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PCIT

Ever wish you had someone to whisper in your ear what to say or do, in-the-exact-moment your child chooses to misbehave, withdraw, or cop an attitude? … Your wish has just been granted.

What is Parent Child Interaction Therapy?

As its name implies, PCIT addresses the interactions between the parent and child. Parents receive training on an interactional approach that has been determined to enhance the parent-child relationship, increase the child’s self-esteem, and provide skills for children in numerous domains of development.

The parent and child play in a comfortable, interruption-free room, their relationship and interactions are directly observed by the PCIT therapist through a one way mirror. This arrangement supports the child in acting natural and being himself with his parent. These are two of the unique and valuable attributes of PCIT: 1) the therapist observes the parent-child dyad without being part of the interaction, and 2) the parent receives immediate step-by-step coaching that is fine-tuned to their child’s responses.


Birth parents of three daughters, ages 2 – 6 at the start of therapy. The client was the middle daughter, aged 4 – 5 during PCIT therapy.

The overarching goals of PCIT are:

  • Enhance the parent’s attunement to their child; gain a heightened awareness of their child’s cues, and a clearer understanding about the “whys?” for their child’s behavior
  • Sweeten the satisfaction that the parent and child experience with each other
  • Strengthen the parenting skills that support their child’s development and optimal well-being
  • Expand the child’s knowledge base, communication and life skills, and support their emotional stability
  • Improve the child’s relationships and emotional well-being

Progressing through the PCIT protocol the child’s initially identified behaviors and mental health concerns dissipate and are replaced with higher functioning behavior and a happier child. The parent-child relationship becomes more peaceful and enjoyable. PCIT has been proven to significantly modify the behavior of children between the ages of 2 and 8 years.

PCIT helps the parent-child relationship by establishing expectations of mutual respect and cooperation from an early age. As parents consistently maintain these important expectations they facilitate greater ease in managing the relationship as their child moves into adolescence and begins to individuate.

Listen to Dr. Lisa’s Interview with Meridian Counseling

  • How does PCIT work?

    While parent and child play together the PCIT therapist discreetly observes their interactions through a one-way mirror and coaches the parent “in-the-moment” through an ear-bud.

    Dr. Cohen conducts three to four training sessions over the course of the treatment to introduce the PCIT curriculum. In between training sessions parents practice using PCIT skills with their child and receive real time coaching during “special play time.” As the parent demonstrates consistency and comfort applying the PCIT skills, the coaching evolves to help them better understand the strategies and subtleties involved in applying the most appropriate skill for each presenting behavior.

    The PCIT therapist observes typical parent-child interactions and behavior weekly. The therapist has numerous opportunities to test various theories that may be motivating a child’s behavior by directing the parent to apply PCIT skills and approaches until a desired behavioral outcome is reached. The PCIT approach with in-the-moment coaching enables the parent to integrate skills useful across multiple situations and environments.

    Once parents have mastered the PCIT skills, Dr. Cohen can travel with families, when needed, to address any high risk or lingering child behavioral challenges that are occurring in specific situations and environments; e.g., non-compliance in parking lots, aggressive behavior in playgrounds, inappropriate behavior at birthday parties or other errands, or events.

  • Who is PCIT for?

    PCIT is for families with children between the ages of two and eight years. It is for parents who want to experience more ease with parenting, improve their parenting skills, and enjoy family time more. It is for children who are having a difficult time navigating their emotions, controlling their bodies, handling challenging situations, or are demonstrating deficiencies in social, coping or problem solving skills.

    PCIT is exceptionally effective for addressing maladaptive behaviors and developmental delays with young children. PCIT also provides structure and support when children are having a difficult time adapting to, and coping with, significant life events.

    What follows is a more detailed list of the parent and child conditions, life circumstances and behaviors that are effectively addressed in the PCIT model.

    Parents/Caregivers:

    • Who may be feeling overwhelmed, depressed, stressed, or confused about how to respond to their child’s disruptive, emotional and challenging behavior.
    • Who want to learn how to create high quality interactions, facilitate closer relationships and strengthen bonds with their children.
    • Along with parents, significant caregivers and step-parents are encouraged to participate in the PCIT treatment.
    • When all the child’s caregivers engage in  effective interactions with the child, the consistency promotes the child’s understanding and integration of important family values and expectations.  Consistency across parents and caregivers also increases a  child’s sense of security, reduces anxiety,  and improves concentration, positively influencing the way the child relates with others.

    Children ages 2 thru 8, exhibiting any of the following or similar behaviors:

    • Difficulty functioning in school, preschool, or daycare
    • School refusal, separation anxiety, lying “story-telling,” or perfectionism
    • Aggression toward parents, siblings, other adults, children or animals
    • Disrespectful or oppositional  attitude toward adults; bullying others
    • Temper-tantrums, problems with emotional regulation, or poor frustration tolerance
    • Refusing to follow directions, defiant behavior, argumentative, or negotiating directives
    • Reacts impulsively to emotions; e.g., curses, spits, bites, pulls hair, destroys property
    • Attention difficulties, delays with coordination or language, hyperactivity, fidgets, can’t sit still
    • Invading others’ physical boundaries; unceasing need for attention
    • Socially immature, difficulties making and keeping friends, social anxiety
    • Sensory integration difficulties; spectrum challenges, Autism, Asperger’s Syndrome
    • Difficulties with transitions; difficulty coping with changes to routine
    • Traumatic stress responses including: nightmares, night terrors, problems sleeping, generalized anxiety, and recurrent triggers.
    • Unstable mood, low self-esteem, cries easily, tearful, whines, minimal joy, sluggish
    • Depressed, anxious, withdrawn, isolated, change in sleeping or eating patterns, fights bed-time, regressed self-care skills, refusing to dress self, sudden difficulties with elimination; i.e., unexplained constipation, or a loss of previously mastered toileting skills
    • Overwhelming emotional feelings following separation from a loved one, grieving a loss
    • Difficulty adapting to changes in family structure; e.g., divorce, separation, family blending, adoption or birth of a sibling
    • Multi-generational conflict, problem with a sibling relationship, insecure parent-child attachment
    • Emotional or behavioral difficulties related to immigration and assimilation status
    • Emotional or behavioral difficulties related to pediatric illness, fearing and resisting treatment protocols or procedures; e.g., injections, breathing treatments, infusions, changing bandages, wearing orthopedic braces, taking oral medications
    • Disabilities; cognitive, physical, sensory or global developmental delays.
  • How does PCIT benefit families?

    As an evidenced based therapy there have been numerous research studies done on PCIT attesting to the strength of the therapy.

    Sighting from one publication that reviewed the research on PCIT, participating families reported the followings outcomes:

    Enhanced parent-child relationships
    Increased positive and supportive interactions between parents and children
    Children improved in the areas of compliance, emotional stability, and mood.
    Families experience a new sense of freedom. Parents feel liberated by the improved well being and behavior of their child, enabling the family to comfortably “go out,” socialize, and travel.
    Children receive more invitations, increasing their opportunities for socialization
    Improved school performance.
    Children demonstrate improved frustration tolerance, patience, and ability to wait their turn.
    Parents have less anxiety about behavioral or emotional relapse, because they are confident in knowing how to respond, and what steps to take to support and manage their child’s challenging behavior.
    Increased satisfaction and joy in parenting
    In families with more than one child, the child who participated in PCIT ultimately became the family’s best behaved child.
    Teachers, relatives, and family friends noticed and commented on the positive behavior changes in the child.

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