Parent-Child Interaction Therapy (PCIT) is an evidenced-based treatment for children ages 2 to 8 who are exhibiting a range of behavior problems including oppositional and defiant behaviors, disobeying authority figures (parents/teachers), poor attention, impulsivity, withdrawal and anxious behaviors. PCIT has also been used successfully with older children. Evidence-based means that this treatment model has been researched and compared to other treatment models for children or control groups and has been found to result in superior treatment outcomes.
PCIT is a unique treatment approach because it actively involves the parents or caretakers of the child in the treatment. Live-coached, step-by-step sessions are used to teach the parent/caregiver specific behaviors and skills while they are interacting with their child. Treatment can be administered through the use of a transmitter-receiver system in which the therapist communicates real-time with the parent while the parent is interacting with the child or though the typical in-room therapist-patient interaction model.
Goals of PCIT:
- Improve the quality of the parent-child relationship
- Decrease child behavior problems with an increase in pro-social behaviors
- Increase parenting skills, including positive discipline
- Decrease parenting stress
Child Directed Interaction (CDI)
This phase addresses relationship enhancement. The focus of CDI is strengthening the nurturing aspects of the parent-child relationship which insures that the bond between the child and parent is secure and comfortable. During CDI the child directs a play activity and the parent is coached by the therapist to use positive reinforcement techniques while interacting with the child, Parents are taught to use certain skills (behavioral description, reflection, imitation and labeled praise) to enhance the parent-child relationship.
Parent Directed Interaction (PDI)
This phase focuses on the development of a structured and consistent approach to discipline. During this phase of treatment the parent takes the lead and learns how to give effective commands with consistent consequences for compliant and noncompliant behaviors. Parents are taught to use the skills learned in CDI to reinforce pro-social behaviors and to immediately consequent negative behavior with a structured time-out procedure. Parents are also taught how to handle their children in more demanding situations outside of the therapy room, such as tantrums in public places.
PCIT has been shown to be a very effective treatment program. Several studies have shown consistent improvements in parenting skills and attitudes, improvements in child behavior and a decrease in parental stress. Follow-up studies report that treatment gains are maintained over time. Several groups of experts in child development and Federal agencies have endorsed PCIT as a model program or promising treatment approach.