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When deciding to add PCIT services at an agency, there is often a great deal of discussion related to what modifications might be needed to the PCIT therapy space in order to implement PCIT with fidelity.

In this installment of Clinician’s Corner, Dr. Rhea Chase talks about the importance of using a Time Out “Room” as a back up to the Time Out chair.

As far as the timeout room – I do a lot of training in community agencies, and, as we’re all aware, they typically don’t have a lot of space! I know the concept of a timeout space can be overwhelming to therapists and agencies just trying to make sure they have enough space to see their clients. But the more training I do, the more I am amazed at the solutions therapists have found! In thinking about what can serve as your timeout “room,” I think it’s helpful to go back to the theory behind timeout and the timeout room. The timeout procedure in PCIT is effective because it serves as a removal from the parent’s attention. So the back up just needs to be a further removal from that attention. It doesn’t have to be an entire room. It only has to be a safe space that serves as a further removal from parental attention. It can be another therapy room, cleared out before your PDI session. Timeout rooms can be built by adding two walls to a corner of the playroom (and they don’t have to go all the way up to the ceiling). They’re doing amazing things in Germany with sturdy, removable timeout rooms that can be wheeled in for the session, hooked into the wall, and removed once the session is over.

If a timeout room is absolutely impossible, or you are working towards its construction, the “swoop and go” procedure can be used. When the child leaves the chair before they’re told, the parent says, “You got off the chair before I said you could, so I’m going to take the toys and wait outside.” The parent then, as quickly as possible, “swoops” the toys into a laundry basket and waits outside for one minute plus five seconds of quiet. In essence, the therapy room becomes the timeout room. In every other way, the procedure is followed exactly the same way. When the parent re-enters the room, they place the child back in the chair and three minutes starts again. The swoop and go will work, but it will probably take longer, because children are often entertained in such a big room. If you are consistent, they will eventually learn the procedure in the same way, but it will take more “trials of learning” so to speak, which is one of the reasons we encourage agencies to work towards a timeout room.

Thanks for the clarification, Rhea! Stay tuned for more Clinician’s Corner features!