Child’s Play

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A new form of behavioral therapy champions childhood success while leaving plenty of room for fun

If all work and no play makes for dullness, Dr. Kristi L. Hofstadter-Duke may be the most interesting person in Savannah. A licensed clinical psychologist specializing in child and adolescent behavior, Hofstadter-Duke wants to enable parents to communicate more effectively with their children through play. Her method of choice — Parent-Child Interaction Therapy (PCIT). An evidence-based behavioral therapy, PCIT involves parent and child directed play emphasizing positive reinforcement, and the development of coping skills for stress and anxiety, through intentional engagement. “It has become the go-to treatment for trauma, anxiety and behavioral challenges for children ages two to seven,” says Hofstadter-Duke, “but there are different modifications that we use to make it more applicable at older ages.”

It is not the type of play that matters, necessarily, but rather the engagement of the parents with their child. The program begins with a parent-therapist consultation, followed by between 10 and 20 hour-long sessions of supervised playtime at the clinic. A therapist coaches the parents through playful interactions with the child, helping them pick up on communication cues and respond in a constructive way. For homework, parents are encouraged to commit to at least five minutes daily of dedicated playtime with their children to ensure the child is immersed in the interaction and receiving praise for positive behaviors such as playing gently and obeying instructions. “It’s not talk therapy, it’s not counseling. PCIT is a very active form of therapy with lots of in-clinic coaching,” Hofstadter-Duke says. “The therapist’s role is to teach the parents. It is a partnership between the therapist, or psychologist, the parents and the family. This is really aimed at changing the relationship and the dynamics between the people who are involved in this child’s life day to day.”

Kate Bailey, a mother of three, wanted help communicating with her youngest, with whom she often butted heads, and whose personality was so different from that of her first two children, and
began Parent-Child Interaction Therapy treatments with Hofstadter-Duke in February. Almost immediately, Kate and her husband noticed distinct differences in their interactions with their 6-year-old and each other. When the family recently renovated their house, an event that can trigger major stressors for children, Kate said the skills she and her husband learned with Hofstadter-Duke ensured everything went smoothly for the whole family. “We use these tools in our everyday life, not just during interactive therapy time,” she says. “It’s been a lifestyle change.” This treatment, though highly effective and well-researched, is relatively new to the Savannah area, the result of few pediatric psychology programs offered in our region. Hofstadter-Duke is working to increase awareness by partnering with primary care providers, supplying information, offering convenient therapy solutions and paving the way for a whole lot of fun.