Professionals: What is PCIT?
Parent-child interaction therapy (PCIT) is an evidence-based behavior parent training treatment for young children with emotional and behavioral disorders that places emphasis on improving the quality of the parent-child relationship and changing parent-child interaction patterns. Children and their caregivers are seen together in PCIT.
Format: PCIT is based on many of the same theoretical underpinnings of other parent training models. However, the treatment format differs from many other behavior parent training programs that take more of a didactic approach to working with families. Specifically, parents are initially taught relationship enhancement or discipline skills that they are actually going to be practicing in session and at home with their child.
In subsequent sessions, most of the session time is spent coaching caregivers in the application of specific therapy skills. Therapists typically coach from an observation room with a one-way mirror into the playroom, using a “bug-in-the-ear” system for communicating to the parents as they play with their child. More recent advances in technology has allowed for coaching via video feed from another room which has reduced the need for adjoining clinical spaces. Concluding each session, the therapist and caregiver together decide which skills to focus on most during daily 5-minute home practice sessions the following week.
Traditional PCIT also differs from other parent training treatment strategies in that treatment is not session-limited. Specifically, families graduate from treatment when parents demonstrate mastery of skills and rate their child's behaviors as being within normal limits.
Below is a brief example of what PCIT looks like at one agency that provides PCIT:
Efficacy of PCIT
PCIT outcome research has demonstrated statistically and clinically significant improvements in the conduct-disordered behavior of preschool age children: after treatment, children’s behavior is within the normal range. Studies have documented the superiority of PCIT to wait list controls and to parent group didactic training. In addition to significant changes on parent ratings and observational measures of children’s behavior problems, outcome studies have demonstrated important changes in the interactional style of the fathers and mothers in play situations with their children.
Based on well-controlled randomized controlled trials, PCIT has been categorized as a probably efficacious treatment for 3- to 6-year-olds with disruptive behavior (Eyberg, Nelson, & Boggs, 2008).
Further, PCIT has been rated as Promising by Blueprints for Healthy Youth Development as a treatment for young children with emotional and behavioral problems. The Blueprints website for PCIT lists additional information about PCIT including a Fact Sheet, Program Costs, Funding Strategies, and a Detailed Evaluation Abstract.
In terms of the use of PCIT for a child welfare population, there is a nice review of the literature from Child Welfare Information Gateway.
You can read further about PCIT research on our literature page.
Based on Baumrind’s (1966) developmental theory of parenting, Parent-Child Interaction Therapy (PCIT) draws from both attachment and social learning principles to teach authoritative parenting—a combination of nurturance, good communication, and firm control. Compared to other parenting styles, the authoritative style has been associated with fewer child behavior problems and better long-term mental health across many clinical populations.
Attachment theory holds that parental warmth and responsiveness underlie the development of a secure parent-child relationship, which contributes to the child’s understanding of relationships and to greater social-emotional regulation. A secure parent-child attachment, in turn, enhances the child’s desire to please and willingness to comply. In contrast, unresponsive parenting leads to insecure attachment, which is related to child aggression and poor peer relations. An insecure parent–child attachment is also related to increased maternal stress and risk of child maltreatment,
The specific behavioral techniques taught in PCIT are based on social learning theory, which emphasizes how contingencies shape dysfunctional interactions between disruptive children and their parents. To interrupt a cycle of escalating negative behaviors between parent and child, the parents learn to incorporate clear limit setting within the context of an authoritative relationship. PCIT posits that a strong, secure attachment relationship is a necessary foundation for establishing effective limit setting and consistency in discipline, which leads to improved mental health for both parent and child.
History of PCIT
Reference: Funderburk, Beverly W., Eyberg, Shelia. History of psychotherapy: Continuity and change (2nd ed.). Norcross, John C. (Ed.); Freedheim, Donald K. (Ed.); Washington, DC, US: American Psychological Association, 2011. pp. 415-420. [Chapter]