Training Opportunities

Working Model of the Child Interview
The Working Model of the Child Interview (WMCI), created by Charley Zeanah and colleagues over 15 years ago, is a semi-structured interview that is designed to assess caregivers’ internal representations, or working models, of their relationship with a particular child. The WMCI has been used for clinical and research purposes in this and other countries. It is most often used with high risk samples, but it has proven widely applicable from low risk to clinical populations. Participants will learn:

  1. Administration of the WMCI for clinical or research purposes
  2. The formal WMCI coding system, including rating scales and classifications

The Working Model of the Child Interview:

  • A systematic assessment of a parent’s perception of his/her child and the relationship with the child.
  • Focuses on the parent’s subjective experiences from the time of pregnancy to current interactions.
  • Takes approximately one hour to administer.
  • May be videotaped for later review and clinical use with the parent/caregiver.
  • Formal coding system comprised of eight scales, each anchored on a 5 point continuum.
  • Overall interview is assigned to one of three classifications of representations: balanced, disengaged, or distorted.
  • Reliability is demonstrated when participants are 80% reliable with experienced coders on a set of 30 WMCI Reliability Test Tapes. (Tapes may be purchased after completing the training.)

Tuition per participant: $1500 USD. For questions, please call 504-988-7829 or email Linzi at lconners@tulane.edu.

Training for the Preschool PTSD Treatment (PPT) Manual
This is a two day training for clinicians wishing to use the Preschool PTSD Treatment (PPT) manual. This 12-session manualized protocol uses a strategic combination of cognitive-behavioral treatment (CBT) and parent-child relational treatment suited for the developmental needs of very young children. There has been a gap in the field for a manual-driven psychotherapy for traumatized young children. This is the first manual developed specifically for the symptoms that follow from a variety of traumatic events in the preschool period. The lead author of the manual was Michael Scheeringa, M.D., Tulane University Health Sciences Center, and was co-authored with Judith Cohen, M.D., Allegheny General Hospital, Department of Psychiatry, and Lisa Amaya-Jackson, M.D., Duke University Medical Center. The principles of CBT and parent-child relational treatment will be briefly overviewed. The CBT techniques are developmentally adapted for younger children with limited cognitive and verbal skills. The parents are involved in all sessions. Parents are taught the CBT techniques so that they can facilitate the generalizations of the treatment to home. The parents are also directly addressed for their own problems with coping and how this might impact the parent-child relationship. Clinicians will learn from this training how to implement the CBT techniques and how to assess and intervene in salient parent-child relational dynamics. They will also learn the systematic use of weekly checklists to ensure therapist integrity, child compliance, parent compliance, parental reluctance, and parental acceptance of the treatment. The training is conducted by Michael Scheeringa, M.D at your home site. The fee is $2,500 per group (maximum participants – 15) plus travel expenses. The fee includes the cost of reproducing the manual and training materials for all of the participants.
Disturbances of Attachment Interview (DAI)
The DAI is a semi-structured interview designed to explore the presence of signs of disturbed or disordered attachment. Information is gathered from a parent or caregiver who knows the child well. The DAI consists of twelve anchored items. The first five items are used to obtain ratings of behaviors relevant to Reactive Attachment Disorder (RAD) inhibited/emotionally withdrawn type. The next three items explore signs of RAD disinhibited type. The final four items query the caregiver regarding distortions of secure base behavior such as self-endangering behaviors, hypervigilance, and role-reversal. The workshop participant will:

  1. Gain an understanding of attachment and attachment disorders
  2. Learn to administer the DAI
  3. Learn to score and interpret the DAI
  4. Have an opportunity to administer the measure and receive feedback

Tuition per participant: $850 USD. For questions, please call 504-988-7829 or email Linzi at lconners@tulane.edu.

