Caregiver Interventions

Brighthouse offers multiple family-based therapies that focus on skill-building, preventative measures, and helping to build healthy family relationships, including parent-child and sibling interactions. Strategies include psychoeducation, caregiver coaching, play-based interventions, and traditional family therapy.

Parent-Child Interaction Therapy (PCIT)

PCIT is a short-term evidence-based intervention that addresses challenging behaviors in children between the ages of 2 and 6 years, 11 months.  PCIT teaches specific parenting skills by incorporating caregiver coaching with live, interactive feedback. Together, these components effectively promote a positive caregiver-child attachment and reduce oppositional and defiant conduct.

Due to the parent training features of PCIT, it is an ideal intervention to implement via telehealth (i.e. I-PCIT). When conducted over telehealth, the benefits and successes of I-PCIT are equal to what can be achieved with in-person sessions.

WE ARE NOT ACCEPTING NEW PCIT CLIENTS AT THIS TIME

Theoretical Framework of PCIT

PCIT is based on extensive research derived from well-established child development models. These include Attachment Theory, Baumrind’s Parenting Styles, Behavior Modification, Social Learning Theory, and Patterson’s Coercive Cycle. PCIT is now considered one of the most prominent evidence-based practices and empirically supported treatments worldwide for young children with disruptive behaviors. 

Elements of PCIT

PCIT sessions incorporate a two-phased model. During the Child-Directed Interaction (CDI) phase, caregivers learn specific skills that they will incorporate during play interactions. A skilled therapist will provide live in-session coaching with the use of an earpiece devise so as to support caregivers in fostering a warm, positive, and secure relationship with their child.  The second phase of treatment, called Parent-Directed Interaction (PDI), focuses on teaching caregivers specific strategies for managing their child’s most challenging behaviors by supporting their ability to be present, nurturing, and encouraging, as well as consistent, predictable, and capable of following-through when necessary.

Families enrolled in PCIT should commit to 12-20 weekly sessions that can be held in person and/or via telehealth.  Daily homework assignments (between 5-15 minutes) will also be assigned to help promote skill development and generalization. A PCIT therapist is with you every step of the way, helping families feel supported, confident in their parenting skills, and less stressed about managing their child’s maladaptive behaviors. 

Areas of Concern

Children who display any of the following challenges will benefit from PCIT:

  • Parent-child relational difficulties

  • Trouble with listening and following directions

  • Temper tantrums, low frustration tolerance, and emotional dysregulation

  • Negative attention-seeking behaviors

  • Physical aggression with others and destruction of property

  • Challenges with self-regulation

  • Problematic social skills (e.g. struggles with sharing, taking turns, and playing with others)

  • Low self-esteem 

Supportive Parenting for Anxious Childhood Emotions (SPACE)

SPACE stands for Supportive Parenting for Anxious Childhood Emotions and is an evidence-based caregiver treatment program that addresses symptoms of anxiety, obsessive-compulsive disorder, and related challenges in children and adolescents. Although the child is considered the identified patient, sessions are focused on changing the caregivers’ mannerisms by increasing their use of supportive statements and decreasing their accommodating behaviors.  Parents are guided to identify their own behavior patterns that inadvertently maintain and exacerbate childhood anxiety. SPACE aims to help children learn to overcome and cope with their anxious feelings to ultimately improve their overall functioning. 

Theoretical Framework of SPACE

SPACE emphasizes the concept of family accommodation and the cycle through which these behaviors maintain the symptoms of a child’s difficulties.  By providing accommodations, the child immediately experiences a brief reduction in their symptoms, such as anxiety or stress.  However, the child will continue to rely on their parents to provide that specific accommodation, which consequently upholds their symptoms.   

Elements of SPACE

SPACE is a short-term intervention that involves a combination of psychoeducation and skill development.  It typically runs weekly for a total of 12 sessions and is suitable for families with children between the ages of 3 and 18. Caregivers are asked to participate in collaborative sessions with the clinician, and then implement strategies at home with their children.

Areas of Concern 

Children who display any of the following challenges will benefit from SPACE:

  • Separation Anxiety

  • Social Anxiety

  • Generalized Anxiety

  • Fears and Phobias

  • Panic Disorder and Agoraphobia

  • Selective Mutism

  • Obsessive-Compulsive Disorder

Collaborative & Proactive Solutions (CPS)

CPS is an empirically supported, evidence-based treatment model that emphasizes the ways in which concerning behaviors are more often than not the result of placing expectations on children and adolescents that do not appropriately match their capacity to adaptively respond. Concerning behaviors may include crying, screaming, kicking, and hitting, as well as struggling to follow routines at home, trouble independently completing homework, and difficulties meeting demands at school. By identifying the skills that children are lacking and clarifying the expectations that they are struggling to meet (i.e. unsolved problems), caregivers and children become better equipped to work together and mutually agree upon solutions.

Theoretical Framework of CPS

CPS is a part of the “third wave” of Cognitive Behavioral Therapy (CBT). It also includes features of social learning theory, neuropsychology, and transactional models of development.

Elements of CPS

CPS is a non-punitive, non-confrontational, trauma-responsive model that encourages cooperation when solving problems and addressing difficult behaviors. It is a manualized intervention with 12 total sessions. CPS is appropriate for families with children from 4 to 18 years age. During the first few sessions, caregivers meet with the clinician to thoroughly identify lagging skills and discuss the unsolved problems. Afterwards, caregivers and children will meet with the clinician and work together to discuss possible solutions to the recognized unsolved problems.

Areas of Concern 

Children who display any of the following challenges will benefit from CPS:

  • “Oppositional” and “defiant” behaviors

  • Parent-child relational difficulties

  • Trouble with listening and following directions

  • Problems with meeting home and school demands (e.x. not cleaning room, not doing homework, or not focusing on class assignments)