父母管理训练

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}} 父母管理训练（英文：Parent Training in Behavior Therapy 、Behavior Management Training for Parents, Parent Behavior Therapy、 Behavioral Parent Training、或 Parent Training）是行为治疗的一部份。父母管理训练是系列性的治疗方案，教授家长正向增强的一些方法，来改善学龄前儿童及学龄儿童的行为情形（如过动、易怒（英语：Tantrum）、难以遵照指令等）<ref name=Maliken2013>Maliken AC, Katz LF. Exploring the impact of parental psychopathology and emotion regulation on evidence-based parenting interventions: a transdiagnostic approach to improving treatment effectiveness. Clin Child Fam Psychol Rev. June 2013, 16 (2): 173–86. PMID 23595362. doi:10.1007/s10567-013-0132-4. </ref>。

父母管理训练是1960年代由儿童心理学家所提出的，其作法是透过介入、改变父母的行为来改变儿童的破坏性行为<ref name=Forehand2013>Forehand R, Jones DJ, Parent J. Behavioral parenting interventions for child disruptive behaviors and anxiety: what's different and what's the same. Clin Psychol Rev. February 2013, 33 (1): 133–45. PMC 3534895 可免费查阅. PMID 23178234. doi:10.1016/j.cpr.2012.10.010. </ref>。此训练是受到操作制约及应用行为分析等原理的启发，一般会维持几个月，主要是让父母学习如何针对儿童适当的行为提供正向的强化（例如赞美及奖励），并且针对不适当的行为，利用一些方式（如转移注意力等）设定适当的限制。

父母管理训练是在用于处理破坏性行为（特别是对立性反抗疾患及品行障碍）的方法中，最多被探讨的方法之一<ref name=Maliken2013>Maliken AC, Katz LF. Exploring the impact of parental psychopathology and emotion regulation on evidence-based parenting interventions: a transdiagnostic approach to improving treatment effectiveness. Clin Child Fam Psychol Rev. June 2013, 16 (2): 173–86. PMID 23595362. doi:10.1007/s10567-013-0132-4. </ref><ref name=Menting2013>Menting AT, Orobio de Castro B, Matthys W. Effectiveness of the Incredible Years parent training to modify disruptive and prosocial child behavior: a meta-analytic review. Clin Psychol Rev. December 2013, 33 (8): 901–13. PMID 23994367. doi:10.1016/j.cpr.2013.07.006. </ref><ref name=Michelson2013>Michelson D, Davenport C, Dretzke J, Barlow J, Day C. Do evidence-based interventions work when tested in the "real world?" A systematic review and meta-analysis of parent management training for the treatment of child disruptive behavior. Clin Child Fam Psychol Rev. March 2013, 16 (1): 18–34. PMID 23420407. doi:10.1007/s10567-013-0128-0. </ref>，可以有效的减少儿童的破坏性行为<ref name=Michelson2013>Michelson D, Davenport C, Dretzke J, Barlow J, Day C. Do evidence-based interventions work when tested in the "real world?" A systematic review and meta-analysis of parent management training for the treatment of child disruptive behavior. Clin Child Fam Psychol Rev. March 2013, 16 (1): 18–34. PMID 23420407. doi:10.1007/s10567-013-0128-0. </ref>，并且提升父母的心理健康<ref name=Furlong2013>Furlong M, McGilloway S, Bywater T, Hutchings J, Smith SM, Donnelly M. Cochrane review: behavioural and cognitive-behavioural group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years (Review). Evid Based Child Health. March 2013, 8 (2): 318–692. PMID 23877886. doi:10.1002/ebch.1905. </ref>，也有一些研究是探讨用父母管理训练来治疗有其他障碍的儿童。有关父母管理训练研究的限制包括缺乏对于改变机制的相关知识<ref name=Kazdin2010>Kazdin AE (2010). Problem-solving skills training and parent management training for oppositional defiant disorder and conduct disorder. Evidence-based psychotherapies for children and adolescents (2nd ed.), 211–226. New York: Guilford Press.</ref>，以及还没有长期治疗结果的研究<ref name=Furlong2013/>。若父母无法全力参与管理训练（可能因为个人精神及认知因素、父母高度冲突，或是无法参与每周的课程），要进行父母管理训练会有困难<ref name=Pfiffner2014>Pfiffner LJ, Haack LM. Behavior management for school-aged children with ADHD. Child Adolesc Psychiatr Clin N Am. October 2014, 23 (4): 731–46. PMID 25220083. doi:10.1016/j.chc.2014.05.014. </ref>。

