In the last few episodes, we have seen examples of
how giving specific instructions can make a change effort successful, but how far does
this theory go? What if we subject it to the toughest possible
test? If we script the critical moves, can we change
child abusers? A study of child abusers was conducted in 2004. 73% had assaulted their children and 20% had
assaulted them violently enough to have caused broken bones and severe lacerations. The parents blamed the children for the abusive
behavior, believing they needed to discipline their children because the children wouldn’t
listen. The parents believed they had gotten a bad
kid and violence was the only way to get them to obey. To stop their abuse, a form of therapy was
used called Parent-Child Interaction Therapy or PCIT. It starts with an assignment: a parent is
asked to play with their child for five minutes a day. The parent must devote 100% of their attention
to the child during these five minutes. At first, the play sessions are conducted
in a laboratory setting. The parent and child sit in an empty room
with only a table and chairs. Three or four toys are put on the table. The parent is told to let the child lead the
play session and to give no commands or criticism or even ask questions. A therapist watches the play session through
a one-way mirror and coaches the parent over an earpiece. A typical interaction goes like this: A parent and child might start coloring and
the parent tries to participate by coloring on the child’s paper. The child objects. So the therapist tells the parent: “Okay,
get a separate piece of paper and imitate what your child is doing.” If the child is coloring a rainbow, the parent
colors a rainbow too, saying “I’m coloring a rainbow just like you. You’re using green, I’m going to use green.” Some children might reach over and grab the
parent’s green crayon yelling, “I want that!” The therapist teaches the parent to say, “Okay,
I’d be happy to share that crayon with you.” They get parents to bend a like a reed. Whatever the child is doing, the parent offers
no resistance, so the child has nothing to fight against. The parent is taught to praise the child’s
behavior. “I like how hard you’re working. Good job. You’re being very kind to that doll.” The parent is also taught to describe the
child’s behavior so that the child feels noticed. “Oh look, now you’re putting the toy car in the
garage.” Eventually, after a parent has gotten better
at these short interactions, a therapist teaches how to give a command combined with a reason
so that the command doesn’t feel arbitrary. “It’s almost time for the bus, so please put
your shoes on now.” In a study of 110 parents who had abused their
children, half were assigned 12 sessions of PCIT and half were assigned the standard treatment
of 12 sessions of anger management therapy. They were tracked for 3 years. 60% of those who received anger-management
therapy abused again. Only 20% of those who received PCIT re-offended. The success of PCIT intervention demonstrates
the power of scripting the critical behaviors to bring about lasting change.