Caregivers

Center for Superheroes

The following time frames are HIGHLY dependent on the following:

Caregivers MUST be involved at EVERY session. NO treatment at Center for Superheroes can be conducted without the caregiver. Caregiver is defined as the safest, most stable adult that the child spends the most chronological time with (e.g., biological parent, foster parent, school teacher, residential treatment staff, etc.). Per dismantling studies in the psychological literature, caregiver involvement in treatment is a critical component for therapeutic change in ANY child treatment.

  • A corollary to #1 is that if the caregiver is changed (e.g., placement disruption by child welfare), or a similar major transition, then the treatment starts over at session 1. For instance, if a therapist was on session #10 of PCIT and the placement was disrupted (with a new caregiver attending at next session), next session would be PCIT Session #1, NOT #11.

Treatment is also dependent on caregivers completing homework assignments outside of session as evidence based treatments are skill driven (i.e., a caregiver cannot only complete a certain number of sessions, they must also demonstrate competency of therapeutic skills). Lack of completion always affects treatment outcomes and treatment may need to be paused if caregiver is not compliant. For instance, PCIT uses the Dyadic Parent Child Interaction Coding System (DPICS) to assess parental use of skills. If the caregiver is not practicing the skills outside of session this will show up on the DPICS behavioral coding system and low scores will continue until the caregiver completes the homework consistently with the child.

  • A corollary to #2 is that we often can treat multiple children with focusing on only one parent-child dyad. For instance, if a foster family has 4 young children, we can work with the most problematic child and the parent using the PCIT model, as it has shown in the literature to GENERALIZE treatment outcomes to other children who live in the home. In other words, the other 3 children may never have to come in and will still get better as long as the parent does the homework and comes to therapy.

If a child is coming in for multiple problems, treatments will be conducted SEQUENTIALLY, NOT SIMULTANEOUSLY. For instance, TF-CBT first, then PSB-A.