Parent-Child Interaction Therapy (PCIT) Program

Big personalities, tiny bodies.

Children are wondrous. The rapid pace that they acquire knowledge, gain skills, and develop their very own personalities is truly miraculous. How can such small people who are so new to the world have so much to say and do?

But sometimes, having so much to say and do can have negative repercussions. For some children, personality development can go hand-in-hand with emotional and behavioral difficulties that become a burden on the whole family. These children may be defiant or oppositional, misbehave, be unable to handle negative emotions, throw tantrums, break or throw things, and not comply with what is being asked of them. They may also be inattentive and/or hyperactive, have developmental delays, or be anxious, withdrawn and unwilling to speak or to engage with others. These difficulties can lead to tremendous stress in the family and lead to conflict between parents and their child, and even between parents who may differ in their approaches to disciplining their child.

Even the most skillful parents need specialized assistance to manage children with defiant, oppositional or anxious and withdrawn behaviors and would benefit from skills to prevent these challenges from spiralizing out of control.

What is PCIT?

PCIT stands for “Parent-Child Interaction Therapy,” an evidence-based treatment for young children between the ages of 2-7 who display emotional and/or behavioral difficulties. PCIT is not individual therapy; it is a comprehensive treatment program that teaches and guides the use of specialized, therapeutic parenting strategies that have been shown to be highly effective in managing children’s emotions and behaviors. PCIT teaches parents these valuable skills to manage their child’s emotions and behaviors, guides parents to engage in these skills during sessions to modify their child's behaviors, and works to establish a healthy, positive dynamic between parents and the child so they can thrive as a family.

We offer specialized versions of PCIT for toddlers (12-24 months) and for older children (7-10 years old).

PCIT seeks to:

• Improve the quality of the parent-child relationship
• Decrease the child’s emotional difficulties and behavioral problems
• Increase the child’s positive social skills and cooperation
• Reduce parental stress
• Help parents build positive, warm relationships with their child
• Support parents as they set firm, developmentally appropriate limits with their child.
• Improve the quality of the parent-child relationship

What should I expect from PCIT?

PCIT is unique in that children and their parents are seen together in session. Before beginning treatment, the family attends an initial intake session where the therapist gathers information about the child’s history and the parents’ goals and concerns for their child. At the intake session, a baseline observational assessment of the parents’ skills is also conducted.

Within the session itself, parents are coached to practice skills with the child. Our PCIT therapists observe the parents and the child from a special observation room with a one-way mirror, and use a “bug-in-the-ear” headset system to coach parents to apply specialized, therapeutic parenting skills as they play and interact with their child. PCIT Therapists at CBC often use a co-therapy model to facilitate training and provide additional support to families in treatment. Our PCIT team provides both in-person and Internet-based Telehealth PCIT. Research has found that Internet-based PCIT is just as (or even more effective) than clinic-provided PCIT, as the therapists can help you practice the skills in the comfort of your home!

At the beginning of each PCIT session, the therapist checks in with parents about any stressors or barriers to homework practice. Parents also complete the same questionnaire about their child’s behavior each week, and this questionnaire is used to track their progress in treatment. At the end of each PCIT therapy session, the therapist and parent collaboratively decide which skills should be practiced at home in between sessions.

There are two phases of PCIT:

• Phase I is called Child-Directed Interaction (CDI). When children are defiant, oppositional, or anxious and withdrawn, the natural warmth and affection between parent and child often suffers, which makes it harder for parents to discipline their child or to even get the child to listen. To overcome this, the CDI phase enhances the parent-child relationship and teaches parents to use their own “play therapy” skills to increase positive child behaviors and improve their child’s self-esteem. Parents are provided live coaching during each session to manage any disruptive behaviors while still facilitating positive parent-child connection throughout the play. These skills have been shown to foster trust and security between the parent and child, improve the child’s vocabulary, increase the child’s sharing behaviors, enhance the child’s self-esteem, and increase the likelihood that children will listen when parents give instructions, make requests, or attempt to discipline them.
• Phase II is called Parent-Directed Interaction or PDI. The PDI phase of treatment builds on the previous phase and teaches parents to use effective skills to increase their child’s ability to comply with instructions and to decrease the child’s unhelpful or problematic behaviors. Parents are coached in several play and real-life situations so that they can generalize the gains made in treatment to their real life. These skills have been shown to increase the child’s compliance with instructions and demands, and improve parents’ confidence in giving instructions and making requests, as well as being consistent and predictable in their approach to disciplining their child.How long does PCIT take?PCIT is a time-limited treatment, averaging approximately 14 weeks, with hour-long weekly sessions and daily therapy practice at home. Families remain in treatment until parents have demonstrated expertise in enacting treatment skills and when their child’s emotional and behavioral concerns have improved