Are you embarrassed by your child’s tantrums? Do you get tired of fighting to keep their attention? Are you frustrated with their destructive outbursts? A form of child therapy called PCIT could help.
If you are struggling with your child’s behavior, you are not alone. Parenting can be an extremely challenging undertaking. Without a manual for each of life’s little moments, parents are left to fend for themselves to determine the best decisions for their children. There are times when it can seem like no matter what you do, your child will always be the screaming one in the middle of the grocery store earning you dirty looks from the other shoppers.
In a world where social media shines a spotlight on “right” and “wrong” parenting styles, you may feel even more isolated in your struggles with your child’s inappropriate behavior. Fortunately, there is help available to improve your child’s disruptive behaviors and equip you with the resources you need to reestablish a strong relationship with your child.
PCIT: What is it?
Parent-Child Interaction Therapy, or PCIT, is a well-studied therapy used to improve a child’s behavior and relationship with their caregiver. In PCIT, parents or other caregivers, their children, and a therapist work together to improve the relationship between the caregiver and the child. Therapists who practice PCIT help coach parents through these struggles with their children to improve their interactions and ultimately improve their child’s behavior.
PCIT focuses on the relationship between the child demonstrating bad behaviors and their caregiver(s). In PCIT sessions, therapists work with children and caregivers to promote more consistent parenting and improve obedience and the attitude of the child. By focusing on both pieces of the relationship, PCIT can create lasting change and a healthier relationship for parents and their children.
How Does PCIT Suggest the Mind Works?
PCIT was created under the assumption that improving a child’s relationship with their parent or caregiver would decrease their negative behaviors. It suggests that when a parent demonstrates consistent expectations and disciplinary actions, their child is more likely to listen because they have a clear understanding of what they are expected to do and the consequence if they do not.
PCIT also teaches parents how to praise their child’s good behavior while ignoring their bad behavior. This strategy is helpful because children naturally seek approval and attention from their caregivers, and when they learn that this is associated with their good behaviors, they will be more likely to exhibit those behaviors. Research has shown this method of improving the caregiver-child relationship results in better child development and improvement in the child’s overall behavior.
How Does PCIT Cause Change?
PCIT has been proven to be effective for causing change in problematic behaviors in both parents and children. Therapists utilizing PCIT help parents improve the relationship with their child by coaching them on appropriate interactions to reinforce positive behaviors and reduce negative behaviors.
The focus of PCIT is to achieve this reduction in negative behaviors by improving the child’s relationship with their caregiver and improving their self-esteem. Building a strong relationship between the caregiver and the child improves the child’s trust in their guardian and allows for improved communication between the two. All of these improvements contribute to the child’s future development.
What Happens in a PCIT Session?
PCIT can be applied in different environments, but the structure is consistently applied. During a therapy session, the therapist observes the parent or caregiver playing with their child. This can be done through a one-way mirror or online through telemedicine platforms. The therapist is able to communicate with the caregiver through an earpiece during these play times to share techniques and strategies with them in order to improve their interaction with their child.
After this portion of PCIT is over, the therapist often goes over the progress between sessions with the caregiver, and they may assign them small homework assignments to practice what they have learned in their home environment. The sessions continue until the parent demonstrates that they have mastered the techniques provided in their PCIT sessions and their child’s behavior is improving.
Techniques Used in PCIT
PCIT is typically performed in a two-phase approach. The first phase of PCIT is called Child-Directed Interaction, or CDI. During this phase, the therapist observes the caregiver interacting with their child and teaches them how to reward their child for positive behavior. The therapist also gives the caregiver strategies to ignore a child’s negative behaviors. The skills taught during this phase are often referred to using the acronym PRIDE.
- Praise: Caregivers are taught to consistently praise their child for demonstrating good behavior.
- Reflection: The caregiver reflects on what their child is talking about by repeating back their words and adding their thoughts to encourage their child to continue talking with them.
- Imitation: The child’s behavior is imitated by the caregiver to demonstrate their consent of that action or activity.
- Description: The caregiver observes their child and explains what they are doing to help their child develop a stronger vocabulary and further demonstrate their attention.
- Enjoyment: The caregiver shows their child that they are having a good time playing and talking with them.
Once the therapist feels that the parent or caregiver has mastered the first phase of PCIT, they can move to the second phase. This phase is called Parent-Directed Interaction, or PDI. During this phase of PCIT, the caregiver is taught how to consistently give direction to and discipline their child.
To accomplish this, the therapist provides instructions for the parent to give the child and directs them in making sure the child obeys. If the child does not obey or acts out, the therapist helps the parent appropriately enforce a disciplinary action. If the child listens, the caregiver is taught to reinforce this behavior by praising them.
