pc-care · puppy . a goofy . monkey take a deep breath, and blow into the bubble wand while...

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Forte, L., Aviv, R., Boys, D., & Urquiza, A. (2016) PC-CARE: Course of Treatment Manual. Unpublished Manuscript.

PC-CARE

• All Sessions – Video Review Worksheet • Session 2 Coding Sheet & Checklist • Session 2 Strategies to Manage Behaviors • Calming Strategies for Young Children • Calming Strategies for Older Children • Co-regulation Techniques Handout • Daily CARE Handout • Session 2 Strategies Questionnaire • Session 2 What Worked Last Week Questionnaire

Weekly Assessment

• WACB-N

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Forte, L., Aviv, R., Boys, D., & Urquiza, A. (2016) PC-CARE: Course of Treatment Manual. Unpublished Manuscript.

Session # _____

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Forte, L., Aviv, R., Boys, D., Königs, M., & Urquiza, A. (2016) PC-CARE: Course of Treatment Manual. Unpublished Manuscript. E.1

PC-CARE Video Review Worksheet

This Worksheet for each PC-CARE session was constructed to help you think critically about each PC-CARE session and should help you during all your sessions dealing with PC-CARE.

Write down the main things the therapist asked about and discussed during check-in: It is essential that the didactic stays within the 10 minute timeframe. For each skill, identify how many ways the therapist defines it, how many explanations are given, and how many examples are given.

Did the caregiver seem anxious and/or overly talkative? If so, describe how the therapist redirected him/her.

Note how the therapist included the child in check-in and didactic (and makes it fun):

Mention pros and cons of the child being involved in the didactic this week. Pros: Cons:

Session # _____

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Forte, L., Aviv, R., Boys, D., Königs, M., & Urquiza, A. (2016) PC-CARE: Course of Treatment Manual. Unpublished Manuscript. E.2

Look at your coding of the caregiver. Are there areas where the caregiver might improve? Describe how the therapist uses coding results to inform coaching. Write at least two Level 3 coaching statements (i.e., explanations, observations of parent and/or child, interpretations) the therapist used during coaching that stood out for you. Note why they stood out (briefly):

Identify each skill taught this week and how the therapist coached each of them:

1) 2) 3) 4) Note instances where the therapist did a good job being gently corrective during coaching. Describe moments when coaching seemed to shift the caregiver’s performance and understanding of skills. Write down how the therapist introduces the graph at the end of session and describes the family’s progress:

Note how Daily Care is presented and encouraged:

PC-CARE – Session 2

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Armendariz, L., Aviv, R., Boys, D., & Urquiza, A. (2016) PC-CARE: Course of Treatment Manual. Unpublished Manuscript. E.3

WEEKLY CODING AND CLINICAL NOTES

4 min. Coding Instructions: “Tell your child that it’s playtime. Use all the skills you’ve learned while you follow along with [HIS/HER] play.”

CLIENT NAME DATE START TIME STOP TIME TOYS USED

CAREGIVER GOAL FOR SESSION

PARENT’S STATEMENTS: POSITIVE TALLY CODES TOTAL

NEUTRAL PARENT TALK

PRIDE (PRAISE, REFLECT, IMITATE, DESCRIBE, ENJOY)

AVOID TALLY CODES TOTAL QUESTIONS

COMMANDS

NEGATIVE TALK (NTA)

STRATEGIES USED TO MANAGE BEHAVIOR – circle all strategies present during 4 minutes of coding

TRANSITIONS REDIRECT CHANGE ENVIRONMENT RULES

MODELING CALMING REMOVAL OF PRIVILEGE WARNING CHOICES

IGNORE WHEN-THEN/IF-THEN RE-DO HAND-OVER-HAND RECOVERY

PARENT-CHILD INTERACTION QUALITY INDEX

During 4 minutes of coding: Not at all Somewhat Very much

Parent seems impatient or annoyed. 1_____2_____3_____4_____5

Parent is bossy or intrusive. 1_____2_____3_____4_____5

Parent is withdrawn and quiet. 1_____2_____3_____4_____5

Child was easily upset and hard to soothe. 1_____2_____3_____4_____5

Child ignored parent. 1_____2_____3_____4_____5

Child was bossy or tried to control play. 1_____2_____3_____4_____5

Child was aggressive or rude to parent. 1_____2_____3_____4_____5

PC-CARE Session 2 Checklist

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Armendariz, L., Aviv, R., Boys, D., & Urquiza, A. (2016) PC-CARE: Course of Treatment Manual. Unpublished Manuscript. E.4

Goals: Assess, reinforce PRIDE concepts, use Selective Attention, Modeling, Redirect, & Calming

