Parent Management Training-Oregon (PMTO) Model
The Parent Management Training Oregon (PMTO) model is a comprehensive approach recognizing parents' fundamental position as the primary change agents within their families. It places a significant emphasis on reinforcing the behavior management skills of caregivers, thereby improving daily social interaction methods and reinforcement patterns. This comprehensive model effectively addresses various social, emotional, and behavioral issues and tracks and monitors the child's behavior (Dishion et al., 2016).
Foundational Assumptions
Problems that warrant treatment for children and adolescents who use the PMTO program fall under three classifications: social, emotional, and behavioral problems; problem and at-risk behaviors; and delinquencies (Kazdin, 2005). Social, emotional, and behavioral problems incorporate dysfunction within the mental health domain and are correlated with the impairment and function that often serve as the foundation of treatment. Dysfunctions in this category are represented as psychiatric or mental disorders, behavioral patterns associated with distress, impairment, or significantly increased risk of suffering, death, pain, disability, or a substantial loss of freedom (Kazdin, 2005).
Interaction learning postulates that behavior is formed via strengthening possibilities provided during repetitive exchanges with key individuals within the environment. In the PMTO model, parents are recognized as the primary socializing instruments responsible for shaping their children's behavior. This approach can be a preventative intervention for at-risk families and families referred clinically for challenges related to conduct, abuse, neglect, or delinquency. The treatment is appropriate for systems with children from preschool through adolescence, and the flexible approach includes family and individual sessions offered in community agencies or the family's home. Although parents are the primary focus, children participate in family sessions and are relevant components.
Assessments
PMTO combines assessment and evaluation within the treatment, as the goal is to modify the child's behavior and improve their adaption and functionality. Once treatment goals are approached or achieved during treatment, new goals are identified. However, specific goals may not be achieved; therefore, modifications are necessary to aid in achieving the goal throughout treatment. Decision-making throughout treatment is needed; therefore, having valid information about progress is crucial.
There are four techniques to evaluate process progress during the treatment. This includes reviewing the program at the commencement of each treatment session, role-playing to assess the progress the caregiver has made and can successfully execute with the child within the session, weekly phone calls to assess progress within the program and conjoint contact sessions with the parent and child are seen in which they reenact exchanges they had at home (Kazdin, 2005).
Progression Through Therapy
Numerous delivery formats, such as individual family treatment, can be offered at the family’s home or in an agency setting, parent groups and agencies, community settings, and telehealth. Clinical cases usually have an average duration of 25 sessions, whereas parent groups and telehealth sessions vary from 6 to 14 sessions. Procedural calls take place weekly for check-in meetings during midweek to troubleshoot issues and a home practice assignment.
Interventions
Intervention with the parents to decrease forced parenting and increase positive parenting methods is the primary goal of PMTO. Forced parenting refers to the use of authoritarian or punitive parenting techniques that can lead to negative outcomes in children. PMTO aims to help parents transition from forced parenting to positive parenting, which involves using more supportive and less coercive strategies to manage their child's behavior. (Kazdin, 2005).
The conceptual view accentuates learning and encounters that can be supported to foster behavioral modification; therefore, the foundation of changing how the individual behaves in everyday life becomes paramount. This entails engaging parents and children in the home and other settings and environments where behavior is essential.
There is a relationship between behavior and events that precede or follow his behaviors; therefore, positive reinforcement is utilized, providing positive praise for the child. Parents then develop specific skills through active training, achieved via role-play, feedback, and modeling by the therapist. These tools assist parents in interacting appropriately with their child, changing the child's behavior, and implementing techniques introduced throughout the treatment. In skill development with parents, the therapists use many methods, such as positive reinforcement, shaping, and using antecedents.
Termination
Prior to termination, a skill review preparation to terminate services is completed. A review of information, including theory and practice from prior treatment sessions, is conducted. Particular importance is considered based on the application of role-playing individual components, which are enacted with the clinician and the parent during the practice of creating novel plans, revising aligning programs, and responding to a complex array of situations in which the principles and practice utilized in prior situations have been studied and implemented.
Parents operate as a fundamental catalyst of change in PMTO; therefore, a clinician directs their energies toward parents instead of directly working with the youth. The clinician's role is to guide and support parents in understanding and implementing the PMTO strategies. It is critical to be aware that the children are included in sessions and are significant. The program highlights the prevention and reduction of outcomes correlated to the youth’s externalized and internalized behavior challenges and includes social, academic, and conduct difficulties, delinquency, and depression (Dishion et al., 2016).
References
Dishion, T., Forgatch, M., Chamberlain, P., & Pelham, W. E. (2016). The Oregon Model of Behavior Family Therapy: From intervention design to promoting large-scale system change. Behavior Therapy, 47(6), 812–837. https://doi.org/10.1016/j.beth.2016.02.002
Forgatch, M. S., & Kjøbli, J. (2016). Parent Management Training-Oregon Model: Adapting intervention with rigorous research. Family Process, 55(3), 500–513. https://doi.org/10.1111/famp.12224
Kazdin, A. E. (2005). Parent Management Training: Treatment for Oppositional, Aggressive, and Antisocial Behavior in Children and Adolescents. Oxford University Press. https://eds-p-ebscohost-com.acu.idm.oclc.org/eds/ebookviewer/ebook/ZTAwMHhuYV9fMTM4MTcwX19BTg2?sid=1d8bf44e-3a03-41df-9e31-6ae7ecb455e3@redis&vid=5&format=EB&rid=7