pmto presentation
TRANSCRIPT
![Page 1: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/1.jpg)
Alison Cox & Miriam Holbrook
PARENT MANAGEMENT TRAINING: OREGON MODEL (PMTO)
![Page 2: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/2.jpg)
WHAT IS PMTO?Created by Gerald R. Patterson, Research scientist;
Founder of Oregon Social Learning Center
PMTO is THEORY-BASED:
Social Interaction Learning Theory:
Emphasizes the influence of the social
environment on behavioral outcomes.
http://www.youtube.com/watch?v=YI5Tylind9E
Coercion Theory
Hypothesis:
One person engages in a negative behavior to get what he/she wants
The other person responds in an equally negative fashion.
The exchange between the two individuals increases in intensity-
Until one of them finally gives in.
![Page 3: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/3.jpg)
REINFORCEMENT A consequence following a behavior that
attempts to increase that behavior
Positive Reinforcement (PMTO): Presenting something goodfollowing a behavior you want to increase
Negative Reinforcement: Removing something badfollowing behavior you want to increase
![Page 4: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/4.jpg)
PUNISHMENTA consequence followed by a behavior that
attempts to decrease that behavior
Positive Punishment: Presenting something bad following a behavior you want to decrease
Negative Punishment:Removing something goodfollowing a behavior you want to decrease
![Page 5: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/5.jpg)
WHO IS PMTO FOR?TARGET POPULATION:
Parents (caregivers) of children 2-18 years of age with disruptive behaviors:
• Conduct Disorder• Substance Abuse• Oppositional Defiant Disorder• School Failure• Anti Social Behaviors• Covert/overt anti-social behaviors• Neglected/maltreated children• Parents with anti social issues
• http://www.cebc4cw.org/program/the-oregon-model-parent-management-training-pmto/
![Page 6: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/6.jpg)
WHAT’S SO SPECIAL ABOUT PMTO?
Based on these theories, PMTO addresses two social contexts:
Negative reinforcement (within the family)- Family coercive behaviors overt antisocial behaviors. Not accepted by peers
Positive Reinforcement (from deviant peer
groups) Covert behaviors such as lying, stealing and truancy.
![Page 7: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/7.jpg)
PARENT MANAGEMENT TRAININGEMPOWERING PARENTS AS AGENTS OF
CHANGE FOR THEIR CHILDREN
Group ( Michigan: Parenting Through Change) 14 weeks, standard
Individual PMTO: 18-22 sessions (more flexible, customized)
Active (not pedantic) teaching
Role-play; home practice assignments
Based on simple routine tasks, then move on to limit setting behaviors
First sessions- Intro to Change:
Identify and build on family strengths and resources
Practitioner observation
Assessment of child’s functioning
Parent’s goals for change
•
![Page 8: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/8.jpg)
PMTO OVERVIEWFIVE CORE PARENTING SKILLS:
1) Skill Encouragement through positive reinforcement
Pro social behavior
2) Limit Setting
decrease deviant behavior 3) Monitoring &
Supervision to ensure behavior stays on track4) Family Problem Solving prevent conflict/manages stress 5) Positive Parent Involvement
![Page 9: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/9.jpg)
CHANGING OLD PARENTING HABITSParents- learn to identify positive parenting, use mild and consistent discipline and identify / avoid harsh discipline:
Avoid negative reinforcement- identify coercion- no “giving in” to child after initiating discipline.
No negative reciprocity- aversive response to child’s aversive behavior
No more inept discipline- anger, coercive discipline, irritability,indecisiveness, inconsistent discipline.
![Page 10: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/10.jpg)
![Page 11: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/11.jpg)
![Page 12: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/12.jpg)
ROLE PLAYTherapist with Mom, Dad (children are Carl and Liv)
![Page 13: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/13.jpg)
CASCADING EFFECTS of PMTONine Year Follow-up study (Patterson, Forgatch & DeGarmo, 2010)
Possible enduring effects of PMTO intervention that generalize through and beyond the family:
• Less deviant peer association
• Positive maternal adjustment: Improved parenting Increase in standard of living (education, income, occupation)
• These effects increased throughout 9-year follow up
Reduced deviant behavior = reduced maternal depression?
