Skip to main content
. Author manuscript; available in PMC: 2017 Feb 1.
Published in final edited form as: Child Youth Serv Rev. 2016 Feb;61:109–116. doi: 10.1016/j.childyouth.2015.12.004

TABLE 1.

Parental Risk Factors Addressed by PFR

Risk Factor PFR Element
Low parental self-efficacy
  • Provider use of positive instructive feedback during video feedback identifies positive shared moments and what the parent is doing well to support the child.

  • Provider engagement that is respectful, contingent, and positive supports the parent’s sense of self as worthy.

Misattribution of meaning of toddler challenging behavior
  • Parent learns to observe child’s behavior via video feedback.

  • Parent learns to reflect on the underlying social emotional needs via video feedback, provider’s use of reflective questions and comments, and handouts all focused on identifying and labeling underlying social and emotional needs of children.

  • Baby Cue (NCAST.org) cards and videos help parent learn how children communicate nonverbally.

  • Reflective questions help parent “enter the mind of the child” and discuss what the child might be needing or feeling.

Difficulty regulating self
while distressed; difficulty
regulating child’s distress
  • Handouts and exercises that specifically address distress of parent and child and methods for calming.

  • Video feedback during times of distress; reflective questions about internal states of parent and child and how needs can be met for both.

  • “Intervention Worksheet” handout takes the parent through steps in the process of understanding challenging behavior: 1) defining the behavior, 2) identifying underlying feelings of parent and child, 3) identifying the underlying needs of parent and child, 4) thinking about ways to meet the needs of parent and child.

Difficulty being present,
calm, and appropriately
responsive to child fear,
anger, distress
  • Handouts to demonstrate attachment-based concepts and help parent understand the child’s need for a secure base from which to explore and a safe haven from which to receive comfort, protection, and support.

  • Video reflection to help parent “see” attachment-based behavior and needs.

  • Providing parent with a supportive presence to enable them to feel safe and secure enough to help the child.

Difficulty following the
Child’s lead in play
  • Positive instructive feedback during video feedback to identify times when the parent successfully follows the child’s lead.

  • Handouts on play and teaching which discuss the importance of following the child’s lead.

Underestimating how
important the parent is to the
child
  • During video feedback, provider points out how child is watching and responding to the parent’s words and behaviors.

  • Celebrating moments of shared joy during video feedback and other times.

Child’s trauma history
leading to behaviors that do
not elicit nurturing care
  • Video observation to help caregiver see the world from the child’s experience.

  • Reflective questions help the caregiver think about the child’s underlying social and emotional needs.