Parent-Child Interaction Therapy
Abstract
Zusammenfassung. Parent-Child Interaction Therapy (PCIT) ist eine speziell für 2- bis 6-jährige Kinder mit Störungen des Sozialverhaltens entwickelte manualisierte Therapieform, für deren Wirksamkeit eine sehr gute Evidenz besteht. PCIT ist außerdem eine evidenzbasierte Intervention bei körperlicher Kindesmisshandlung. Darüber hinaus konnten für PCIT bei Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung, Autismus-Spektrum-Störungen, Trennungsangststörungen und depressiven Störungen positive Effekte nachgewiesen werden. Es könnte sich somit zukünftig zum ersten evidenzbasierten transdiagnostischen Therapieansatz für 2- bis 6-jährige Kinder entwickeln. PCIT basiert auf der Bindungstheorie und der Lerntheorie und verbindet spieltherapeutische und verhaltenstherapeutische Ansätze miteinander. Es besteht aus zwei Behandlungsphasen: dem Spieltraining und dem Erziehungstraining. In beiden Phasen werden den Eltern Fertigkeiten vermittelt, die sie unter Live-Anleitung durch den Therapeuten in der Interaktion mit dem Kind einüben. Das Spieltraining dient dem Aufbau bzw. der Konsolidierung einer guten Eltern-Kind-Beziehung und bildet die Basis für das spätere Erziehungstraining. Im Spieltraining lernen die Eltern, dem Kind bei angemessenem Verhalten die Führung zu überlassen. Im Erziehungstraining üben sie hingegen, effektiv die Führung zu übernehmen, wo dies notwendig ist. Die Therapie, die im Mittel etwa 15 bis 20 Sitzungen dauert, kann beendet werden, wenn die Eltern die erlernten Fertigkeiten beherrschen, expansives kindliches Verhalten auf ein eindeutig normales Niveau reduziert ist und die Eltern keinen Bedarf mehr für eine Behandlung sehen.
Abstract. Parent-child interaction therapy (PCIT), a manualized evidence-based intervention, was originally developed to treat disruptive behavior problems in children aged 2–6 years. It is also considered to be an evidence-based intervention for physical abuse among children. Moreover, PCIT has proved to be effective for attention deficit hyperactivity disorder, autism spectrum disorder, separation anxiety disorder, and depression. Thus, it could become the first evidence-based, transdiagnostic intervention method for 2–6-year-old children. PCIT is based on attachment theory as well as learning theory, combining aspects of play therapy and behavior therapy. It consists of two treatment phases: child-directed interaction (CDI) and parent-directed interaction (PDI). In both phases parents are taught special skills. When interacting with their child parents practice these skills and are live coached by the therapist. CDI aims at improving the parent-child relationship and is the basis for PDI. In CDI, parents learn to follow their child’s lead as long as the child shows appropriate behavior. In PDI, parents practice effectively taking the lead wherever necessary. On average, it takes about 15–20 sessions to complete PCIT, which can be terminated as soon as the parents demonstrate a mastery of the skills, when child disruptive behavior has been reduced to clearly normal levels, and when the parents have become confident in managing child behavior on their own.
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