Does PCIT Work?
PCIT is an extremely well studied and effective therapy for behavior disorders in children. It has been proven to improve disruptive behaviors in children, and it has also been shown to help reduce depression and stress in parents and caregivers. While it was originally developed for children with behavioral problems, it has since been studied and applied in many other populations.
What Kinds of Concerns is PCIT Best For?
PCIT has the most evidence for helping children aged 2-7 years old with behavior problems. It has been found to help children who do not listen to their parents, who act out to get attention, or who are aggressive towards others. It has also been adapted to help children who have suffered from abuse or trauma or those who demonstrate signs of anxiety. It has been applied in cases of ADHD and autism as well. While the goals of these therapy sessions may differ for these different cases, the strategies used and techniques taught to parents are the same.
How Are PCIT Specialists Trained?
PCIT specialists are expected to be licensed mental health providers with at least a master’s degree in counseling or mental health and be licensed in the state they practice in. Providers who provide services under a licensed provider can also be trained in PCIT. PCIT International offers a certificate in PCIT. This certificate is awarded if providers complete the required workshops and training time.
Concerns/Limitations of PCIT
PCIT is an extremely effective method for improving the relationship between a caregiver and child. Because it involves a high level of commitment from the caregiver, it may not be the best option for children with parents or caregivers that have minimal contact or are unable to participate in therapy due to a history of abuse or substance abuse.
It can also be difficult to implement if the parent is unable to use the earpiece to hear the advice of the therapist during each session, so parents who are hard of hearing or unable to wear the earpiece might not be able to participate in the traditional PCIT sessions.
Important Practitioners in PCIT
Sheila Eyborg is credited with developing PCIT in the 1970s. She combined and restructured multiple recognized therapy techniques, including social learning theory, behavior therapy, and play therapy, to create PCIT to help children with behavioral issues. Cheryl McNeil and Toni Hembree-Kigin played an important role in helping practitioners utilize this therapy by creating a guide for PCIT. Robin Gurwitch, Beverly Funderburk, and Anthony Urquiza were also notable therapists who created manuals for applying PCIT to other specific pediatric populations.
How to Find a Therapist
There are many resources available to help you find and choose a therapist who can help you and your child through PCIT. Talk with your child’s pediatrician to see if they are aware of any providers in your area who offer PCIT, or seek out a school guidance counselor for help finding a therapist. When you identify your options, evaluate their qualifications and talk with them to determine which therapist would work best with your family.
What Should I be Looking for in an LMHP?
When you are looking for a LMHP for PCIT, there are some important qualities that can help ensure you and your child receive excellent care.
- Trained: It is important to find someone with the appropriate qualifications. There are training programs available to providers to ensure they are adequately prepared to offer PCIT to children and their caregivers. Ask each therapist if they have received training in PCIT.
- Adaptable: Each child and situation is unique. Talk with each LMHP about their ability to adapt PCIT to different problems or situations, and see if they think they can work with you and your child.
- Approachable: Although PCIT does not have as much direct interaction between children and the therapist as other forms of therapy, it is important that you and your child feel comfortable with the LMHP you choose. This will help you openly discuss your concerns and help your child feel comfortable interacting with you and the therapist.
There may be other qualifications or traits that are important to you and your child. These should be considered when choosing with LMHP you will work with.
Questions to Ask a Potential Therapist
There are many questions you can ask your potential LMHP before and during PCIT therapy. They include:
- What is your experience with PCIT?
- What types of behavioral problems have you worked with in the past?
- How many sessions should we expect to participate in?
- How will you communicate your suggestions to me during therapy?
- Will there be homework assignments?
- How fast should I expect to see improvement in my child’s behavior?
- What caused or could have contributed to my child’s behavior?
- What caregivers should be involved in this therapy?
- Do I need to explain these techniques to my child’s school or daycare?
Find a Therapist Now
Finding a therapist for provide PCIT does not have to be challenging. Online therapy is a great option for working with a therapist. ThriveTalk has many therapists available with a wide variety of qualifications to help you receive the help you and your child need. Online therapy allows you to work with a therapist while in your own home, allowing you to apply the techniques they recommend in real-life situations.
PCIT is a proven therapy to help you if your child is struggling with behavioral problems. While it was originally developed to help decrease destructive or aggressive behavior in children, this therapy has now been successfully applied to children who have experienced past trauma or who have developmental concerns as well.
By learning how to provide consistent praise and discipline for your child, you can strengthen your relationship with them and ultimately provide them with the improved self-esteem and trust they need to improve their behavior. PCIT can also benefit you by lowering your stress level and helping to improve your mood.
If you are concerned about your child’s behavior or development, consider PCIT to help guide both of you to a healthier, happier life.