Practitioner Guides Demonstration Site: Practice Guide Contents

Practice
Audience
Use
Objectives
Practice Audience Use Objectives
Activity Selection Child To introduce mood-elevating activities into the child’s day To emphasize the link between positive activities and feeling good
To note that doing more things with someone we like is a good way to enjoy activities
To explain that we can make ourselves busy so that we don’t have time to worry or feel bad
To discuss helping other people; it makes them and us feel good
Antecedent/Stimulus Control Family To identify and alter signs or events occurring before a behavior in order to increase or decrease that behavior To teach how signs or events occurring before a behavior can affect the behavior itself
To identify specific signs or events for behaviors targeted for change
To create a plan for modifying signs or events that lead to behaviors targeted for change
Attending Caregiver To improve the quality of the caregiver-child relationship To increase the amount of positive attention provided to the child, even if the child has misbehaved at other times during the day
To teach the caregiver to attend to positive behaviors
To promote the child’s sense of self-worth
Cognitive: Anxiety (STOP) Child To teach younger children how their thoughts can influence their anxiety, especially when such thoughts interfere with treatment To introduce the idea of thoughts and how they are related to anxiety
To modify anxious self-talk into coping self-talk
To provide the child with a 4-step plan to use when feeling anxious
Cognitive: Anxiety Child To address thoughts that maintain or intensify anxiety and avoidance To introduce the idea of thoughts and how they are related to anxiety
To introduce cognitive restructuring as a technique for correcting negative thinking
Cognitive: Depression Child To counter negative thoughts that interfere with mood or motivation To teach the youth that his/her thoughts and behaviors influence the way he/she feels
To identify types of negative thoughts and to develop the ability to generate positive, realistic alternative thoughts
To discourage rumination, which is repeatedly thinking about negative experiences
To encourage perspective change through seeking out social support
Commands or Effective Instructions Caregiver To increase child’s compliance with caregiver instructions To provide the caregiver with strategies to clearly and consistently communicate instructions to the child
To provide the caregiver with strategies to demonstrate to the child that caregiver will see the task through to its completion
To minimize discord between the child and caregiver regarding directives
Communication Skills: Advanced Family To help facilitate more positive caregiver-child communication To organize discussion of difficult topics using a “communication hierarchy”
To teach and practice communication skills to members of the family to improve positive relations among family members
Communication Skills: Early Development Caregiver To teach caregiver to help the child develop a repertoire of functional language To teach caregiver how to gradually shape and reinforce child’s receptive, expressive, and functional communication
To promote generalization of child’s communication skills
Engagement with Caregiver Caregiver To understand and address barriers to treatment to improve participation To begin to establish rapport with the caregiver
To elicit the caregiver’s perspective regarding the child’s main challenges and goals for improvement
To identify and reduce practical and psychological barriers to participation
To help the caregiver understand basic information about the treatment
Exposure Child To decrease anxiety associated with an object or situation To gather information on what kinds of situations make the child anxious and construct a list of feared items
To practice exposure to feared items or situations and allow habituation to occur
To repeat exposure practice exercises across trials until all ratings for feared items are reduced
Differential Reinforcement or Active Ignoring Caregiver To decrease minor disruptive behaviors and increase alternative, appropriate behaviors To teach caregiver to remove attention and rewards from minor disruptive behaviors
To teach caregiver to provide increased attention and rewards for appropriate behaviors
Maintenance Child To review the goals the child has accomplished throughout treatment and discuss ways to maintain gains To review primary concepts underlying treatment
To emphasize the child’s and caregiver(s)’s efforts in achieving progress
To plan for the future by brainstorming potential difficulties
Modeling Family To promote rapid acquisition of a new skill (e.g., approaching a feared object, having a conversation) To provide an opportunity for a caregiver to demonstrate the skill or to cue the child to use the skill in appropriate situations.
