WHAT IS PCIT

Parent-Child Interaction Therapy (PCIT) is an empirically-supported 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. PCIT utilizes a live-coaching model wherein parents are in a therapy room with their child while the therapist is in an observation room watching via one-way mirror and/or live video feed. The parent wears a 'bug-in-the ear' device through which the therapist coaches the parent live on the skills being learned in treatment.

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. 

THEORETICAL UNDERPINNINGS

The development of PCIT was based on Baumrind’s developmental research associating parenting practices with child outcomes. Baumrind demonstrated the importance of parents meeting young children’s dual needs for nurturance and for limits, which she described as authoritative parenting. Her research showed that to promote optimal child outcomes, we must focus on promoting optimal parenting styles and parent-child interactions. PCIT draws on both attachment and social learning theories to achieve authoritative parenting. Attachment theory asserts that sensitive and responsive parenting provides the foundation for the child’s sense of knowing that he or she will be responded to when necessary. Thus, young children whose parents show greater warmth, responsiveness, and sensitivity to the child’s behaviors are more likely to develop a secure sense of their relationships and more effective emotional and behavioral regulation. 

For this reason, in the first phase of PCIT parents learn the Child-Directed Interaction (CDI), which aims to restructure the parent-child relationship and provide the child with a secure attachment to his or her parent. Social learning theories emphasize the contingencies that shape the interactions of children and their parents. Patterson’s coercion theory provides a transactional account of early conduct-disordered behavior in which child conduct problems are inadvertently established or maintained by the parent-child interactions. Thus, in the second phase of PCIT parents learn the Parent-Directed Interaction (PDI), which specifically addresses these processes by establishing consistent contingencies for child behavior.