The Nursing Child Assessment Satellite Training Program (NCAST)
The Nursing Child Assessment Satellite Training Program (NCAST) developed and published two scales, the Feeding and Teaching Scales, designed to assess parent-child behavior. The scales provide conceptually parallel views of the same caregiver/infant pair, and allow for generality of observations across settings. The existence of two scales gives the health care professional flexibility in choosing the setting that is most suitable to a given pair. One principle that guided the development of the NCAST Scales is that relatively brief observations of caregiver-child interaction can provide a valid sample of the dyad’s ongoing experiences and expectations. Observations of teaching and feeding situations allow glimpses of somewhat different samples of interaction. The feeding situation is familiar and makes few new demands on the dyad. The teaching interaction assessed by the scale is quite brief but more novel, and thus places some stress on the caregiver-infant pair. This potential for stress allows for a measure of adaptive functioning outside of well-versed routines. Both the Feeding and Teaching Scales are made up of 76 binary items organized into six subscales, four of which describe the caregiver’s behavior and two of which describe the child’s. The subscales are: I. Caregiver’s Sensitivity to Cues, which measures the caregiver’s ability to recognize and respond to the child’s signals, both subtle and powerful, II. Caregiver’s Response to the Child’s Distress, which measures the caregiver’s ability to soothe or quiet a distressed infant, III. Caregiver’s Social-Emotional Growth Fostering, which measures the affective domain and communicates a positive feeling, IV. Caregiver’s Cognitive Growth Fostering, which measures the type of learning experiences the caregiver makes available to the child, V. Child’s Clarity of Cues, which measures the infant’s ability to send clear cues to the caregiver, and VI. Child’s Responsiveness to Caregiver, which measures the infant’s ability to respond to the caregiver’s attempts to communicate and interact. Scores are derived for each subscale, and a total score is computed. Actual scores are compared to possible scores, and interpretive guidelines exist by which one can compare a particular dyad to that of a normative group. The goal of the NCAST system is to identify areas of concern at a point before problems develop and when intervention can be most effective. Use of the Feeding Scale is applicable for children from birth – 12 months of age. The Teaching Scale can be used with children up to 36 months of age. In order to use the Teaching and Feeding Scales, one must be a Certified Learner, which requires being trained by a qualified NCAST Instructor and attaining reliability using the Scales. Once certification is obtained, your name is entered in the NCAST International registry and you are sent a certificate as a reliable user of the Scales.
Keys to Caregiving
In the last 25 years, we have learned how to read the language of the baby. Knowledge about an infant’s states, response patterns, and non-verbal language gives us a more informed basis for relating with the infant. Keys to Caregiving is a series designed to insure that all new parents and caregivers have the knowledge we now have about the newborn infant. An understanding of the infant’s behavioral repertoire will give the caregiver an advantage. Research has demonstrated that parents who have appropriate expectations of their infant develop richer and more positive interactions and provide enhanced environments. This enhanced caregiving environment is associated with better developmental outcomes for the child, including both cognitive and language skills. Thus, it is a goal that all parents and caregivers of young babies will have awareness of the keys to caregiving. These keys are knowledge of infant states, infant response patterns, non-verbal language, the ability to modulate the infant’s state, and provision of a growth-fostering environment through sensitive and responsive interactions. The principles in Keys to Caregiving are widely applicable to all caregivers engaged in the care of young infants. Keys to Caregiving was designed to present up-to-date information about infant behavior, describe its impact on caregiving, and aid professionals in translating this knowledge to parents. Although this program was initially developed with the hospital nurse in mind, other health professionals working with new parents and their infants will find the information equally valuable. The Keys to Caregiving program contains the following materials: Six video cassettes that provide examples to dramatically highlight the information presented, a study guide, and five parent handouts designed for distribution to parents. The program is divided into six components:

  1. Infant State – provides the basis for understanding infant behavior.
  2. Infant Behavior – describes the variety of ways infants have of communicating their individual differences.
  3. Infant Cues – describes the language of the newborn.
  4. State Modulation – presents techniques caregivers can use to help infants organize their sleeping and waking states, and improve feeding.
  5. The Feeding Interaction – describes both the parent’s and the infant’s responsibilities that make for a more successful and pleasant feeding interaction.
  6. Worker-Parent Communication – describes how to effectively translate new information to parents so they feel cared for and gain confidence.

Parent-Child Structured Play Interaction (Crowell)
This procedure provides a method of observing caregiver-child interactions (Crowell & Feldman, 1988; 1991; Crowell, Feldman & Ginsburg, 1988) in a clinical setting. This procedure involves a series of eight episodes designed to elicit behaviors that allow the clinician to focus on the relationship between a child and his or her caregiver in a setting that is unstructured enough to allow for “real-life” or spontaneous interactions. This procedure requires 45 to 60 minutes to complete. The eight episodes include free-play, clean-up, a bubble blowing episode, four increasingly difficult problem-solving tasks, and a separation/reunion episode. These episodes allow the clinician to see how comfortable and familiar the dyad is with each other, how the dyad negotiates transitions, the dyad’s ability to problem solve together, their use of shared affect (positive and negative) to communicate, and attachment behaviors. We have used this procedure with children between the ages of 12 and 60 months. There are two workshops associated with this procedure. One is for clinical interpretation or use and the second is for research purposes. The two workshops are described below:

  • CLINCIAL WORKSHOP: USE OF THE PARENT-CHILD STRUCTURED PLAY INTERACTION (CROWELL) IN CLINICAL SETTINGS This is a two-day workshop that covers the administration and interpretation of the Crowell procedure in clinical settings. The participant is provided with specific information on the materials and guidelines necessary for administration of the Crowell procedure. Interpretation of the Crowell for use in therapeutic work with parent-child dyads is also a focus of this workshop. Observations are made regarding how the pair balances the task demands with enjoyment of task completion, their level of comfort with one another, how they share affection, the degree to which they cooperate, and how they handle disagreements. Numerous video vignettes of Crowell procedures are presented throughout the workshop in order to enhance the participants understanding.
  • RESEARCH WORKSHOP: USE OF THE PARENT_CHILD STRUCTURED PLAY INTERACTION (CROWELL) AS A RESEARCH TOOL. At this four day workshop participants will be trained in how to administer the procedure. Brief exposure to the use of this procedure as part of a clinical evaluation is also presented. The main focus of the workshop is to train participants in coding the procedure for research purposes. A practice tape and a reliability tape will be made available to all workshop participants. Scales have been developed to rate the interaction on a more formal level. There are seven child scales: positive affect, withdrawn/depressed, irritability/anger, non-compliance, aggression, persistence, and enthusiasm. There are five caregiver scales: behavioral responsiveness, emotional responsiveness, positive affect, withdrawn/depressed, and irritability/anger. The scales are scored on a 7-point anchored system.

