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What is Parent-Child Interaction Therapy?

Parent-Child Interaction Therapy – also called PCIT – is an evidence-based, short-term treatment designed to help young children with highly disruptive behavior learn to control their frustration. In PCIT, we work with each parent to strengthen their relationship with their child and build their confidence and ability to effectively guide and direct their child’s behavior, set limits, calmly discipline, and restore positive feelings to their interactions.  PCIT treats the parent, the child and most importantly their interactions. Families change one interaction at a time!

PCIT is regarded by national expert panels as a gold standard treatment because for most families:

  • it works (50+ years of research showing huge gains)
  • the gains last over time
  • the gains generalize to school settings
  • the gains generalize to siblings
  • it includes all the key elements found by the CDC (Centers for Disease Control and Prevention) to be essential in helping parents with disruptive kids
    • teaching parents emotional communication skills
    • teaching parents positive interaction skills
    • live in-session practice with your child during the session while the coach/therapist gives live, in-the-moment feedback (we use a bug-in-ear)
    • teaching correct use of safe time-out procedures
    • teaching and reinforcing parental consistency

Two age groups available:

  • PCIT 2-7 yrs old*
  • PCIT Older Child 7-11* years old

* Choice of which PCIT protocol depends on size and maturity and would be determined with your treating clinician. For families with children older than 11, there are other research-supported Parent Management Training (PMT) programs that we offer.

What does PCIT treat?

Children who display any or all of the following:

  • Parent-child relational problems
  • Refusal and defiance of adult requests
  • Emotional dysregulation
  • Low frustration tolerance
  • Easy loss of temper
  • Touchy or easily annoyed by others
  • Deliberately annoying others
  • Being spiteful or vindictive
  • Blaming others for their mistakes
  • Destruction of property
  • Difficulty staying seated
  • Difficulty playing quietly
  • Difficulty taking turns

Typical Internet Telehealth PCIT session. The parent is being coached by their therapist remotely and unobtrusively through either a wireless or wired headset.

Typical PCIT session done in the office setting using a discrete wireless earpiece for the parent to hear their therapist coaching while looking through the one-way mirror.

What diagnoses might PCIT be best suited to?

Children getting PCIT typically have one or more of the following diagnoses:

  • Oppositional defiant disorder (ODD)
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Autism spectrum disorder (ASD)
  • Other disruptive behavior disorders (DBDs)
  • Anxiety disorders
  • Selective mutism

How is PCIT structured? What are sessions like?

We use our state-of-the-art PCIT rooms for the treatment. The parent and child are on one side of our one-way mirror while the therapist coaches their interactions in real time using our bug-in-ear technology to coach the interaction live throughout the session. This keeps the interactions more “real” as it is just you and your child engaging in developmentally-appropriate activities.

In internet or telehealth PCIT, we work with you remotely to do the same exact treatment. Using headsets that are wireless or wired, we discreetly coach you through the structured sessions. Research shows the gains are as good or better when compared to in-office PCIT!

Parents learn to master skills in the two phases of the treatment the relationship phase (Child Directed Interaction) and the discipline phase (Parent Directed Interaction).

Why are there two phases in the treatment?

PCIT is a two-phase treatment. The first phase is called Child-Directed Interaction (CDI) which is our chance to help parents become incredibly good reinforcers – learning the best ways to pay attention to desired behaviors to reinforce good behaviors when they happen. We also teach the appropriate times and ways to ignore mild disruptive or inappropriate behaviors. After mastering these skills we move on to the discipline phase.

The Parent Directed Interaction (PDI) phase builds on, or scaffolds on, the skills you learned in the CDI phase and teaches your child how to obey more and behave better.  The treatment is so well designed that we start with practicing obeying and good frustration tolerance just in the clinic, before carefully rolling out the gains to your home setting. We are with you every step of the way with live coaching so that each and every session is a guaranteed success. This is called errorless learning.

How often are sessions? How long does treatment last?

Sessions are held weekly until a family graduates. While sessions are weekly, the most important work is the daily five minutes of practice parents need to do with their child at home. First you graduate in the CDI phase and then in the PDI phase. Graduation happens when:

  • Parents reach and maintain mastery of CDI skills, meaning they are top notch at being great reinforcers
  • Parents reach and maintain mastery of PDI skills, meaning they are top notch at limit setting and calm, assertive discipline
  • Parents rating of the child’s behavior returns to within “normal limits” – the same as typically developing children
  • Parents report being confident they can continue to use the skills in real life situations

Most families need 14-20 coaching sessions to complete the treatment.

Where does PCIT come from?

PCIT was developed in the 1970’s by Dr. Sheila Eyberg and has stood the test of time in research and clinical practice. PCIT was developed from three very important traditions in understanding child development, parenting practices, and developmental problems:

  • Attachment theory research (Bowlby)
  • Parenting practices research (Baumrind)
  • Social learning theory (Bandura)

PCIT International is the certifying organization to ensure quality control in how PCIT is delivered. Dr. Kurtz is certified as one of only 21 Master Trainers in PCIT. He and his team are committed to delivering PCIT at the highest level of integrity.

Adaptations of PCIT

PCIT started as a treatment only for disruptive behavior in young children. The clinical reach of PCIT has greatly expanded.  Adaptations of PCIT have been tested and found to be effective for:

  • Selective Mutism
  • Autism
  • Trauma-exposed children
  • Abusive, maltreating parents
  • Child Anxiety
  • Language-delayed children
  • Infants/toddlers
  • Hearing impaired and deaf families

PCIT Around the world

Over these 40 years, the reach of PCIT has greatly expanded.  21 Master Trainers have made PCIT available now in Holland, Germany, Australia, New Zealand, Japan, South Korea, Taiwan, Norway, and Hong Kong. Cultural adaptations and translations are part of the international process as needed.

What is Parent-Child Interaction Therapy? | Kurtz Psychology