What is Parent-Child Interaction Therapy?

Psychology Today defines Parent-Child Interaction Therapy (PCIT) as a combination of play therapy and behavioral therapy for children and their caregivers. In this form of therapy, adults learn how to relate to and help children with emotional or behavioral problems, developmental disabilities, and mental health disorders. It is most effective for children ages 2 to 7 years old and has been shown to help children who are on the autism spectrum, as well as those who have experienced trauma or display disruptive behavior.

How Does it Work?

Parent-child interaction therapy has a wide range of behaviors it addresses in the caregiver-child relationship. Some of the negative behaviors it targets are swearing, fighting, temper tantrums, arguing, low frustration threshold, as well as many more. These issues commonly stem from one central issue, most often a behavior learned and perpetuated by the caregiver. PCIT helps to break the habit of bad behavior through coaching the parent in techniques to deal with their own behavior, which the child will, in time, learn to use.

To effectively help caregivers and children, a therapist typically observes their interactions from another room, usually through a one-way mirror, while the child and caregiver play and interact together. The therapist coaches the adult through interactions with their child, usually through an earpiece. Negative language is discouraged by the therapist and caregivers are instructed to use positive reinforcement to encourage good behavior, while ignoring behavior that is negative but harmless. Caregivers are also taught to help the child’s communication and vocabulary by using similar language as the child and describing things out loud to the child, as well as to show approval by imitating the child’s good behavior. The goal of PCIT is that the relationship between the caregiver and child improves, therefore improving the behavior of the child.

What are the Benefits of PCIT?

The biggest benefit of PCIT is that a caregiver can improve their relationship with the child. It is important that caregivers establish a positive relationship with the child while still maintaining their role as the caregiver or parent. Parent-child interaction therapy teaches caregivers how to communicate and respect their child, in turn leading to another benefit of PCIT: reducing child abuse. Often, when caregivers are frustrated, they say and do things that can be hurtful or emotionally abusive to the child. Most caregivers aren’t even aware of this behavior, as it was how they were disciplined as a child. Parent-child interaction therapy helps to stop the cycle of abuse by teaching the caregivers how to effectively communicate with their child without emotionally or physically abusing them.

According to Christina Lorella at Encompass, a program that provides resources to families with children with special needs based out of North Bend, WA., the way caregivers cope with frustration and stress relates directly to children’s abilities to process their own emotions. She writes that while there are no concrete indicators of what will make a caregiver abusive, it is estimated that at least thirty percent of abusers were abused as children, leading to a higher chance of them being abusive to their own children. Because these adults lacked positive parenting models, they tend to react poorly to stressful situations with their own children, which can lead to unwanted behavior from the child. However, is it important to note that being abusive does not mean parents or caregivers do not love their children. They simply have not learned to parent in a positive manner.

The intent of parent-child interaction therapy is to empower caregivers to respond predictably and consistently with effective parenting before emotional or physical abuse has a chance to occur. With positive interactions between the caregiver and the child, the child’s behavior will improve and the relationship between the child and caregiver strengthens. In children, PCIT reduces anxiety, depression, ADHD symptoms, negative attention-seeking behavior, and aggression, while increasing self-esteem, confidence, and helping speech to develop. PCIT also helps caregivers be consistent with discipline, helping children feel safer knowing what to expect from their caregiver.

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