Parenting with Love and Limits (PLL) is a system of care that targets families with youths who are at low to high risk for out-of-home placement (commitment programs, foster care, group homes, or residential facilities), and families with youths who are returning from an out-of-home placement. The treatment is aimed at families with youths ages 10–18 who have emotional and behavioral problems such as depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), alcohol/drug use, severe disrespect, truancy, domestic violence, or suicidal ideation. The average service duration is 3 to 6 months.
The primary goals of the PLL model are to teach families how to restore the parental hierarchy, reestablish healthy communication patterns, and restore family attachments. Specific treatment techniques used to accomplish these goals are based on structural and strategic family therapies. The PLL model is designed to move families progressively through the stages of readiness to change (Prochaska et al., 1994) while keeping youths from penetrating deeper into the system, reducing the length of an out-of-home placement, reducing recidivism, and lowering rates of maltreatment. The PLL model also uses a specialized reentry or expedited permanency-planning model, a reintegrative service that aims to prepare youths in residential or foster care for transition back into their community.
PLL is aimed at engaging hard-to-reach parents or caregivers when other treatment models have failed. The program uses a motivational interview process and a combination of group therapy, family therapy, and family-systems trauma treatment within one continuum of care.
PLL includes six multifamily group sessions, conducted by two facilitators, which employ group therapy, videotapes, age-specific breakout sessions, and role plays. Individual families also receive intensive 1- to 2-hour family therapy and trauma-based treatment in an outpatient or home-based setting to practice the skills and concepts learned in the group setting. A relapse-prevention component is also included, in which the clinician reaches out to the families 30, 60, and 90 days subsequent to program completion to ensure the intervention is still being practiced appropriately.