This procedure has been shown to be related to different types of caregivers’ representations (Crowell & Feldman, 1988; Zeanah, Aoki, & Heller, 1998), to distinguish between clinic-referred and comparison toddlers (Crowell & Feldman, 1988), to distinguish between delayed and non-delayed toddlers (Crowell & Feldman, 1988), and to be specific for a given dyad (Zeanah, Aoki, & Heller, 1998).

Parent-Child Interaction Therapy (PCIT) for Children 2-7 Years Old
WORKSHOP DESCRIPTION: PCIT is a treatment, created by Sheila Eyberg, Ph.D., that is specifically designed for young children (ages 2-7) who have behavior problems such as noncompliance, defiance and agression. Participants in this workshop will receive an overview of this type of treatment, including specific assessment and treatment strategies, and information about the empirical support for PCIT. The workshop will include videotaped presentations of clinical cases and role-play activities to practice specific PCIT skills. LEARNING OBJECTIVES At the conclusion of this workshop, you will be better able to:

  • Understand the theoretical underpinnings of Parent-Child Interaction Therapy (PCIT).
  • Identify how PCIT differs from other forms of child psychotherapy and parent management training.
  • Be familiar with the empirical support for PCIT.
  • Understand the major intervention strategies involved in the conduct of Parent-Child Interaction Therapy.

For questions, please call 504-988-7829 or email Linzi at lconners@tulane.edu.

The Response to Diagnosis Interview (RDI): Administration and Scoring
Presented by: Robert Marvin, Ph.D. The Response to Diagnosis Interview (Pianta and Marvin, 1993) The Response to Diagnosis Interview (RDI) is a semi-structured narrative interview intended for research use with populations of parents of children with some form of disability or chronic illness. The Interview was designed to measure parents’ reactions to and coping strategies for dealing with, the diagnosis of their child with a disabling condition or illness. The Interview consists of a series of questions eliciting the parent’s beliefs, memories and emotional reactions to the news of their child having an illness or disability. The Interview takes approximately 10-15 minutes to administer and the interviewer should be trained in the administration of semi-structured interviews in general, and the Reaction to Diagnosis Interview specifically. The RDI Coding Manual was designed to code parents’ responses to the Reaction to Diagnosis Interview. In particular it codifies the parents’ representational, or mental, models of the child with the disability or illness, and the extent to which the parent has resolved the trauma of the diagnosis and diagnostic process. The manual and coding has been used with parents of children with disabilities, chronic illnesses (cerebral palsy, mental retardation, epilepsy, autism, deafness). Validity data indicate that the classification of Unresolved or Resolved, based on the descriptions in this manual, is strongly related to the classification of the child’s attachment (secure, insecure) to the parent (Marvin & Pianta, 1992; Pianta & Marvin, 1993). In a study of 57 children with cerebral palsy between the ages of 15 and 50 months, in which all were seen at least one year post-diagnosis, 30 mothers were classified as Unresolved, and 27 were classified as Resolved using this Manual. Looking more closely at the link between Resolution and child-parent attachment in 33 of these children, 11 of the 14 mothers classified as Resolved had children with Secure attachments; 16 of the 19 mothers classified as Unresolved has children with Insecure attachments. The overall hit rate between child-parent attachment and mothers’ classifications as Resolved or Unresolved with respect to the child’s diagnosis was 82% (Chi-square 8.79, <.01). Participants will learn:

  1. How to administer the Response to Diagnosis Interview for research purposes.
  2. How to code the Reaction to Diagnosis Interview using the procedures described in the RDI Manual to perform a Resolved/Unresolved classification at the molar level.
  3. How to code the subtypes of the major classifications.
  4. The clinical applications of the procedure on which research questions and treatment goals can be identified.

Participants will receive a copy of the RDI and the administration and scoring manual after paying the tuition fee. Please review the manual and use the Interview carefully prior to the June 16th training. For further information contact: Linzi Conners at lconners@tulane.edu or (504) 988-7829.

Developing Expertise in Infant Mental Health
Developing Expertise in Infant Mental Health is an online course that will provide mental health professionals with an understanding of the theory and practice of assessing parent-child relationships in early childhood.

Attention will be devoted to understanding the familial context of children’s early development and providing information helpful to clinicians as they identify strengths and concerns in families who have young children.

Topics that will be covered include development and early adversity, attachment, parent-child observations, and parent perceptions. The course consists of numerous videos featuring the faculty of the Tulane Institute of Infant and Early Childhood Mental Health, interspersed with learning activities designed to facilitate the participants’ application of the training material to their practice. For more information, please email us at imhonline@tulane.edu