Parent-Child Interaction Therapy (PCIT)

Parent-Child Interaction Therapy (PCIT) is an evidence-based treatment program that uses training, modeling and live-coaching to provide parents the help that many have wished for – a trained professional whispering specific techniques in their ear.

While the parent and child are engaged in play, the therapist coaches from behind a two-way mirror via a microphone and earpiece device, allowing the therapist to assist in managing challenges as they occur.

Parent-Child Interaction Therapy (PCIT) is a 15-20 session, specialized treatment program designed for caregivers and their young children ( up to 10 yrs old) experiencing behavioral and/or emotional difficulties. PCIT has been found to help children who have any of the following:

• frequent temper tantrums
• act defiantly &/or refuse to follow directions
• backtalk or sass adults
• whine &/or cry easily
• are experiencing adjustment problems
• constantly seek attention
• interrupt others
• short attention span
• engage in power struggles with parents/caregivers
• difficulty behaving in school, preschool, and/or daycare
• are aggressive, who hit, throw things and express great anger
• may already be on medication to manage behavioral problems

• parents who have limited experience with children
• parents who have limited support
• parents who feel overwhelmed by their child’s behavior
• parents who feel angry at their child
• parents who have a child with an opposing temperament from their own
• parents who feel their child is out of control

PCIT has been proven to be highly effective in helping caregivers build warm and responsive relationships with their children, in improving overall behavior, and in reducing parenting stress. Upon completion of PCIT, parents report high levels of satisfaction, decreased stress levels, and positive changes in their children’s behaviors at home, school, and childcare settings.

• Improve parent/caregiver-child relationships
• Improve children’scooperation
• Increase children’s abilities to manage frustration and anger
• Increase children’s appropriate social skills
• Improve children’s attention skills
• Build children’s self-esteem
• Increase parenting skills
• Decrease caregiver’s stress

In addition to the appropriate training, it is important to select a therapist who is sensitive to the needs of your family. Your therapist should be able to explain the course of treatment, the role of each family member, and how your family’s cultural background will be addressed. Your family should feel comfortable with, and have confidence in, the therapist with whom you will work.

Training: What is the nature of your training? When were you trained? By whom? How long was the training? Do you have access to follow-up consultation? What resource materials on PCIT are you familiar with? Are you clinically supervised (or participate in a peer supervision group) by others who are trained in PCIT?

Treatment: Why do you feel that PCIT is the most appropriate treatment model for my child? Would my child benefit from other treatment methods at the same time, or after s/he completes PCIT (i.e. individual or group therapy).

Techniques: What techniques would you use to help my child manage his/her emotions and related behaviors? How will my family and I be involved in this process?

Assessment: Do you use a standard assessment process to gather baseline information on the functioning of my child and family and to monitor treatment progress over time?

Equipment: Do you have access to the appropriate equipment for PCIT (two-way mirror and audio equipment)? If not, how do you plan to structure the sessions to assure that the PCIT techniques are used according to the model?

Risk: Is there any potential for harm associated with this treatment?

The effectiveness of PCIT is supported by a growing body of research and increasingly identified on inventories of model and promising treatment programs. At least 30 randomized clinical outcome studies have found PCIT to be useful in treating children with behavioral problems. Research findings include the following:

Improvements in child behavior. A review of 17 studies that included 628 preschool-age children identified as exhibiting a disruptive behavior disorder concluded that involvement in PCIT resulted in significant improvements in child behavior functioning. Commonly reported behavioral outcomes of PCIT included both less frequent and less intense behavior problems as reported by parents and teachers, increases in clinic- observed compliance, reductions in inattention and hyperactivity, decreases in observed negative behaviors such as whining or crying, and reductions in the percentage of children who qualify for a diagnosis of disruptive behavior disorder (Gallagher, 2003).

Benefits for parents and other caregivers. Examining PCIT effectiveness among foster parents participating with their foster children and biological parents referred for treatment because of their children’s behavioral problems, researchers found decreases in child behavior problems and caregiver distress for both groups (Timmer, Urquiza, & Zebell, 2005).

Lasting effectiveness. Follow-up studies report that treatment gains are maintained over time (Eyberg et al., 2001; Hood & Eyberg, 2003).

Usefulness in treating multiple issues. Adapted versions of PCIT also have been shown to be effective in treating other issues such as separation anxiety, depression, self-injurious behavior, attention deficit hyperactivity disorder (ADHD), and adjustment following divorce (Johnson, Franklin, Hall, & Preito, 2000; Pincus, Choate, Eyberg, & Barlow, 2005).

Adaptability for a variety of populations. Studies support the benefits of PCIT across genders and across a variety of ethnic groups (Capage, Bennett, & McNeil, 2001; Chadwick Center on Children and Families, 2004; McCabe, 2005).

Improvements in parenting skills and attitudes. Research reveals that parents and caretakers completing PCIT typically demonstrate improvements in reflective listening skills, use more prosocial verbalization, direct fewer sarcastic comments and critical statements at their children, improve physical closeness to their children, and show more positive parenting attitudes (Hembree-Kigin & McNeil, 1995).

Reductions in the risk of child abuse. In a study of 110 physically abusive parents, only one-fifth (19%) of the parents participating in PCIT had re-reports of physically abusing their children after 850 days, compared to half (49%) of the parents attending a typical community parenting group (Chaffin et al., 2004). Reductions in the risk of abuse following treatment were confirmed by another recent study among parents who had maltreated their children (Timmer, Urquiza, Zebell, & McGrath, 2005).

Information from Child Welfare Information Gateway

Problem Areas
– Anger/Stress management
– Disobedience/Acting out
– Tantrums/Aggression
– Sibling Rivalry
Treatment Goals
– Bond with your child
– Improve parenting skills
– Improve coping skills
– Decrease behavior issues
– Reduce stress

Other Services
– Treatment for Anxiety
– Coping with Loss/Grief
– Coping with Trauma/PTSD
– Family Issues & Dynamics