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低品质的管教、不适当的监管、双重标准、父母本身的心理状态、压力、物质滥用都将间接导致早发性的行为问题，让整个社会蒙受不少损失。<ref name=Furlong2013_2> Furlong M, McGilloway S, Bywater T, Hutchings J, Smith SM, Donnelly M. Cochrane review: behavioural and cognitive-behavioural group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years (Review). Evid Based Child Health. March 2013, 8 (2): 318–692. PMID 23877886. doi:10.1002/ebch.1905. </ref> “父母亲负面的教养方式”和“孩子负面的言行”彼此之间常构成一个“高压胁迫的循环”（coercive cycle）。“高压胁迫的循环”起始于循环中的其中一人（甲方）开始用负面的言行来控制另一个人（乙方）的言行举止；乙方也用负面的言行回敬甲方。于是甲乙之间如此的负向交击便不断的恶化直到甲乙其中一方认输为止。<ref name=PMTO> Forgatch MS, Patterson GR. Parent management training — Oregon model: An intervention for antisocial behavior in children and adolescents. Evidence-based psychotherapies for children and adolescents (2nd ed.), 2. New York: Guilford Press. 2010: 159–78. </ref>{{#if: |{{ safesubst:#ifeq:| 

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}} 举例来说：倘若一个孩子试图借由闹脾气来逃避一件事，而孩子的父母亲用吼叫的方式，要求小孩必须要做；此时孩子便以更倔强的脾气来做回应，于是孩子的父母亲便可能向孩子屈服，以避免亲子冲突进一步扩大。孩子哭闹的行为可能因此而被强化了，因为孩子发现闹脾气是一个能有效避免做那件事的方法。（这并非告诉父母要吵赢孩子）
父母管教训练的宗旨即是教授父母亲如何强化孩子好的行为，并避免在不知不觉中强化了孩子负面的行径。<ref name=Maliken2013/>

父母管教训练的训练内容以及训练内容中各项教学课程的排序会因为不同的教学方案而有所不同。然而在绝大多数的父母管教训练课程中，父母亲会学习如何定义及记录下对于孩子言行举止（涵盖正面及负面的言行）的观察。这将是父母与治疗师用来共同制定具体的改善目标、疗程目标的重要参考依据，而且还能当成孩子成长的进度表。<ref name=Kazdin2010/>{{#if: |{{ safesubst:#ifeq:| 

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父母管教训练的主旋律就是教导如何正向的强化孩子适当的行为。 总体来说，父母将学到透过交际回馈（Social rewards）（例如：称赞、笑容、拥抱等）方式及具体报酬（concrete rewards）（例如：给予贴纸或点数并和孩子约好集满一定的点数或贴纸就可以得到另一个更大的回馈）来酬赏孩子适当的言行。<ref name=Kazdin2010/>{{#if: |{{ safesubst:#ifeq:| 

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父母管教训练也教受父母亲如何适当地以结构化技巧来为孩子的负面行为设限。 父母将学习到用不同的方法来应对孩子正面或负面的行为。这种差异性应对称为“差异性强化”（differential reinforcement）。 当孩子的行为稍微扰人但不危险的时候，父母将练习去忽略孩子的此种行为。 治疗师会跟父母介绍当孩子不好的行为出现时，如何使用[[:{{#if:暂时隔离法|暂时隔离法|time-out (parenting)}}|{{#if:暂时隔离法|暂时隔离法|time-out (parenting)}}]]（英语：-{time-out (parenting)）。 父母将孩子暂时从犯错的地方隔离，让孩子暂时离开那个他想待著的环境。<ref name=Barkley>Barkley RA (2013). Defiant children: A clinician's manual for assessment and parent training. New York: Guilford Press.</ref>{{#if: |{{ safesubst:#ifeq:| 

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}} 父母也会学习利用循环且固定的方式（systematic way）暂时剥夺孩子的权利（例如：孩子看电视、孩子玩耍），以应对孩子不恰当的行为（unwanted behavior）。 所有的处罚都一样，必须在孩子犯错时，立即实行且保持一致性。必须注意的是，夫母在整个过程中需要保持平和，且要对孩子的好行为给予赞扬，以确保赏罚平衡。 标签<ref name=PMTO/>{{#if: |{{ safesubst:#ifeq:| 

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除了正向强化/激励和局限在家庭中的情境设定，许多父母管教训练的疗程也融入了孩子在学校情境中的行为追纵且把它连结到在家中的行为奖励制度，并与学校老师合作实行之。 <ref name=Kazdin2010/>{{#if: |{{ safesubst:#ifeq:| 

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父母管教训练大都由治疗师（心理师或社工师）授予一个时段一个家庭或一个时段很多个家庭。父母是父母管教训练的主角。然而孩子可以在父母和治疗师觉得合适的时候共同参与。 <ref name=PMTO/>{{#if: |Template:Page needed |{{#if: 

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}} 一般来说，整个训练课程包含12堂核心训练课程（每周一堂）；然而不同的方案（programs）会有不同的核心训练课程堂数。<ref name=Kazdin2010>Kazdin AE (2010). Problem-solving skills training and parent management training for oppositional defiant disorder and conduct disorder. Evidence-based psychotherapies for children and adolescents (2nd ed.), 211–226. New York: Guilford Press.</ref>Template:Rp<ref name=Furlong2013/>

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参考资料[编辑 | 编辑源代码]

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Template:婴儿及护理 Template:教养

取自“https://positive.wiki/index.php?title=父母管理訓練&oldid=260”