Parent Management Training – Oregon Model (PMTO™) An Evidence-Based Practice Developed in Our Community Presented at ORI’s 8 th Annual Research to Practice Conference, Supporting Families Through Evidence-Based Approaches: Meeting Diverse Levels of Need, Eugene, OR (December 3, 2010). Mark Eddy Laura Rains
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Parent Management Training – Oregon Model (PMTO™)
An Evidence-Based Practice Developed in Our Community
Presented at ORI’s 8th Annual Research to Practice Conference, Supporting Families Through Evidence-Based Approaches: Meeting Diverse Levels of Need, Eugene, OR (December 3, 2010).
Mark EddyLaura Rains
Focus For Today
1. How This All Came About2. Implementation History3. Active Teaching4. Summary5. Conversation
Eugene-Springfield Non-Profits
Oregon Social Learning Center
Implementation Sciences International, Inc.
A Typical Case
• 8 year old • Having trouble at home• Having trouble at school • Parent feels has tried everything• Don’t know what to do
Eugene-Springfield, 1950s
• Child Guidance Clinic• Child Study Center• Play therapy
– Child focused– Wasn’t working for typical case– Needed new model
Jerry Patterson, 1960s
• When things aren’t working, go back to the drawing board
• Basic research– Conclusion that problem not just inside the
child, but that what is going on around the child matters
– What parents, teachers, and other adults do can change what a child does
• Teaching is active!• Learning is kinesthetic• Engages family in the change process• Decreases time spent in “talk”• Parents practice skill before using at home
with children
Active Teaching: The 3-D Approach
• Demonstrate: Model appropriate and sufficient information. Engage family quickly and effectively with RP. Be theatrical.
• Differentiate: Help parents specify characteristics that differentiate effective and less effective action.
• Debrief: Punctuate and frame effective actions. Guide parents to recognize and reinforce their own and each other’s successes.
PMTO Role Play: 3-Step DanceRP Setup• Models/demonstrates • Draws family in quickly and effectively • Provides direction (who is to do exactly what)
RP Practice• Guides (exactly how)• Uses theatrical strategies• Breaks role play into small steps
RP Debrief• Punctuates, reinforces, supports, encourages • Weaves in instructional material• Differentiates effective and less effective action
Spotlight: Wrong Way / Right Way RP
• Wrong way demonstration normalizes the parenting experience, increases session comfort and introduces humor into the situation
• Dramatic wrong way RP ushers in surprise and insight
• Wrong way/right way RPs are used to compare and contrast
• Emphasis is spent on practicing the right way
Let’s
try
it
out!
Let’s try it out!Role Play #1: Practice as parent
Practice 2 wrong way, 2 right way directionsRoles: Parent, Child
“Put your shoes in the closet now, please.”•“Use an inside voice now, please.”•“Put your toys away in the toy box now, please.”•(Name), do (________) now, please.”
Let’s try it out!Role Play #2: Practice as therapist
Practice demonstrating “wrong way/right way” directions and debriefing role plays
Roles: Therapist, Parent
1. Model wrong way directions2. Debrief3. Engage parent in building better direction4. Model right way direction5. Debrief
PMTO at a Glance
1.Core belief: Parents are their children’s best teachers
2.Strength-based: Strengthening skills via coaching
3. Implementation strategy: Teach therapists to teach parents to teach children
4.Teaching: Engaging, active, fun!
5.Based on 40 years of research and practice*
* Forgatch, M.S., & Patterson, G.R. (2010)
Shine the light on what you want to grow!
Sigmarsdóttir, Rains, Knutson, & Forgatch, 2009
Fidelity of Implementation Rating System (FIMP)
• Rating system that evaluates competent adherence to PMTO.
• Based on direct observation of therapy.
• Video recordings uploaded to portal.
• Used to certify PMTO therapists, coaches, group leaders
Knutson, Forgatch, Rains, & Sigmarsdóttir, 2009
Knowledge: Proficiency in understanding theoretical model, core and supporting principles and practices, details and proceduresStructure: Session management, leads without dominating, responsive, sensitive pacing/timing Teaching: Promotes mastery, elicits goal behavior, teaching is active (e.g., role play) and engagingProcess: Proficient clinical & strategic skills, safe learning context Overall: Promotes growth, satisfaction, likely return, adjusts for context, difficulty Sessions scored: Encouragement and Limit Setting (intro & troubleshooting)
Fidelity of Implementation Rating System (FIMP): The manual for PMTO™