![Page 14: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/14.jpg)
History and Implementation of PMTO
• Created by Dr. Gerald Patterson (1960s) and his colleagues at Oregon Social Learning Center (OSLC)
• Implemented in:• Norway: First wide range implementation
(national), 1999
• Later (2001) Iceland, the Netherlands, Denmark
• Statewide programs in Michigan and Kansas• Some implementations in Utah• Military families in Minnesota• Prevention program in Mexico City
![Page 15: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/15.jpg)
PMTO: CULTURAL ADAPTATIONS
• Latino families-( Mexico City) Utah, Minnesota, Michigan)• Norway- Studies with Somali and Pakistani immigrant and refugee populations
Adaptations:• Translation of all materials• Cultural adaptations of PMTO
handbook • Use of trained bilingual • “link workers” from the population• Gender separation
Somali/Pakistani- no fathers
• Results show fidelity across cultures
![Page 16: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/16.jpg)
ENSURING FIDELITYFidelity of Implementation Rating System (FIMP)
Team of PMTO specialists – reliability checks
Database used by all PMTO sites
Used across all implementation sites
Certification – every three years
Trainees -narrow range of excellence
- more homogeneous as they
work toward certification
Monitored by ISII coaches
to be sure standard is sustained
Regular meetings in supervision
Fidelity should cross generations- linger to their children, etc.
“Competent adherence”
![Page 17: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/17.jpg)
LIMITATIONS and FUTURE RESEARCH
Managing fidelity in large-scale implementation
Better efficiency with older children
Need additional recruitment
strategies to reach ethnic minorities
Need more research with
ethnic minority families
(Pakistani/Somali- validity?)
Cascading Effects:
Why? Can we do more?
![Page 18: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/18.jpg)
PMTO in MICHIGAN2004 SED population only- referred to CMH
Training/certification is only for CMH agency employees (Free)
Funded through block grants 50,000.00 per region
In long run, saves money
2013: 35agencies with PMTO
practitioners in the state community mental health system
83 certified PMTO practitioners
97 currently in training and providing services to families on individual basis
![Page 19: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/19.jpg)
CERTIFICATION and TRAINING• Advancement to PMTO certification candidacy is based on ISII
and onsite mentor feedback• Free (must be CMH agency worker)• 12-18 months, workshops• Practice with real and simulated cases
with feedback- children age 4-12• Coaching- at least 12 sessions based on
video observation of therapy • Must achieve passing scores when
tested each session• Certification period- 3 years• Must renew certification through documentation of
cases, seminars,
observation and supervision
![Page 20: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/20.jpg)
FURTHER INFORMATION ON THE WEB:
• Implementation Sciences International, Inc. (ISII):http://www.isii.net
• Oregon Social Learning Center:http://www.oslc.org
• PMTO in MICHIGAN: https://michiganpmto.com
•Two day workshops- informational, for anyone (parents)•State seminar coaching day- End of March: Lansing, MI.•Five-day training sessions (February, January)
![Page 21: PMTO Presentation](https://reader030.vdocuments.us/reader030/viewer/2022032506/55ce8166bb61eb9a088b4798/html5/thumbnails/21.jpg)
ReferencesBjorknes, R., Kjobli, J., Manger T., & Jakobsen, R. (2012). Parent training among ethnic minorities: Parenting practices as mediators of change in child conduct problems. Family Relations, 61, 101-114,
Forgatch, M. S., Patterson, G. R., & Gewirtz, A. H. (2013). Looking forward: The promise of widespread implementation of parent training programs. Perspective on Psychological Science, 8(6), 682-694.
Kjobli, J., Hukkelberg, S., & Ogden, T. (2013). A randomized trial of group parent training: Reducing child conduct problems in read-world settings. Behaviour Research and Therapy, 51, 113-121.
Ogden T., Hagen, A. K., Askeland E., & Christensen, B. (2009). Implementing and evaluating evidence-based treatments of conduct problems in children and youth in Norway. Research on Social Work Practice, 19 (5), 582-591.
Patterson, G. R., Forgatch, M. S., & DeGarmo, D. S. (2010). Cascading effects following intervention. Development and Psychopathology, 22, 949-970.
Reed, A., Snyder, Staats, S., Forgatch, M. S., DeGarmo, D. S., Patterson, G. R., . . . Schmidt, N. (2013). Duration and mutual entrainment of changes in parenting practices engendered by behavioral parent training targeting recently separated mothers. Journal of Family Psychology, 27(3), 343-354.
Solholm, R., Kjobli, J., & Christiansen, T. (2013). Early initiative for children at risk: Development of a program for the prevention and treatment of behavior
problems in primary services. Prev Science, 14, 535-544.