Resources for Parents

Resources for Parents

What is Parent-Child Interaction Therapy?

What is Parent-Child Interaction Therapy?

Takeaways for busy parents:

  • Parent-Child Interaction Therapy (PCIT) is the gold standard, empirically-supported treatment for young children and their parents.
  • PCIT is an effective therapy for children under 7 with symptoms of ADHD, disruptive behaviors, frequent tantrums, aggressive behaviors, difficulty listening to instructions, anxiety, etc.
  • One primary goal of PCIT is to support parents in aligning their parenting strategies and reinforcing positive behaviors to create a more harmonious family dynamic.
  • The treatment is completed virtually or in person through 12-20 weekly sessions.
  • PCIT uses data collection and in-vivo coaching at each session to ensure parents and their therapist mutually observe positive effects throughout treatment.

Parent-Child Interaction Therapy (PCIT) is a type of therapy that involves working with both parents or caregivers and their children to improve communication, relationship building, and other skills that are essential for healthy social and emotional development. PCIT is used to help parents better understand their child's behavior while teaching them new parenting skills to respond to their child appropriately. PCIT is a Behavioral Parent Training (BPT), specifically a behavioral therapy that focuses on improving the parent-child relationship and providing parents with the strategies to handle difficult behaviors.. Behavioral Parent Training (BPT) provides parents and caregivers the tools to support children using evidence-based therapeutic techniques.

What is PCIT?

Parent-Child Interaction Therapy (PCIT) was originally developed in the 1970s. Since then, PCIT has been the focus of hundreds of research studies. PCIT holds the highest level of treatment efficacy as an empirically-supported treatment. This classification indicates that the positive results of PCIT have been replicated in more than one randomized control trial (the gold standard of research methods), and there have been meaningful effect sizes on target symptoms through evidence-based outcome measures. Parents are encouraged to use the California Evidence-Based Clearinghouse online tool to learn if a child-focused therapy is evidence-based and understand the research backing that treatment.

PCIT is based on the principles of social learning theory, which suggests that behavior is learned through observation and positive reinforcement. PCIT utilizes in-vivo coaching to learn and apply therapeutic skills effectively. The therapy aims to teach parents new skills to interact with their children more positively and effectively, which can improve the child's behavior and reduce negative interactions between parent and child. Therapists know how powerful PCIT skills can be for children, as these are skills that many play therapists utilize. PCIT Clinicians help parents become their child's therapists by teaching these therapeutic parenting skills.

Who is PCIT for?

Any family can benefit from the parenting skills delivered through PCIT! However, PCIT is most often recommended for families of children under 7 with ADHD or challenging behaviors. Families looking for PCIT may have a child experiencing significant tantrums, emotional dysregulation, difficulty with attention, impulsivity, poor social skills, or complex family dynamics with increased parental frustration.

PCIT has been adapted for various childhood mental health conditions and presentations, including Toddler PCIT, Older Child PCIT, PCIT for Selective Mutism, Emotional Dysregulation, Autism, anxiety disorders such as Social Anxiety or Separation Anxiety, children that have experienced trauma or abuse, etc. Depending on your child's developmental age and presenting issues, the therapist will decide if PCIT is the best fit for your family.

How does PCIT work?

PCIT is a structured, evidence-based intervention designed to improve the parent-child relationship. The therapy teaches parents specific skills to interact with their child positively and effectively, which can improve the child's behavior and reduce negative interactions between parent and child. PCIT is typically conducted in a series of sessions, each focusing on a different aspect of parenting.

The therapy typically consists of 12-20 weekly sessions, with each session lasting one hour. During these sessions, the therapist observes the parent-child interaction and provides feedback and coaching to the parent. The therapy is divided into the Child-Directed Interaction (CDI) phase and the Parent-Directed Interaction (PDI) phase.

During CDI, the therapist teaches the parent special positive reinforcement skills to engage their child in positive interactions. Many child therapists refer to CDI skills as the "special sauce" of any parenting protocol. Historically, parents are encouraged to fix problems as they arise, such as telling a child not to jump on the furniture. We often forget the importance of recognizing when kids are already doing well, such as when they have a calm body on the furniture. It is common to inadvertently over-reinforce negative behaviors. Over time this creates negative interactions in the parent-child dynamic and can reinforce a negative coercive cycle. During CDI, therapists help to shift the parents' perspective and use specific skills to engage with their child positively. These skills include using labeled praise, which involves verbally acknowledging and praising the child's positive behaviors, and reflective listening, which consists of repeating what the child has said to show that the parent is listening and understanding. Parents are also encouraged to use descriptions to help improve attention and focus and help keep their child focused on the activity and engaged in the play for extended periods.

CDI skills are imperative to seeing improvement with Parent-Child Interaction Therapy, and parents are encouraged to practice these skills during sessions and through home practice. Parents often describe learning these skills as learning a new language-- which can be challenging. Throughout PCIT, parents are guided and directly coached using bug-in-ear coaching techniques. Parents have reported that this level of in-vivo coaching and feedback helps them use the skills between sessions.

The second phase of PCIT is Parent-Directed Interaction (PDI), which focuses on teaching the parent to use specific skills to support their child's challenging behaviors. These skills include setting clear expectations and consequences for behavior, using a predictable consequence for negative behavior, and providing positive reinforcement for positive behavior. The two phases work in tandem to ensure that children are provided with a high level of positive reinforcement and praise with clear limits and expectations. This phase helps to provide the optimum delivery of nurturing and supportive parenting coupled with appropriate and reasonable expectations.

Is PCIT right for my family?

During PCIT sessions, parents work with a therapist to learn strategies for establishing a supportive and nurturing relationship with their child. While PCIT is a manualized treatment, meaning there are clear session guidelines and expectations, families need to work with a provider that will listen to their unique needs and offer flexibility while maintaining the fidelity of the treatment. It is important to find providers with appropriate training and certifications through PCIT International. PCIT Certified Therapists have completed 40 hours of didactic training with a PCIT Trainer and receive supervision on PCIT cases, typically throughout the course of a year or longer, to earn full certification.

It is essential to speak with a PCIT provider about your unique family needs, and they can determine if PCIT is the best fit for your family. PCIT is a collaborative treatment; parents should feel they are working with the therapist to support their child best.

The goal of PCIT is to improve the quality of the parent-child relationship, which can positively impact the child's mental health and well-being. By providing parents with the tools they need to communicate and connect effectively with their child, PCIT can help to reduce difficult behaviors and create a happier, healthier family environment. Families that complete PCIT typically report improved behavior and a stronger parent-child relationship.

Disclaimer: This information is for educational purposes only and is not meant nor intended to be health care advice or treatment. Should you need assistance with any mental health or psychological issue, including any parenting issues, you should contact a mental health professional.