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Parent-Child Interaction Therapy (PCIT)

Reviewed by Psychology Today Staff

Parent-Child Interaction Therapy (PCIT) is a combination of play therapy and behavioral therapy for young children and their parents or caregivers. The adults learn and practice new skills and techniques for relating to children with emotional or behavioral problems, language issues, developmental disabilities, or mental health disorders.

The treatment was developed in the 1980s and 1990s by Sheila Eyberg, a psychology researcher and professor at the University of Florida. Eyberg wrote the Parent-Child Interaction Protocol and is the president and CEO of the group PCIT International.

When It's Used

Used mostly by parents and caregivers, this intervention teaches specific skills to help improve physical and verbal exchanges with their children. PCIT was developed for use with children ages 2 to 7 and has been shown to be effective for children who exhibit disruptive behavior or have experienced trauma, as well as those on the autism spectrum. PCIT and PCIT-based programs can also serve as interventions for preventing child abuse and neglect and for decreasing a child’s risk for antisocial and criminal behavior later in life.

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What to Expect

In Parent-Child Interaction Therapy, parents and caregivers play with the children in one room, while the therapist observes and coaches from an adjacent room equipped with a one-way mirror. The therapist communicates with the adults through an earphone, providing training and guidance. Parents and caregivers are discouraged from using negative language and encouraged to ignore harmless negative behaviors while showing enthusiasm and giving praise for positive behaviors. Therapists also help parents reflect the child’s speech back to them to help with communication, describing the child's actions out loud, improving the child’s vocabulary, and imitating the child’s good behavior in order to demonstrate approval.

These techniques aim to produce several outcomes for children, including:

  • Decreased frequency or severity of tantrums
  • Increased feelings of security, safety, and attachment to the primary caregiver
  • Increased attention span
  • Increased self-esteem
  • Decreased frequency, severity, or duration of aggressive behavior
  • Decreased frequency of destructive behavior and defiance

And for parents:

  • Increased calmness and confidence during discipline
  • Reduced stress and depression
  • Decreased frustration
  • More positive family interactions

During the COVID-19 pandemic, therapists increasingly used video calls with clients to conduct PCIT. Recent research finds that, due to the observational role of the therapist in the treatment, PCIT (in its digital form sometimes called iPCIT) is particularly useful as a teletherapy, where the video screen replaces the one-way mirror.

How It Works

By learning specific techniques, parents and caregivers can build a better relationship with a child, and the child may start to demonstrate improved behavior. Overall, PCIT can help improve family dynamics by reducing negative behavior and interactions within the family by practicing new behaviors and methods of communication that are encouraging and reassuring.

When practiced consistently, these new skills and techniques can instill more confidence, reduce anger and aggression, and encourage better individual and interactive behavior in both the parent and the child.

Researchers also find evidence for improved outcomes among untreated children in the family, likely due to the parent or caregiver’s overall enhanced skills.

What to Look for in a Parent-Child Interaction Therapist

Practitioners of PCIT must be certified by the group PCIT International, which requires practitioners have a master’s degree and additional training in the technique. PCIT therapists, social workers, and counselors work in private practice and in community mental health settings.

In addition to finding someone with the appropriate educational background and relevant experience, look for a therapist with whom you feel comfortable working on personal and family issues.

References
Ginn, N.C., Clionsky, L.N., Eyberg, S.M., Warner-Metzger, C.W., Abner, J.P., Child-directed interaction training for young children with autism spectrum disorders: Parent and child outcomes. 2017. Journal of Clinical Child & Adolescent Psychology. 2017;46(1):101–109.
Piquero, A.R., Jennings, W.G., Diamond, B., et al. A meta-analysis update on the effects of early family/parent training programs on antisocial behavior and delinquency. Journal of Experimental Criminology. June 2016;123(2):229–48.
Lyon, A.R. and Budd, K.S., A community mental health implementation of parent-child interaction therapy (PCIT). Journal of Child and Family Studies. October 2010;19(5):654–68.
Gurwitch, R. H., Salem, H., Nelson, M. M., & Comer, J. S. (2020). Leveraging parent–child interaction therapy and telehealth capacities to address the unique needs of young children during the COVID-19 public health crisis.Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S82–S84. https://doi.org/10.1037/tra0000863
Last updated: 11/28/2022