Monitoring Caregiver To illuminate areas of concern and provide important information about treatment progress To identify target behaviors to monitor
To develop a rating scale to increase the accuracy of observation
To create a recording procedure
Praise Caregiver To increase child’s appropriate behavior To inform the caregiver about the value of praise
To provide the caregiver with strategies to increase the child’s appropriate behavior
To encourage participation in treatment
Problem Solving Child To provide children with a systematic way to negotiate problems and to consider alternative solutions to situations To teach a method of problem solving that involves clearly defining the problem, generating possible solutions, examining the solutions, implementing a solution and evaluating its effectiveness
Child Psychoeducation: Anxiety Child To introduce a course of treatment for anxiety or phobias To educate the child about how anxiety works in order to build a rationale for activities to follow
To instill optimism about the child’s situation
To encourage participation in treatment
Child Psychoeducation: Depression Child To introduce a course of treatment for depression To discuss purpose and process of sessions; including practice assignments, regular attendance, and end-of-session caregiver briefings
To explore the child’s understanding of why he/she is in treatment and establish a framework of feeling better by learning there are things we can do to control our mood
To introduce the general concept that we can control our feelings by (a) how we act and/or (b) how we think
To discuss causes and “symptoms” of feeling good and bad for the child
Caregiver Psychoeducation: Anxiety Caregiver To introduce a caregiver course of treatment for child anxiety or phobias To educate the caregiver about how anxiety works in order to build a rationale for activities to follow
To instill optimism about the child’s situation
To encourage the caregiver’s participation in treatment
Caregiver Psychoeducation: Depression Caregiver To introduce a caregiver course of treatment for child depression To discuss purpose and process of sessions; including practice assignments, regular attendance, and end-of-session caregiver briefings
To explore the caregiver’s understanding of why the child is in treatment and establish a framework of feeling better by learning there are things we can do to control our mood
To introduce the general concept that we can control our feelings by (a) how we act and/or (b) how we think
To discuss causes and “symptoms” of feeling good and bad for the child
Caregiver Psychoeducation: Disruptive Behavior Caregiver To introduce a caregiver course of treatment for disruptive behavior problems To educate the caregiver about various factors (e.g., temperamental, developmental, physiological, genetic, psychological, etc.) that contribute to the development of disruptive behaviors and how these behaviors can be learned over time
To instill optimism in the caregiver about the child and family’s situation
To encourage participation in treatment
Relaxation Child To introduce relaxation training and its use in controlling tension To present the idea that staying calm and relaxing is a good way to affect the way we feel
To demonstrate what relaxation feels like to children who have difficulty relaxing
To increase a child’s awareness about his or her own tension so that relaxation skills can be applied at the proper time
To teach the child to relax on demand in certain situations (e.g., bedtime, before a test)
Response Cost Caregiver To decrease the likelihood of undesirable behavior in conjunction with rewards To provide the caregiver with a convenient, systematic, immediate, and powerful consequence for misbehavior
Rewards Caregiver To increase the likelihood of a desired behavior To provide the caregiver with a strategy designed to increase desired behavior
To teach the caregiver how to maximize the effectiveness of rewards
Self-Monitoring Child To illuminate areas of concern and provide important information about treatment progress To identify target behavior or emotion to monitor
To develop a rating scale to increase accuracy of the observations
To create a recording procedure
Skill Building Child To assist children in developing talents and skills they can feel good about To teach the child benefits of skill building
To identify a skill that the child wants to develop
To set a goal involving the talent or skill he/she wants to develop
To start practicing to master small steps needed until each goal is achieved
Social Skills Child To provide the youth with concrete skills to develop healthy relationships and navigate social situations To identify prosocial skills that build upon the youth’s current development
To teach verbal and nonverbal social behaviors and skills
To practice, refine, and utilize social skills in daily life
Time Out Caregiver To decrease the occurrence of undesirable behavior To provide the caregiver with a strategy designed to decrease serious or resistant misbehaviors
To provide the child and caregiver with a strategy that allows them time to cool off following misbehavior, so that the negative behavior does not escalate
