BEHAVIOR CLINIC
The Behavior Clinic was founded in 2003 by Marquette University’s School of Education in partnership with Penfield Children’s Center, a large, community-based agency serving inner-city families with young children who have developmental disabilities. The Behavior Clinic offers free mental health services for children who are experiencing significant behavior and emotional problems. Graduate students receive specialized training and gain supervised clinical experiences working directly with the children and their families. The clinic also has an ongoing applied research program that regularly contributes new findings to the relatively new field of pediatric mental health.
The Role of the Behavior Clinic
Raising a child can be a difficult task. But raising a child with significant behavior and emotional problems including aggression, major temper tantrums, high non-compliance, hyperactivity, separation anxiety or self-abuse can be overwhelming for many parents. This is particularly true for families who have the added stress of living in poverty. The early identification and treatment of these challenging behaviors helps prevent more serious issues from developing in these children and improves the quality of life for their families. The Behavior Clinic provides proven treatment strategies to assist parents in improving the mental health of their young children.
The need for the Behavior Clinic quickly became clear through Marquette’s partnership with the Penfield Children’s Center. Ninety-five percent of the families who seek help at Penfield live at or below poverty level, and three-quarters of the parents are single mothers, many of whom have less than a high school education. Nearly 80 percent of the children at Penfield have been diagnosed with a developmental disability, and approximately 70 percent who are seen at the Behavior Clinic also meet the criteria for a psychiatric diagnosis.
When the Behavior Clinic was established in 2003, the original goal was to run the initiative as a one-year pilot project to gain information regarding the need, viability and success of such a program. During the inaugural year, the Behavior Clinic served a total of 23 families—enough to justify a second year. In its second year, the clinic served 58 families, with more than 350 clinical visits made to the homes of the families. The clinic now routinely serves 100 children each year, including 1000 in-home treatment sessions.
Clinic Goals and Objectives
As a collaborative program between Marquette University’s School of Education and Penfield Children’s Center, the Behavior Clinic has three primary goals: service, training, and applied research.
- Service
The Behavior Clinic offers free mental health services for low-income families with toddlers who are experiencing significant behavior and emotional problems and developmental disabilities. Clinic services begin with a comprehensive intake evaluation to evaluate each child’s referral concern. Following the intake evaluation, parents are encouraged to participate in the clinic’s in-home treatment program that directly addresses their child’s behavior and emotional problems. A behavior plan is developed for each child through which parents are taught effective child management strategies to improve their child’s behavior over an average of 10 to 12 treatment sessions in their homes.
- Training
Training is a central activity at the Behavior Clinic. Graduate students become involved in the clinic through their university’s clinical practicum courses, as paid clinicians, and as volunteers. Graduate students receive specialized training to fully participate in all aspects of the Behavior Clinic. After an intensive training program that introduces Penfield and the Behavior Clinic’s procedures, new students are paired with “veteran” students to immediately begin their work with the children and their families. Graduate students learn the clinic’s procedures through training seminars, observation, shadowing and finally by assuming the role of a case manager. All students receive regular supervision.
- Applied Research
The Behavior Clinic routinely collects outcome data to assess the effectiveness of its clinical services. A primary goal is to develop effective clinical procedures that can be taught to other students and professionals around the country. Beyond applied research efforts, graduate students are encouraged to use the clinic for their doctoral dissertation research.
Clinic Services
Dr. Robert A. Fox, Professor of Counseling Psychology and a licensed psychologist, is the director of the Behavior Clinic. The clinic is staffed by doctoral and masters-level graduate students enrolled in counseling or psychology programs at Marquette and other local universities.
Intake
Each family referred to the Behavior Clinic goes through a comprehensive two-hour intake evaluation that includes the following components:
- Direct observation of the interactions between a parent and child during play.
- Assessment of the child’s level of compliance to simple requests by the parent and the clinician.
- Administration of an intellectual screening test to assess the child’s current level of cognitive development.
- A comprehensive parent interview to evaluate the referral concern and the parent’s willingness and motivation to participate in the treatment program.
- Administration of a number of instruments such as: the Parent Behavior Checklist—this measures parent expectations and responses to the child’s behavior problems and Parent-Child Relationship Scale—this evaluates the quality of the present parent and child relationship.
- A staffing to share the intake results with the family.
In-Home Treatment Program
Over 90 percent of the families seen at the intake evaluation decide to participate in our treatment program. Families are visited weekly in their homes for an average of 10 to 12 sessions. A day before each visit, a clinician contacts the families to remind them of the appointment. At the first session, specific rules are established regarding how the home visits are to occur (e.g., the child and parent must be present; distractions such as visitors and TV must be kept to a minimum). The first part of the treatment program involves strengthening the parent-child relationship. This goal is achieved by teaching parents nondirective play strategies to use with their children every day.
The second part of the treatment program addresses the original referral concern. Parents are taught specific techniques to strengthen their children’s prosocial behaviors such as following parental requests, playing appropriately with siblings and picking up their toys. As this treatment component is implemented, parents also are taught how to provide effective consequences for their children’s challenging behaviors such as tantrums, aggression and property destruction. For these consequences, the clinic relies on proven strategies from professional literature such as ignoring, time-out, and redirection. Parents are instructed to use the strategies every day and to document their effectiveness.
In addition to the in-home treatment program, staff members routinely refer the children and their parents to other services such as early education programs for the children and counseling for the parents. To encourage families to participate fully in the treatment program, they are given a gift certificate to a local grocery store each session when they follow through with our recommendations.Summary
The Behavior Clinic makes a significant impact both locally and nationally. Graduate students and area professionals gain valuable experience by working with children and parents, learning new ways to understand early child behavioral and emotional problems and to help parents interact positively with their children. The research that results from this program provides valuable knowledge in the field and is disseminated to others. Furthermore, the Behavior Clinic helps children and parents who have a very great need but limited resources, providing services that would otherwise be unavailable to them. For more information about the Behavior Clinic, training opportunities for graduate students, and the clinic’s research, contact Dr. Robert Fox at robert.fox@marquette.edu or 414-288-1469.
