PCIT: Parent Child Interaction Therapy

Most of us cannot recall our emotions and feelings when we were two years old. We can look at pictures of ourselves when we were two, but we most likely cannot recall the feelings (perhaps fears) that we encountered when we transitioned from infant to toddler. We became mobile, daring to up our gait from small steps to a run. We became self aware. And the notion of language became part of our learning journey. Some toddlers move through this transition with little difficulty while others may struggle and develop behavioral problems and conflict with parents or caregivers.

Problematic cases that cannot be solved at the home level include these behaviors. Child Behavior: Aggression, defiance, noncompliant, disruptive behavior and breaking the rules. Parental Behavior: Permissive, harsh, demanding, impatient and authoritative. When these behaviors escalate to the point where the family is not functioning at a healthy level, it may be time to seek the help of a professional certified therapist. One therapy that might be suggested is parent-child interaction therapy (PCIT).

What is PCIT? Parent-child interaction therapy focuses on children (between the ages of two and seven years of age) and their parents. To begin with the therapist may observe the interaction between child and parent to determine what interaction is positive and what interaction needs modification through coaching. The coaching may be in an individual or group setting and lasts on average from twelve to fourteen weekly sessions although more problematic cases may take up to twenty sessions.

Child parent interaction may be observed by the therapist via a two way mirror. The parent wears a microphone so they may receive real time feedback from the therapist. The negative parenting practices identified during the assessment period are decreased over time. Positive parental communication replaces negative communication by providing positive reinforcement to the child for good behavior and simply ignoring bad behavior. Increased praise for good behavior gradually replaces parental use of criticism and commands. Homework is given between therapy sessions to insure that the new interactions are taken back into the home environment. Progress is measured by tracking and charting behaviors.

It should also be noted that PCIT has been found to be an effective therapy with children who have limited attention spans as well as autism spectrum disorder. ADS symptoms may range from mild to severe but most always include social issues, and difficulty communicating. A pediatrician and or therapist will be able to advise if PCIT is right for a child with ADS.

After a sufficient period of coaching, usually between twelve and fourteen weeks, parents and therapist hope to achieve the following goals: the child’s behavior has returned to normal as evidenced by their display of feelings of safety, security and calmness, the child’s anger and frustration have diminished, parent-child relationship is closer as evidenced by less resistance and tension, and the child’s self esteem is improved as evidenced by improved social skills and the ability to share. If you are experiencing similar difficulty with your child (ages two to seven) PCIT may be an effective therapy. A professional certified therapist trained in PCIT will be able to advise you as to its appropriateness.

Colin B. Denney, Ph.D., is the Director of the Pacific Psychology Services Center in Honolulu, Hawaii, he is a Child Psychologist Honolulu.