Parent-Child Interaction Therapy (PCIT) trains parents to help their children develop emotional and behavioral skills. PCIT directly teaches many parenting skills through two phases: child-directed interaction and parent-directed interaction. The step-by-step approach is accessible to a wide range of families and situations and is strongly backed by decades of research. PCIT sees parents as the agents of change so children can receive daily guidance, helping families progress faster and more effectively.

What Are the Benefits of PCIT?

For children under the age of 10, there is not a therapy that exists that is as strongly supported by the research as PCIT. It has had a proven track record for decades.

PCIT can bring many benefits for the entire family. Many basic parenting skills don’t come naturally. A lot of problems resolve as parents begin to learn the basic skills taught in the first phase.

What happens when a plan you made goes awry, and you didn’t have a backup plan? Even a great plan that starts out well can end poorly. PCIT provides coaching not only for developing basic parenting skills, but also for handling situations that go wrong. This very structured approach is what makes PCIT so effective and universal.

As families progress through PCIT, the parent-child relationship strengthens, parenting confidence increases, and family stress reduces. Children display greater compliance and have fewer tantrums. Research suggests that families continue to see benefits long after ending therapy because of its direct, practical approach to skills instruction.

What Happens During PCIT?

PCIT occurs across two phases. In phase one, child-directed interaction (CDI) focuses on strengthening the parent-child relationship. Parents learn special play skills called PRIDE skills:

* Praise

* Reflection

* Imitation

* Description

* Enthusiasm

Parents will learn the skills during the sessions and immediately apply them at home. These skills help children feel seen, heard, and valued.

Learning these skills may feel awkward at first. When I started training in PCIT, I felt awkward copying what 4- and 5-year-olds were saying and describing their behavior. My supervisor advised me to practice the same techniques with my friends and colleagues. To my surprise, they liked it! When I described the skills I was using, they told me they liked receiving praise and attention!

Another component of the CDI phase includes three “don’t skills”:

* Don’t ask questions

* Don’t give commands

* Don’t criticize

Reducing or eliminating these behaviors improves the parent-child relationship and increases compliance whenever parents do use commands.

The second phase transitions to parent-directed interactions as parents learn how to give and enforce commands. Parents learn how to give clear directions, set appropriate limits, praise compliance, and enforce consequences consistently. Children gain an understanding of expectations and develop self-control.

During the second phase, I sometimes deviate from the PCIT manual. Not everyone’s situation is the same. For example, what if the child is too big or heavy to carry, what if you have a small apartment, or what if there are siblings? I get creative and modify the second phase to best reflect the individual family’s needs. This helps strike the balance between pursuing treatment fidelity and effectiveness.

How Long Does PCIT Take?

The short answer: it depends. The long answer: the length of treatment varies depending on each family’s consistency, goals, and progress. PCIT focuses on skill mastery rather than a fixed number of sessions. Families continue learning until they feel confident using their skills independently. Some families complete treatment in a few months, and others need more time to hone their skills.

What Makes PCIT Different from Play Therapy?

In play therapy, the therapist focuses on building a relationship with the child. Then, the therapist uses the positive relationship to engender change in the child. If I were the play therapist, I could train your child to obey me, listen to me, and trust me. However, I would rather teach your child to listen, obey, and trust you. The parent-child relationship is much more important. A therapist will only be with your child once each week, and therapy should not be needed long-term, particularly for children.

Who Can Benefit from PCIT?

PCIT was originally developed for young children with challenging behaviors. Research has shown that it can benefit children with a variety of concerns. These include tantrums, defiance, aggression, noncompliance, ADHD, and anxiety.

A main benefit of PCIT is that even parents who have emotional or cognitive struggles of their own can develop fundamental parenting skills. Whether you begin with lower confidence and few parenting skills or higher confidence and many skills, PCIT can provide the instruction and guidance you need to help your family.

Is PCIT Right for My Family?

PCIT is a great fit for families seeking more positive interactions at home. Consider PCIT if your child frequently struggles with general issues such as managing emotions or following instructions. PCIT does not directly address very specific behavioral issues, such as skin-picking or toileting. On the other hand, PCIT can provide a great foundation of basic skills upon which we can address specific behavior needs.

If you feel frustrated, overwhelmed, or unsure about how to help your child, PCIT can help build your confidence. For PCIT to work well for your family, however, you must be willing to be involved and committed. In some forms of therapy, the child attends alone without much parental involvement. Somehow, the parents and the therapist think the child will magically improve without parental support throughout the week. Some might even think the child is improving because they like their therapist. While we do hope a child will like their therapist, it is much more important that the child improves. Therefore, PCIT requires significant involvement from parents with the promise that families can achieve real progress.

Final Thoughts

When I had my firstborn, I sat admiring her, thinking that I couldn’t believe they would let me out of here with this tiny human! I wish they had sent me home with a manual to accompany her. Parenting is hard! Kids tend to push parents past their comfort zones. My graduate training, working in the schools as a school psychologist, and working alongside other psychologists has provided helpful knowledge and tools for my own parenting. I hope I can use my knowledge and tools to give other parents confidence that they can be “good enough” with their parenting as well.

If you have questions about PCIT or would like to begin PCIT, please contact the office.

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Post written by Dr. Krystal Mendez, Licensed Psychologist with Provisional Status

Please note posts are educational in nature and are not intended to replace psychological services when needed.