Interacting With Children Training for Undergraduates

Children interact with adults in almost every setting, including caregiving, schooling, extracurriculars, and mental health support. Adults within these roles are positioned to enhance children's growth through modeling appropriate behaviors, teaching prosocial interactions, and facilitating positive relationships with other people in their environments. Adults often require explicit instruction to reach their full potential while using these skills. The therapy context is one such capacity through which adults, and particularly caregivers, can learn relationship-enhancing strategies to bolster their interactions with children. Given the positive effects that psychological treatment can have on the caregiver-child relationship, efforts to expand teaching these skills to broader adult-child interactions are underway. One such training is Child-Adult Relationship Enhancement (CARE), which is rooted in both parent management training (PMT) and Parent-Child Interaction Therapy (PCIT). Both PMT and PCIT are types of empirically supported treatments that teach relationship enhancement and limit-setting strategies to caregivers of young children with disruptive behavior disorders. Given the wide-reaching successes of PMT and PCIT for families of children with externalizing behavior problems, substantial efforts have been made to teach PCIT skills and principles to additional audiences beyond therapy settings. Despite the success of these interventions, PCIT is ultimately a treatment intended for children between ages two and seven with clinically significant disruptive behaviors and is not designed for implementation outside of the therapy setting. In order to increase access to the behavioral principles taught through PCIT for children of a wider age range and for interactions with non-caregivers, the Child-Adult Relationship Enhancement (CARE) training protocol was created

CARE:

CARE is a preventative program that teaches any adult working with any child or adolescent ages two to 18 highly effective play therapy skills in order to mitigate the risks of disruptive behavior concerns and/or child maltreatment. CARE utilizes a trauma-informed approach so that participants can both help prevent child maltreatment and lessen the negative impacts that abuse and neglect have on children and adolescents. The primary focus of CARE is to enhance the relationship-building skills that adults bring to an adult-child interaction so that children and adolescents will be more likely to engage positively with adults and, as a result of having a warm foundation, be more willing to comply with adult requests.

Regarding CARE training format, trainings typically last for three to six hours across one to two sessions and contain both didactic and role-play portions. During didactic segments, participants learn about childhood trauma, the positive effects of play on child-adult relationship enhancement, statements to use and avoid, how to give good commands, and how to utilize selective attention. Role-play activities allow participants to practice the skills learned throughout training with each other while being coached with live feedback from training facilitators. CARE trainings are designed to be application-focused such that participants complete the training with real-world skills that they can apply during their future interactions with children and adolescents. CARE teaches adults to increase their positive skills ("P skills") and decrease their statements to avoid during interactions ("Q skills") while engaging with a child or adolescent. The P skills include Praise, Paraphrase, and Point Out. The Q skills include Quash the Need to Lead, Quit Unnecessary Questions, and Quiet the Criticisms.

CARE trainings have historically been provided and proven highly effective for professionals working in pediatric settings, including allied health professionals, pediatricians, and teachers, as well as caregivers and foster caregivers. However, one population that has received little attention within CARE literature is undergraduate students. Undergraduates are uniquely positioned to receive behavioral management and child-adult relationship enhancement trainings because many students are involved in child-oriented activities (e.g., volunteering, coaching, mentoring), others focus on child-facing careers such as teaching, medicine, and psychology, and some are caregivers themselves. Students in university settings are primed to readily absorb new information and knowledge, given that they are immersed in classroom environments and eager for skills-based curricula. However, only one previous study has examined the efficacy of CARE trainings among undergraduates. The study found that undergraduate participants significantly improved their observed usage of positive skills, recognition of those skills during coding exercises, and overall CARE knowledge following CARE trainings. The investigator noted that CARE should continue to be examined among undergraduates given that study's success and recommended implementing a true experimental design (i.e., intervention versus control group).