Check-in (7 min.): Start Time_________________ Assessment measures and feedback (WACB, etc.) Daily CARE handout collected, reviewed, discussed barriers to completion if applicable Discussed objectives and goals (related to child behaviors) for session Complete “Strategies Learned – How did they work?” questionnaire

Mini-Didactic (10 min.): Start Time_________________ Present Session 2 Strategies handout Explain, model, and/or role play Selective Attention, Modeling, Redirect Present and explain Calming Strategies handout (choose handout for Younger or Older child)

4-minutes Coding (5 min.): Start Time_________________ Lead in statement given Reliable coding Gives feedback to caregiver Give coaching strategy for session, connect with session plan

Coaching (20 min.): Start Time_________________ Uses 3 levels of coaching: sufficient quantity, timing, pace, tone, and variety

Coach Coding (tally up coaching levels used in 5 minutes)

Start Time: End Time:

Level 1 (Lead)

Level 2 (Follow & Praise)

Missed Opp. Errors

Level 3 (Explain and Rapport)

Explanations Observations Generalizations

Coached to stated objectives of session: a. Selective Attention __________ b. Modeling __________ c. Redirect __________ d. Calming __________

Used exercises to achieve coaching goals if needed Gave warning (1, 2, 5 minute) before end of session

Closing the session (12 min.): Start Time_________________ Reviews accomplishments of session related to child behaviors Complete “Strategies Learned – Will they work for us?” questionnaire Shows graph of parent progress, connect with treatment goals Gives Daily CARE handout, connect with parent performance and treatment goals: Selective

Attention, Modeling, Redirect, Calming at home Asks if caregiver will be able to come to session next week Tells caregiver plan for next week

CLINICAL NOTES:

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Forte, L., Aviv, R., Boys, D., & Urquiza, A. (2016) PC-CARE: Course of Treatment Manual. Unpublished Manuscript. E.5

PC-CARE

SESSION 2 Skill Reason Example

Selective Attention

Ignore inappropriate behavior (unless it’s

dangerous or destructive)

• Helps child notice differences between your responses to good and bad behavior.

• Helps parents stay calm. • Avoids increasing negative,

attention-seeking behavior by only rewarding good behavior with your attention.

• Child: (plays roughly with toys) • Parent: (says nothing about it,

turns focus to own toys; making it fun) “I’m going to make some cookies. Oh these are so tasty!

• Allows child to know what behavior you want.

• Helps to correct difficult behaviors by showing child the positive opposite behavior.

• “I am putting my toys away gently.”

• “I am going to slow down and think about what to do next.”

• Child: (shouting loudly) Parent: (quietly) “I’m going to use my indoor voice.”

• Gets child to focus on another toy, behavior, or activity without use of strict discipline.

• Provides opportunity to praise good behavior and create positive interaction.

• If the child wants another sibling’s toy, the parent can redirect the child by showing them a different yet equally fun toy.

• “Wow, I have a space station. It is really fun to get the rockets ready for blastoff.”

Calming

• Gives parents the opportunity to model skills and calm themselves.

• Gives child some skills in learning how to calm.

• “I feel really upset. I am going to calm down. I am going to take a deep breath and count to 10.”

• “I feel nervous. I am going to tighten my shoulders and then relax them.”

Redirect

Modeling


TECHNIQUE DESCRIPTION

Label Feelings

Help your child identify big feelings by labeling your child’s feelings in a neutral tone of voice.

For example, “It seems like that really frustrated you,” or “I can see it made you feel sad when . . .”

Breathe Together

Calmly take deep breaths so your child can see you practicing self-calming. If it does not make your child more upset, sit next to or hold your child while you breathe deeply

so your child can feel the rhythm of breathing.

Body Calming

Slowly and rhythmically rub your child’s back, feet, etc, when they are recovered. Connecting like this lets them know that you will be

there when they are ready to talk or interact.

Back

Stories

Tell your child a story while drawing on the top half of your child’s back. For example, draw a circle with rays for the sun,

draw triangles for mountains, tap your fingers to walk up the mountain, and brush your hand back forth to make wind.

Then, switch places and let your child tell a story on your back.

Sing or play relaxing songs. Model how to sing/dance/play an instrument.

Your child will learn to use music as an active calming tool.

Creating a soothing environment can reduce distress. Try lowering lights and turning off noisy toys and devices.

Weighted blankets or other objects that children can touch or feel can help them focus and calm down.

A cold washcloth over the eyes can reduce visual stimulation and calm an overly stressed system.

