Parent-Child Interaction Therapy

Parent-Child Interaction Therapy (PCIT) is an evidence-based therapy designed for children age 2-7 with emotional and behavioral disorders. As it’s name implies, PCIT focuses on the quality of the parent-child relationship and works to improve interactional patterns. Originally developed in the 1970s primarily by Shelia Eyberg, the therapy pulls heavily from attachment theory and social learning theory, and has evolved into one of the most effective therapy treatments. 

How Does PCIT Work?

The first step in PCIT is assessment. The clinician gathers biological, social, and psychological information about the child, administers a behavioral inventory, and observes parent-child interactions to gather baseline data. This may take 2 sessions. The clinician then reviews assessment results with parents and discusses appropriateness of PCIT for the family. 

PCIT involves two phases: Child-Directed Interaction (CDI) and Parent-Directed Interaction (PDI). In CDI, the aim is to strengthen the parent-child relationship. During this phase, parents learn basic play therapy skills and learn how to use only positive attention to shape child behavior. The therapist first teaches the skills in a parent-only session, and then actively coaches parent implementation of skills with their child in subsequent sessions. Coaching is typically done with the therapist in an observation room communicating with parents via a “bug in the ear” device.  Parents also complete daily 5-minute practice sessions at home. When parents have mastered CDI skills, they move on to the second phase of treatment.

The second phase, PDI, aims to improve compliance and discipline. PDI also starts with a parent-only session, in which the therapist teaches parents rules of effective commands and introduces a predictable and developmentally appropriate discipline procedure.  The therapist then actively coaches skill implementation with the child. As parents master those skills, the therapist generalizes skills and introduces house rules and rules for public behavior. PCIT is complete when parents have demonstrated mastery of CDI and PDI skills, when behavioral inventories are within a normal range, and when parents report confidence in their ability to have healthy interactions and manage behaviors.   

How Can PCIT Help?

Research with PCIT has shown it to be an effective treatment for improving parent-child relationships, reducing child conduct problems, improving child language, improving child focus and attention, and reducing parent stress. 

Can PCIT be adapted?

Yes, PCIT can be adapted. The clinician may provide PCIT for primary caregivers that are not parents, may stray outside of the typical age-range due to developmental factors, and may be adapted for different settings. Since our practice does not have an observation room, the clinician would do live, in-room coaching as opposed to the “bug in the ear” approach. This adaptation does not impact therapy outcomes. 

For more information, please visit the PCIT International website.