When looking for ways to support your child who is struggling with behavioral difficulties or mental health concerns, there are many different modalities and styles of therapy. One type of therapy that helps caregivers to enhance parenting techniques, increases the parent-child relationship, and decreases behavior problems is Parent-Child Interaction Therapy or PCIT.  


What is Parent-Child Interaction Therapy?

PCIT is an evidenced-based based therapy focused on the relationship between young children and their parents/caregivers. PCIT is a combination of play therapy and behavior therapy developed in the 1970s by Dr. Sheila Eyberg. Unlike other therapies that focus on either the child or the parent individually, PCIT focuses on the interactions between children and parents to create a positive relationship and help parents develop key strategies to manage their child’s disruptive behavior. 

PCIT is typically used with children between the ages of 2 and 8 can be used for children up to the age of 12 depending on the circumstance. PCIT can help a wide variety of children who are struggling with a variety of diagnoses including oppositional defiant disorder (ODD), Attention-deficit/hyperactivity disorder (ADHD), Autism spectrum disorder (ASD), Anxiety disorders, selective mutism, and kids who have experienced trauma. PCIT is most helpful when kids have behavioral problems such as refusal and defiance of adult requests, low frustration tolerance, tantrums, easily annoyed, destruction or property, difficulty taking turns, and frequent emotional dysregulation.

Along with the child, a parent/ caregiver must attend the sessions and be an active participant. In a PCIT session, the parent and child meet in a special room that has age-appropriate toys. In the room, there is a one-way mirror that the PCIT therapist sits on the other side of. The parent and child then play freely in the room while the therapist coaches their interactions using a bug-in-ear system. This technique allows for a natural space between the child and parent while also getting individualized live coaching. 


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This coaching happens in two phases. The first phase is Relationship Enhancement / Child-Directed Interaction (CDI) In the first phase of treatment, the focus is on enhancing the parent and child relationship. In order to enhance the relationship, the sessions involve the child leading the session and the parents playing with the child while being coached by the therapist. During CDI, parents use positive reinforcement and positive interactions like praise, imitation, reflection, and description of behaviors. Parents are asked to refrain from using criticisms or negative words during play. In between sessions, parents are given homework to recreate these sessions and positive interactions with their children for 5 minutes a day as homework. 

The second phase of treatment is Discipline and Compliance / Parent-Directed Interaction (PDI). In this phase, parents take the lead of the session and the focus shifts to establishing and developing skills for parents. These skills include things like consistent ways to discipline their child, time-out procedures, how to best use clear commands, and how to provide consistent consequences for positive or negative behaviors. Parents continue to receive live coaching during these sessions along with homework to better promote these skills into daily interactions. 

Most families need 14-20 sessions of PCIT, however, treatment is not time-limited, and sessions are held until a family graduates from the PCIT program. Graduation for the program occurs when parents/ caregivers have mastered both CDI and PDI skills and they rate their child’s behavior on a behavior rating scale within normal limits.


How effective is parent-child interaction therapy?

PCIT is considered a highly effective therapy training program to help with child behavior problems as well as to help with parent training. PCIT’s effectiveness has been demonstrated in at least 30 randomized clinical outcome studies and more than 10 true randomized trials. Overall, the studies have shown that PCIT helps parents to learn parenting styles and behavior management strategies to help navigate behavioral concerns. It has also been shown to increase the child’s positive behaviors and the child’s self-esteem. These studies have also helped to shed light on the various ways in which PCIT can be effective. Many studies have focused on the interaction between PCIT and children who have experienced child abuse or are in the child welfare system. These studies have found that these children benefit highly from PCIT with their parent/caregiver, foster parents, and/or adoptive parents. PCIT is now a common suggestion when working with children and families who have experienced trauma. 


How to find parent-child interaction therapy near you

PCIT therapy can be accessed in a variety of places throughout the world. A great resource for finding Certified PCIT Therapists through PCIT International is here. On this website, you will find therapists who have been through the proper training and certification in your area. If your family is working with a therapist or counselor, you can also speak with them to see if they have any recommendations.