What Is Parent-Child Interaction Therapy?

Table of Contents
View All
Table of Contents

Parent-child interaction therapy is a type of therapeutic intervention available for the parents and guardians of children between the ages of 2 to 7 who aim to strengthen the connection with their child and reduce unwanted disruptive behaviors, such as tantrums, acting out, and aggressiveness.

This article will explain what parent-child interaction therapy is, how it works, and ways to get started with a trained therapist.

A little boy uses sign language to talk to a woman

Catherine Falls Commercial / Getty Images

What Is Parent-Child Interaction Therapy?

Parent-child interaction therapy (PCIT) is a therapeutic approach to helping parents learn to work with their children to have fewer disruptive behaviors. This approach is based on a basic understanding that the relationship between a child and adult caregiver is critical to boundary setting and behavior.

PCIT focuses on developing a positive connection between the child and caregiver and using appropriate discipline that emphasizes positive reinforcement for good behavior. Parents are coached or guided the entire time by the therapist, and feedback is based on observations the therapist makes during interactive sessions between the child and caregiver.

Efficacy of PCIT

Research shows that even engaging in as few as four parent-child interaction therapy sessions can have a significant impact on improving a child's behavior. Those who complete all of the sessions will see the biggest and most impactful behavioral changes.

Who Can Benefit From Parent-Child Interaction Therapy?

Parent-child interaction therapy is the most widely studied and accepted treatment method for children with behavioral problems. This can include those exhibiting disruptive behaviors consistent with conduct disorder and oppositional defiance disorder and some challenging behaviors from those with an autism spectrum disorder.

This type of therapy can also be helpful for children who have difficulty with emotional and behavioral regulation, such as those with attention deficit hyperactivity disorder (ADHD), as well as those experiencing other mental health concerns like depression or anxiety.

Though it is common for young children to express defiance and aggressive or disruptive behaviors from time to time, some children consistently show concerning behaviors. Early intervention can help prevent these unwanted behaviors from getting worse over time. Some examples of behaviors that can be treated through parent-child interaction therapy include:

  • Verbal or physical aggression
  • Hyperactivity
  • Whining
  • Noncompliance
  • Perfectionism

How Does Parent-Child Interaction Therapy Work?

With parent-child interaction therapy (PCIT), the therapist observes behaviors and interactions between the parent or guardian and the child and provides coaching on what to say and how to interact. There are two ways this is done:

  1. With parent-led behaviors and interactions
  2. With child-led behaviors and interactions

The therapist will usually start each session by providing some education to the parent or guardian about the expectations and then following with guided coaching. This is often done with the therapist out of the room and observing through a one-way mirror while communicating with the adult through an earpiece. The coaching provided encourages the parent to be calm, supportive, positive, and reassuring in their interactions with the child.

Parent-Led Phase

During the parent-led interactions phase, the parent or caregiver positively responds to the child's good and welcome behaviors. When the child shows a negative or unwanted behavior, the parent calmly corrects or redirects the child in a predictable way by offering clear and pre-communicated consequences to the child's actions.

Parents are encouraged to speak calmly and with a neutral tone while clearly delivering the consequence. This allows the child to know upfront what the consequences of their actions will be.

Child-Led Phase

During the child-led interactions phase, the parent follows the child's lead during play and other interactions. The child decides what activities to engage in and how the play should unfold while the parent engages positively without directing the behavior in any way. Negative behaviors are ignored by the parent during this phase unless they are aggressive, in which case, the parent will end the playtime.

Practicing Skills at Home

Successful PCIT includes completing weekly homework assignments outside of therapy sessions. Research shows that the most significant changes occur when parents practice the skills they learned in session at home with their child.

How to Get Started

Therapists who provide parent-child interaction therapy have special training and certification. If you currently see a therapist, you can ask for a referral to someone who specializes in this type of therapeutic approach. You can also search for a trained therapist on a PCIT-specific site, like PCIT International, or by using a general therapy-finding tool.

You might also be able to obtain a referral from your healthcare provider or health insurance carrier. The important thing is to make sure the therapist has specialized training and full certification in this type of intervention.

Summary

Parent-child interaction therapy can be a helpful option for parents and caregivers who are looking to learn ways to help manage their relationship with their child, support their positive behaviors, and better control their negative behaviors. PCIT is available for parents and their children who are between the ages of 2 and 7.

During PCIT, a trained therapist will educate the adult on what to expect and how to intervene with the child's behavior. This is done in two phases, which include parent-led sessions and child-led sessions. The goal for PCIT is to learn how to ignore a child's negative behavior, intervene appropriately to a child's aggressive behavior, and reward a child's good behavior.

To find a PCIT-trained therapist, specific sites, like PCIT International, list certified providers. Referrals can also come from healthcare providers and health insurance carriers.

A Word From Verywell

If you have trouble connecting with your child or are concerned about their behavior, parent-child interaction therapy (PCIT) may be a good option. This type of therapeutic intervention goes beyond traditional talk therapy. It involves the parent learning what to say and do to encourage the child's positive behaviors and lessen negative or aggressive ones.

Raising a child can be difficult, especially when you are worried about how your child is acting and whether you are helping or hurting things with your parenting style. You can talk with a certified PCIT therapist for detailed information about how sessions work and what to expect.

Was this page helpful?
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Weisz JR, Kazdin AE. Evidence-based psychotherapies for children and adolescents. Third Edition. Guilford Publications; 2017.

  2. Lieneman CC, Quetsch LB, Theodorou LL, Newton KA, McNeil CB. Reconceptualizing attrition in parent–child interaction therapy: “dropouts” demonstrate impressive improvements. Psychol Res Behav Manag. 2019;12:543-555. doi:10.2147/PRBM.S207370

  3. Hembree-Kigin TL, McNeil CB. Parent—Child Interaction Therapy. Springer Science & Business Media; 2013.

  4. Thomas R, Abell B, Webb HJ, Avdagic E, Zimmer-Gembeck MJ. Parent-child interaction therapy: a meta-analysis. Pediatrics. 2017;140(3):e20170352. doi:10.1542/peds.2017-0352

  5. Parladé MV, Weinstein A, Garcia D, Rowley AM, Ginn NC, Jent JF. Parent–child interaction therapy for children with autism spectrum disorder and a matched case-control sample. Autism. 2020;24(1):160-176. doi:10.1177/1362361319855851