Assertiveness Training Child To teach youth how to express needs or intentions appropriately To explain the different ways that people relate to one another
To teach youth how to use socially appropriate strategies to express feelings, stand up for themselves, and disagree with others
To assist youth in practicing situations in which assertive strategies would be appropriate
Goal Setting Family To assist the child and family with identifying and achieving desired outcomes To provide a rationale for using a goal setting framework
To identify goals that are important to the child and family
To establish a realistic, achievable progression of steps towards desired goals
To instill optimism about goal achievement
Relationship/Rapport Building Child To foster a positive and trusting therapist-client relationship To connect with the youth by learning more about him or her and his or her experiences and interests, or by engaging in enjoyable activities together
To convey to the youth through verbal and nonverbal means that you are a positive, trustworthy, and consistent source of support
Engagement with Child Child To facilitate the child’s active participation in therapy To develop the child’s power and efficacy with regard to treatment decisions and outcomes
To build strong collaborative relationships with the child and others in the child’s support network to support the child�s progress
To enhance the child’s understanding of therapy services and the roles of those involved
To reduce barriers to active participation in services
Behavior Alert Caregiver To decrease undesirable behaviors by setting up alerts that provide feedback following those behaviors To assist the child and caregivers in setting up behavior alerts to signal the occurrence of undesirable behaviors
To assist the child and caregivers in knowing how to respond to such alerts
To train the child to anticipate the alerts so he or she can abstain from engaging in the undesirable behavior before it starts
Retention Control Training Caregiver To increase the child’s capacity to delay urination To teach the caregiver steps to help the child practice resisting the urge to urinate
To assist the child in postponing urination for increasingly longer periods of time
Narrative: Trauma Child To promote coping and construct meaning regarding a traumatic event To understand the purpose of constructing a narrative about a memory of a traumatic event
To complete a narrative detailing the memory of a past traumatic event
To learn to manage and cope with anxious responses related to the memory of a traumatic event through repeated retelling of the narrative
To identify and challenge cognitions contributing to anxious responses related to the memory of the traumatic event
Support Networking Family To increase family access to resources and social supports To identify others who can provide resources and support to the family
To identify opportunities for others to support the family
Behavioral Contracting Family To facilitate a commitment to a particular course of action To establish an explicit agreement of terms regarding a specific therapeutic plan or behavioral goal
To assure clear and consistent communication concerning the plan
Personal Safety Skills Child To increase the child’s security and resilience in potentially harmful situations To help the child understand issues related to personal safety
To develop the child�s ability to assess risk to his or her personal safety
To develop strategies for maintaining personal safety
Caregiver-Directed Nutrition Family To assist caregivers in supporting the child’s ability to responsibly manage his or her nutrition and weight To support caregivers in temporarily managing the child’s nutritional intake and weight
To develop the child’s ability to responsibly monitor his or her nutrition and weight
Cognitive: Disruptive Behavior Child To identify and challenge thoughts that contribute to aggressive and oppositional behavior To help the child understand how thoughts influence behaviors
To help the child identify and challenge cognitive errors
To help the child evaluate alternative perspectives
Motivational Enhancement Child To increase reflection, efficacy, and commitment about behavior change To highlight the discrepancy between values and life goals and current behavior
To increase perceptions of self-efficacy
Performance Feedback Family To promote skill enhancement through comparison to an identified standard To select a skill and set standards for performance
To review information about the family’s performance relative to the standard
To identify activities and resources for subsequent practice to improve performance
To create a sense of safety, efficacy, and persistence in the face of adversity
Self-Verbalization Child To reduce impulsivity and increase self-regulation through self-talk To help the youth stay on task, work independently, and improve performance by means of self-instruction
To show the youth how task performance can be guided by verbal instructions
To teach the youth to reinforce or praise him or herself for on-task performance
Self-Praise/Self-Reward Child To increase self-efficacy, effort, and performance of desirable behaviors To identify opportunities to administer self-praise or self-reward
