What Is Parent-Child Interaction Therapy?

What Is Parent-Child Interaction Therapy?

According to PCIT International, Parent-Child Interaction Therapy (PCIT) is “an evidence-based treatment for young children with behavioral problems…conducted through ‘coaching’ sessions.” The parent and child engage in a playroom while the therapist observes, either through a one-way mirror or via live videoconferencing.

In addition, the parent wears a Bluetooth or earbud device that allows the therapist to provide real-time feedback and suggestions for how the parent can respond to the child’s behavior and facilitate positive attachment.

There is an extensive body of evidence for the effectiveness of PCIT for both emotional and behavioral issues in children.

Treatment Plan

PCIT is conducted in two phases. First, the therapist emphasizes building a positive relationship between the parent and child. Second, the therapist will guide the parent in building effective communication skills, using a calm tone to de-escalate the child when necessary, and establishing a sense of trust and security between the child and parent.

Families often find themselves in dysfunctional cycles of the parents reacting to the child’s behavior in a way that escalates the child and reinforces negative attention-seeking behaviors. In the first phase of PCIT, the parent learns how to break this cycle and create a pattern of healthier, more positive interactions.

The second phase of PCIT teaches parents specific skills and techniques to address problem behaviors healthily and enforce clear, consistent, and reasonable boundaries with their children. The goal is to show improved behavior in the child and healthier, more regulated responses from the parent.

PCIT is not limited to a set number of sessions; however, effective treatment regimens can last as little as 12 weeks,with many treatment regimens spanning from 12 to 20 sessions.

Techniques

A PCIT office setup typically includes a play space for the parent and child, with a separate room (either behind a mirror or connected via live video feed), as well as a time-out spot. PCIT International recommends that the time-out space be separate from the play area.

During a PCIT session, the therapist guides positive interaction between the parent and child. Families also complete homework in between sessions to reinforce the skills learned, improve problem behaviors, and foster healthy attachment.

In the first phase of PCIT treatment, the parent is taught to implement PRIDE skills when interacting with their child: Praising the child, Reflecting the child’s behavior, Imitating the child’s positive behavior, Describing/narrating the child’s behavior, and Enthusiastically engaging with the child.

In the second phase, parents learn to make commands effectively and exhibit consistent expectations for the child. Improved emotion regulation and communication in both the parent and child leads to more positive interactions and healthier relationships in the family.

What Parent-Child Interaction Therapy Can Help With

There is ample research backing for the effectiveness of PCIT with children as young as 14 months of age. In addition, studies have shown that children with various diagnoses, including attention-deficit/hyperactivity disorder, autism, oppositional defiant disorder, and anxiety can benefit from PCIT. 

Because PCIT emphasizes both the child’s immediate, obvious behavioral concerns and underlying attachment issues and relationship dynamics, it addresses the immediate reason for the referral and the underlying issues causing these problems. Thus, it is not a “BAND-AID” approach to “fixing” a behavior but an in-depth intervention that also addresses what might be causing the problem in the first place.

Parents can learn not only how to communicate effectively with their children and teach compliance, but they can foster more secure attachment at the same time.

Things to Consider

If you find yourself overwhelmed by your child’s behavior and are unsure whether your parenting approach is effectively addressing these problems, you might consider PCIT as an intervention for your family.

If your child has an individual therapist but you feel like there are family dynamics that should also be addressed, PCIT might be a good fit to work through these issues.

PCIT requires parent involvement in treatment, so appointments will need to be scheduled when the parent can be at the appointment with the child and involved throughout the session. It also requires homework between sessions, so ongoing commitment to this is essential.

How to Get Started

PCIT International has a directory of certified PCIT therapists around the world and can give you information about providers in your geographic area. Your child’s pediatrician may also have a list of providers that they recommend for your specific concerns.

If there are no providers near you, don’t panic! Fortunately, PCIT can be effectively administered via telehealth, so as long as the therapist is licensed to practice where you are located, you can still get services without traveling to their office.

The therapist will likely want to do an intake interview to gather information about your child’s history and family dynamics. Please keep in mind that the therapist is not there to judge you as a parent but to help you make positive changes in your family.

Your therapist will give you information about their process and the specific details of your treatment plan. Open communication is key for progress, so bring any questions or concerns that you have.

PCIT is a widely-respected approach to children’s behavior problems, as it addresses both the child’s difficulties and the underlying dynamics and systems that may be reinforcing them. Children do not come with a manual, and PCIT can help parents learn effective skills to reinforce preferred behaviors and foster healthy attachment with their children.