Being a parent is hard. Being a parent of a child with severe behavioural issues would drive anyone to their wit's end, as was the case for young mother Shannon Murphy.
The Armidale mother-of-two says she felt trapped, unable to walk down the street with her sons because of her eldest son's unpredictable behaviour.
Two-year-old Joey would bang his head against a wall, kick and scream when in trouble, failed to listen and just wouldn't sit still.
"From the moment he wakes up in the morning to the time he goes asleep he goes a hundred miles and hour," Ms Murphy said.
"I could barely leave the house because of the way Joey was."
But life has changed dramatically for her family thanks to a new childhood behavioural support program being trialled in regional and remote NSW.
Dr Jane Kohlhoff, who is working with parenting service Karitane, is for the first time running a pilot parent training program via the internet - funded by NSW Health - to provide specialist intervention therapy for families in remote areas.
Clinical psychologists use a live video link to coach parents as they play with their children, then give support based on the interactions and behaviour they observe.
The play-based program, known as Parent Child Interaction Therapy (PCIT), is an extension of Karitane's Toddler Clinic, a service that launched more than 10 years ago for families in Sydney's metropolitan areas seeking help for toddlers with aggressive behaviour, persistent tantrums, hyperactivity, defiance and separation anxiety.
The philosophy of PCIT is that a child's behaviour improves through strengthening the parent-child relationship and the evidence shows it works, said Dr Kohlhoff, from UNSW Medicine's School of Psychiatry.
"The whole program in based on the knowledge that children need warmth and sensitivity, combined with positive discipline," she said.
The outcomes for the child include improved concentration and social and emotional skills, better listening skills and greater compliance.
"Just all the things that really set them up to be on a good pathway as they start school and get older," Dr Kohlhoff said.
For Ms Murphy getting therapy for a two-year-old sounded "ridiculous".
"But I was that desperate that I just did it anyway."
The change in Joey's behaviour was gradual but the impact the program has had on Ms Murphy's life has been dramatic, with a reduction in extreme tantrums, aggressive behaviour and disobedience.
"I go down town now with both kids on my own and I can handle it," Ms Murphy said.