To help the youth reinforce him- or herself in order to complete a task and work independently
To show the youth how task performance can be improved by self-praise/self-reward
Natural and Logical Consequences Caregiver To assign appropriate consequences to youth misbehavior in order to teach responsibility and independence To foster youth’s decision making, sense of responsibility and ability to learn from mistakes
To create fair, age-appropriate consequences that are closely tied to the youth’s misbehavior
Functional Analysis Family To understand the relations among behavior, antecedents, and consequences To identify triggers or antecedent events that bring about a behavior
To identify consequences of the behavior that maintain it
to test ideas about the function of a behavior by altering antecedents and consequences
Crisis Management Child To support recovery from an emergency event or situation To identify the crisis event or situation that is impacting the youth’s immediate well-being
To reduce the impact of the crisis by managing safety, developing an intervention, coping with immediate stressors, and involving others for support
To establish a plan for the prevention and management of future crises, should they occur
Insight Building: Emotion Identification Child To promote reflection on a range of emotions in order to increase self-understanding To assist the youth with identifying and labeling his or her emotions
To guide the youth to identify the emotions of others
To promote the youth�s deeper understanding of emotions by becoming more aware of internal experiences and external contexts
Accessibility Promotion Family To find opportunities for services to be more accessible to the family before barriers emerge To consider which factors might influence the family’s ability to meet with you
To arrange services to maximize the likelihood for successful meetings with the family
Child Psychoeducation: Trauma Child To inform the youth about the nature of traumatic stress and its treatment To build understanding about the occurrence of trauma and common short- and long-term reactions
To introduce the idea that avoidance of trauma-related thoughts, feelings, or reminders may play a key role in maintaining or worsening problematic reactions
To describe the plan, rationale, and anticipated results of treatment
Discrete Trial Training Child To help the youth develop verbal and nonverbal skills through repeated learning trials To assess current skills and determine a set of tasks to build upon current skills
To facilitate learning of specific skills through repeated practice with feedback
To extend learning to multiple natural settings
Line of Sight Supervision Caregiver To manage and reduce dangerous or inappropriate behaviors To provide the caregiver with a strategy for enhancing youth safety and appropriate behavior
To help the caregiver or supervising adult plan for times when direct observation of the youth is indicated
Peer Pairing Child To promote social learning and skills practice among similar-aged peers To facilitate interactions with prosocial peers
To increase the frequency of positive peer interactions
To encourage practice of social skills with peers
Caregiver Psychoeducation: Trauma Caregiver To inform the caregiver about the nature of traumatic stress and how it may be treated To build the caregiver’s understanding about trauma and common short- and long-term reactions
To introduce the idea that avoidance of trauma-related thoughts, feelings, or reminders plays a key role in maintaining or worsening problematic reactions
To describe the plan, rationale, and anticipated impact of treatment
Guided Imagery Child To mentally rehearse successful performance in a challenging situation To generate mental images associated with specific feelings and behaviors
To facilitate mental rehearsal of effective behaviors and coping
To encourage visualization of positive outcomes
Caregiver Coping Caregiver To enhance the caregiver’s ability to deal with stressful situations To explain that our interpretation of demanding circumstances influences the stress we feel
To discuss two different types of coping
To develop a plan with specific strategies for effective coping
Educational Support Caregiver To enhance communication and functioning related to academic performance To provide the rationale for using strategies to support academic functioning
To identify specific opportunities to support academic functioning using different strategies
To develop a plan for implementing support strategies, including a timeline and the individuals responsible
Cognitive: Trauma Child To address thoughts that maintain or intensify trauma-related stress To help the youth understand how thoughts related to a trauma influence feelings and behavior
To help the youth identify unhelpful thoughts and beliefs associated with trauma
To help the youth generate alternative, helpful thoughts
Supportive Listening Child To demonstrate warmth, empathy, and positive regard To provide a comfortable, safe environment for the youth
To support the youth in talking about concerns
To help the youth feel heard and understood
Practice Audience Use Objectives