Sensory Activities

Music

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Forte, L., Aviv, R., Boys, D., & Urquiza, A. (2016) PC-CARE: Course of Treatment Manual. Unpublished

Manuscript. E.9

Pretend you are holding a ball of Play-Dough.

SQUEE-EEEZE it as hard as you can!

Then, let it go.

Make your body rigid like a robot.

Then, relax your body, like a ragdoll.

Pretend you are smelling a beautiful flower.

Then, pretend you are blowing out

candles on a birthday cake.

Make your back very straight,

And make your stomach very hard, So that you can squeeze between two trees.

Then, relax and shake it all out!

Silly Face Contest! Make a face: A puffer fish

A turtle A friendly puppy A goofy monkey

Take a deep breath,

and blow into the bubble wand

while thinking of what you want to say.

Your words go into the bubble

and float away!

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Forte, L., Aviv, R., Boys, D., & Urquiza, A. (2016) PC-CARE: Course of Treatment Manual. Unpublished

Manuscript. E.10

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Forte, L., Aviv, R., Boys, D., & Urquiza, A. (2016) PC-CARE: Course of

Treatment Manual. Unpublished Manuscript. E.11

Snowman/Puddle: Make your body tense like a snowman.

Then, slowly melt your body down to the ground in a puddle.

Robot/Ragdoll: Make your body rigid like a robot. Then, relax your body, like a ragdoll.

Turn it into a game!

Flower/Birthday Cake:

Pretend you are smelling a beautiful flower. Then, pretend you are blowing out

candles on a birthday cake.

Down Dog:

Rest on your hands and knees. Curl your toes under and

make an upside-down ‘V’ with your body. Press through your fingers and your heels.

Feel your body stretch.

Sit & Breathe:

Find a quiet place to sit on the floor. Sit cross-legged, with a straight back,

looking at the ground about two feet in front of you. As you breathe, feel the cool air coming into your nose,

then feel the warmed-up air going out of your nose. If it helps, count the breaths: one, two, three . . .

Imagine a Rainbow:

Imagine you are walking down a beautiful path. A storm is clearing and you see a rainbow. Stand under it and let its warm, bright light fill you with

happiness. You are a rainbow too. Red: You are strong and safe. Orange: You are happy and playful. Yellow: You are proud and confident. Green: You are

kind and caring. Blue: You are honest and truthful. Indigo: You are clever and creative. Violet: You are a good friend.

Color/Art:

Coloring, painting, playing with playdough, and other arts and crafts are also

great ways to relax. Focus on what you are making, noticing the colors, the way the materials feel, and the shapes you are forming. Notice how your big

emotions get smaller as you create new things.

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Forte, L., Aviv, R., Boys, D., & Urquiza, A. (2016) PC-CARE: Course of

Treatment Manual. Unpublished Manuscript. E.12


Child’s Name: _____________________________________ Therapist – Session #: _____

Parent Name: _____________________________________ Date Returned: __________

During 5 Minutes Throughout the day

DATE

5-minute Special Play

Time!

What toys did you play

with?

Circle PRIDE skills used today

List strategies to manage

behavior used today

Overall, how was your child today?

(circle one)

__________ YES NO

Praise Reflect

Imitate Describe

Enjoy

__________ YES NO

Praise Reflect

Imitate Describe

Enjoy

__________ YES NO

Praise Reflect

Imitate Describe

Enjoy

__________ YES NO

Praise Reflect

Imitate Describe

Enjoy

__________ YES NO

Praise Reflect

Imitate Describe

Enjoy

__________ YES NO

Praise Reflect

Imitate Describe

Enjoy

__________ YES NO

Praise Reflect

Imitate Describe

Enjoy


SPECIFIC SKILLS TO PRACTICE DAILY

Use your Relationship Enhancement Skills (PRIDE)

P Praise!

R Reflect!

I Imitate and model!

D Describe!

E Enjoy out loud!

Use “physical positives” such as smiles, eye contact, hugs, kiss, sitting closely Reduce questions and commands Avoid “NO”, “DON’T”, “STOP”, “QUIT”, & “NOT”

Use your Strategies to Manage Behaviors

Transitions between activities. Compliance-friendly environment: Help

child to succeed. Ignore unwanted behaviors that are mild. Redirect & Model appropriate behavior. Keep Calm! When-then, if-then, & choices to

encourage compliance. Set up Rules. Effective commands: Praise compliance,

remove privilege for non-compliance. Redo and hand-over-hand to practice

positive behaviors. Recovery by using PRIDE skills after

compliance.

