Many families express finding it difficult to identify appropriate and effective treatments for young children. It can be hard to tell if play or talk therapy approaches for young kids are addressing the core challenges that they and their families face. At the same time, young kids are less likely to engage meaningfully in individual cognitive behavioral therapy approaches due to limited developmental capabilities. Parent-Child Interaction Therapy was designed to facilitate prosocial behavior change for kids between the ages of 2 and 7, through the scaffolding of parents. It still incorporates play, to keep it fun and engaging for the child, but each step of treatment is intentionally building skills that the child needs to succeed.
PCIT was originally designed to treat behavioral problems, including social, behavioral, and emotional difficulties related to Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD). Many common challenges that are addressed are: frequent temper tantrums, refusing to follow directions, physical and verbal aggression, destruction of property, whining, inappropriate speech, hyperactivity, and behavioral difficulties at school or with peers.
PCIT addresses these challenges through a two-phase treatment process. The first phase is called Child Directed Interaction (CDI). In this phase, treatment emphasizes the power of a positive bond between parent and child, and the abilities of praise and attention to shape prosocial behaviors. In CDI, caregivers learn and master skills, through consistent practice and coaching, how to maximize positive praise, and how to use attention as their superpower to encourage or discourage behaviors during small time-periods of child-led play.
CDI comes first, to enhance the caregiver and child bond, and to set the stage for the second phase. The second phase of PCIT is called Parent Directed Interaction (PDI). PDI is introduced once caregivers have mastered the positive skills taught in CDI. In PDI, caregivers learn skills and strategies that help them be consistent, reliable, and predictable when delivering consequences to or holding limits with their child. Some of the strategies include learning how to give effective and clear commands that young children can understand, and how to structure effective consequences, like time-out.
Throughout both phases, the therapist teaches the caregivers the appropriate skills, and then the following sessions consist of live practice with coaching from the therapist. PCIT uses a “bug in the ear” system to give instruction and encouragement in real time to the caregiver to enhance their proper use of the skills. Traditionally, this process was done through a one-way mirror, but it has been found to be equally effective over Zoom.
PCIT has been tested in research over and over since it’s creation in 1970, and it is widely recognized as the gold-standard treatment for young children with behavioral difficulties. Researchers have proven that PCIT results in greater child compliance with parent and teacher requests, greater child attention span and more frequent prosocial behaviors, liking sharing or taking turns, increased attachment between parent and child, better behavior at home and in public, greater child feelings of self-esteem, safety, and security, and greater parent confidence in their ability to handle challenging moments with their children. In addition, PCIT results in a decrease in frequency and severity of tantrums, aggression and destruction of property, hyperactivity and negative attention-seeking behaviors, and parent stress.
The overarching goal in PCIT is to help caregivers create and maintain a nurturing, positive, and consistent environment for raising their child through specific skills and strategies that help safely set limits and encourage positive behaviors. The parent-child bond is powerful, and when healthily maintained, it can be a source of learning, security, and love for the child.
Since PCIT has had so much success, it has been adapted to address many different challenges that young kids may face.
Want to learn more?
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