PMT

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Dr. Alan Kazdin is a former president of the American Psychological Association (APA) with numerous publications to his name and who, in 2000, edited the APA/Oxford University Encyclopedia of Psychology. Much of his professional work has focused on externalising disorders and problems in young people. These includes disorders that result in antisocial or disruptive behaviours such as oppositional defiant disorder (ODD) or conduct disorder (CD).

Devising effective, evidence-based treatments for these disorders is important. For instance, ODD often occurs alongside CD and Attention Deficit Hyperactivity Disorder (ADHD), and it has been argued that it is a better predictor of depression than depression itself. This does not mean that effectively treating ODD will necessarily help prevent depression, but this is a plausible possibility, and the effects of ODD are damaging enough on their own to make such efforts worthwhile.

The causes of externalising disorders are not fully known, although it has been suggested that both genetic and parenting factors play a role in ODD. Parents may react to troubling behaviour by giving way to a child’s wishes and this, in turn, reinforces that behaviour. For instance, in one study, what the researchers referred to as ‘timid discipline’ on the part of parents predicted worsening ODD symptoms and ODD symptoms, in turn, predicted timid discipline (although no such relationship was found for ADHD).

This is where Dr Kazdin and a model known as Parent Management Training (PMT) enter the picture. If parental behaviours influence conditions such as ODD then it seems reasonable to think that we can help treat the condition by changing these behaviours.

Parents involved in PMT work with a clinician who takes them through a classic behaviourist approach involving antecedents, behaviours and consequences. Antecedents are things like instructions, rules and prompts that attempt to anticipate desirable behaviours. Consequences can be positive or negative.

At the start of PMT, parents are taught to describe behaviours factually rather than emotively. They are told to initially avoid directing their child but to instead simply focus on positively reinforcing prosocial behaviours in an age-appropriate way. This does not necessarily mean a tangible reward like a sticker, it could be something a simple as a smile. Later, they attempt to be more directive and are introduced to what Kazdin refers to as ‘mild punishments’ such as a brief time-out or loss of a privilege.

This is the point where a lot of your backsides will start to itch. In education, we want to mince any words related to punishment. We talk of ‘contingencies’ or ‘response costs’ in order to try and dodge any charge of being punitive. I think there are two reasons for this. The first reason, which would be upheld by all good behaviourists, is that the focus should be on antecedents and positive reinforcement, with punishments playing a minor and infrequent role and certainly not being cruel, unusual or enforced with theatrical relish. It’s too easy to become sidetracked into a discussion focused solely on punishments and so we seek to play them down. The second reason we dislike discussing punishments is in deference to the progressivist tradition in education that essentially sees all attempts to control children as coercive and against nature. I have less sympathy for this impulse, given the results.

Some of you will find the principles of PMT familiar from your work as teachers because they map almost exactly onto behavourist approaches to classroom management. These are the methods they probably didn’t tell you much about as a trainee because they are coercive and run against progressive principles. That’s why I made them a focus of the chapter on classroom management in my new book (shameless plug – you can pre-order it here).

You may be wondering whether PMT is effective. From what I can gather, it is one of the most well-researched and effective treatments in this area of psychology and has been subjected to scores of randomised controlled trials (RCTs).

Which makes me wonder if the following hypothesis might be true: If we adopt similar approaches to classroom management, robust approaches that involve antecedents, behaviours and consequences, and we uphold these approaches consistently, then we might reduce the level of disruptive behaviour and, as a consequence, reduce the number of school exclusions.

Note that I have used the medical terms of ‘disorder’ and ‘treatment’ in this post without entering into a discussion about whether these are always appropriate.

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9 thoughts on “PMT

  1. I’m sorry Greg, but I’ve taught SEN pupils for a quarter of a century, and it seems odd that I’ve never met a pupil who I had any serious trouble teaching, even though many of them were on the register for poor behaviour and unquestionably could be disruptive. I was an NCO instructor in a TA company where about a quarter of our strength was recruited from Glasgow, where ‘oppositional’ behaviour is all but built into their culture. Once again, they alway behaved in my classes. I never, ever had to use formal sanctions–the mere threat of them was sufficient. I’ve also worked with projects with young people on probation and care orders. Same results.

    I don’t think I’m that exceptional–I’ve met lots of teachers who could do the same. For all of Dr Kazdin’s RCTs, I think the answer is a lot simpler: the profession as a whole is so bloody wet you could shoot snipe off them. Kids can sniff that woolly social worker mentality a mile off, and believe me, they play it up for all it’s worth. When you’re in a classroom where teachers bore them rigid with ‘minimally-guided instruction’, the result is all but guaranteed.

  2. Hi Greg
    Just a minor point of clarification, if I may. You state that “Antecedents are things like instructions, rules and prompts that attempt to anticipate desirable behaviours.” However this is not strictly correct. In behaviour analysis, antecedent events are simply phenomena that occur immediately prior to a particular behaviour of interest – “ante” meaning “prior to” (ante meridian, antenatal etc). So, for example, if the “target behaviour” (behaviour of interest) is a child getting up and leaving his seat at inappropriate times, behaviour analysis might find that the antecedent event is the teacher signalling the commencement of a particular activity. So antecedent events are not necessarily directional – they are just antecedent to a particular behaviour of the child’s. One of the strengths of good behaviour analysis is that changes can sometimes be effected simply by changing or removing antecedents – without having to ask a student to do anything different. This is sometimes referred to as “environmental manipulation”.

    1. This is correct. I was thinking of PMT and the attempt to manipulate antecedents. Antecedents can be exactly as you describe. Similarly, consequences can be any consequence of a particular behaviour. For instance, if a child engages in an undesirable behaviour and, as a result, a parent gives in to the child then this consequence may reinforce the undesirable behaviour. PMT attempts to manipulate antecedents and consequences to ensure that they reinforce desirable behaviours rather than undesirable ones.

  3. the focus should be on antecedents and positive reinforcement, with punishments playing a minor and infrequent role and certainly not being cruel, unusual or enforced with theatrical relish.

    Sounds perfectly reasonable to me. “Punitive” is just a word. It describes, for example, a teacher’s response. It’s interesting that those of us on the progressive side see no harm in using the word when it is justified: it tends to be those of a traditionalist bent that bristle when it is mentioned. Maybe that’s because teachers of a progressive nature see responses and antecedents for what they are?

    the progressivist tradition in education that essentially sees all attempts to control children as coercive and against nature. I have less sympathy for this impulse, given the results.

    I’m not sure what you mean by this comment. The only link is to another one of your posts, which doesn’t have anything about “results”, let alone what this “tradition” would be “impulsive”.

  4. Thanks for another interesting post. I find Deci and Ryan’s Self Determination Theory offers a compelling contrast to the behaviorist approach, and I see value in both. This chapter (https://pdfs.semanticscholar.org/aebe/c232c843f4bc935c24a03e15e5bd1ea997e3.pdf) from this useful volume (https://www.researchgate.net/profile/Azkananda_Widiasani/publication/310773130_Handbook_of_Student_Engagement/links/5836a0dd08aed45931c772b7/Handbook-of-Student-Engagement.pdf) may be of interest to some.

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