Increase the behaviors you want to see by using key words:

Unwanted behaviors:

Dawdling, stalling, delaying

Misbehaving at meal times

Disobeying, acting defiant

Acting angry or aggressive

Words to encourage appropriate behaviors:

Quickly Complying (first

time) Focusing

Right away

Quietly Waiting

Hands to self Sitting in seat Using manners Polite words

Good attitude Calmly

Following directions

Cooperative Complying

Using calming skills Softly Gently

Carefully Calmly

Thinking things over

Screaming, yelling

Destroying or being rough with

things

Provoking others, picking fights

Interrupting, seeking attention

Trouble paying attention, overactive

Using nice words Big boy/girl voice

Indoor voice Using calming

skills Speaking softly Talking calmly

Safely Calmly Gently Softly

Carefully Hands to self

Hands to self Polite words

Saying nice things Cooperative

Sharing

Letting others talk

Listening Waiting Patiently

Taking turns

Listening Focusing

Concentrating Waiting Patiently

Copyright © 2016 by University of California, Davis. Timmer, S., Hawk, B., Lundquist, K., Forte, L., Aviv, R., Boys, D., & Urquiza, A. (2016) PC-

CARE: Course of Treatment Manual. Unpublished Manuscript. E.15

PC-CARE

Today we learned the following strategies. Please rate how well you think each strategy will work for you and your family by circling the appropriate number on a scale of 1 (not at all well) to 5 (extremely well).

Selective Attention/Ignore Not at all Slightly Well Somewhat Very Well Extremely well well well

1 2 3 4 5

Modeling Not at all Slightly Well Somewhat Very Well Extremely well well well

1 2 3 4 5

Redirect Not at all Slightly Well Somewhat Very Well Extremely well well well

1 2 3 4 5

Calming Not at all Slightly Well Somewhat Very Well Extremely well well well

1 2 3 4 5

SESSION 2



PC-CARE

Last session, we practiced the following strategies. Please rate how well these strategies worked since the last session on a scale of 1 (not at all well) to 5 (extremely well). Circle the number that reflects how well each strategy worked.

PRIDE Skills

Not at all Slightly Well Somewhat Very Well Extremely well well well

1 2 3 4 5 Avoid Skills


1 2 3 4 5 Transitions


1 2 3 4 5 Compliance Friendly Environment


1 2 3 4 5

SESSION 2



Forte, L., Boys, D., & Timmer, S. (2012) The use of brief child behavior assessments for weekly check-ins in PCIT: WACB-N and WACB-P. Poster presentation at the 12th Annual PCIT Conference for Traumatized Children, Davis, CA. Updated 8/01/18

WACB – N (Weekly Assessment of Child Behavior – N)

Admin Use Only: Check if administered by therapist Session # __________________

Your Name __________________________ Relationship to Child _______________ Today’s Date ___/___/___

Child’s Name _________________________ Child’s Gender _______________ Child’s Age ___________

Directions Please fill out the whole form by circling one number per sentence. For each sentence:

a) Please circle the number that shows how often your child behaved that way in the last week. b) Circle either “yes” or “no” to show whether you need that behavior to change.

For example: If your child rarely cried at bedtime (once or twice) last week, you might choose 2 and circle “NO.” How often does your child… Never Sometimes Always Change? 1. Cry at bedtime? 1 2 3 4 5 6 7 YES NO

STEP 1:

In the past week…. Not at all Sort of Very Does this need to change?

How stressful was it to parent this child? 1 2 3 4 5 6 7 YES NO

STEP 2:

How often does your child…. Never Sometimes Always Does this need to change?

1. Dawdle, linger, stall, or delay? 1 2 3 4 5 6 7 YES NO

2. Have trouble behaving at meal times? 1 2 3 4 5 6 7 YES NO

3. Disobey or act defiant? 1 2 3 4 5 6 7 YES NO

4. Act angry, or aggressive? 1 2 3 4 5 6 7 YES NO

5. Scream and yell when upset and is hard to calm?

1 2 3 4 5 6 7 YES NO

6. Destroy or act careless with others’ things? 1 2 3 4 5 6 7 YES NO

7. Provoke others or pick fights? 1 2 3 4 5 6 7 YES NO

8. Interrupt or seek attention? 1 2 3 4 5 6 7 YES NO

9. Have trouble paying attention or is overactive?

1 2 3 4 5 6 7 YES NO

Total Score

(items 1 through 9 ONLY)

/63 /9 (1 per YES)

Forte, L., Boys, D., & Timmer, S. (2012) The use of brief child behavior assessments for weekly check-ins in PCIT: WACB-N and WACB-P. Poster presentation at the 12th Annual PCIT Conference for Traumatized Children, Davis, CA. Updated 8/01/18

pc-care · puppy . a goofy . monkey take a deep breath, and blow into the bubble wand while...

Documents