few target behaviors for the tokens
- The child can regularly earn rewards
- Points or tokens are not taken away as punishment
- The child receives points immediately following desired behavior
- it’s simple and consistent
Contingency Management
Contingency management is the normalized, systematic reinforcement of desired behaviors and the withholding of reinforcement or punishment of undesired behaviors.
- “You may watch an hour of YouTube after you bring me your completed homework to check.”
- “You may go out with your friends to the mall as long as you are home by 5. If you are late, you will not go out for the rest of the week.”
- “You may play your game until 6. If you fuss when I tell you it’s time to stop, you will not play your game tomorrow.”
Contingency management is simply behavioral rules based on "if-then".
- Link expectations and rewards or penalties tightly in time and in proportion.
- Once issued, do not continue to attach anger, shame or blame to a penalty.
- Avoid “taking away everything” because then the child has nothing to lose.
- Avoid making penalties so long induration the child feels she has nothing to work for.
- Avoid any penalty that you don’t have the endurance to carry out.
The path of parenting is one of guiding children from a state of complete dependence to one of increasing independence and responsibility. Parents will make mistakes, and children will make bad decisions, and the path will involve some backward steps during which trust and maturity can grow. Ultimately, ideally, the child will develop a sense of self as an autonomous being, responsible to himself and to those around him, and ready to participate in the world.