MARIA PISTORIO LPC, NCC
Parent-Child Interaction Therapy, Individual Therapy for Adults and Children, Parent Coaching, Family/Couples Therapy
EVIDENCE BASED CARE
Maria Pistorio is a Nationally Certified Counselor. She is also certified in Cognitive Behavioral Therapy (CBT) by Philadelphia College of Osteopathic Medicine, and is certified therapist and Within Agency Trainer by PCIT International.
PARENT-CHILD INTERACTION THERAPY
Parent-Child Interaction Therapy, commonly referred to as PCIT, is an exceptionally effective treatment backed by nearly 50 years of research. PCIT is a short term, specialized, evidence based treatment for children 2 to 7 years of age with behavioral issues and their families. PCIT teaches caregivers to manage the child’s difficult behaviors while increasing positive behaviors. In PCIT we work together to improve behavior and reduce caregivers’ stress.
Signs your child could be a good candidate for PCIT:
Easy loss of temper/frequent temper tantrums
Gets angry when told no
Yells, Screams and/or Whines
Aggressive towards parents or siblings
Caregiver-child relational problems
Refusal and defiance of adult requests
Destroys toys or other objects
Destruction of property
Overactive or restless
Difficulty staying seated/playing quietly
Acts defiant when told to do something
Refusal to follow house rules
Difficulty taking turns
Purposeful annoyance of others
Social skills deficits
PCIT typically is conducted with caregiver and child together in one room and the therapist observing either in another room or on a HIPPA compliant video platform where the therapist can effectively see how the child reacts with just the caregiver’s use of specialized behavioral skills. The therapist uses live coaching via a bug in ear device on how to increase use of those skills and how to respond to negative behaviors. Skills are acquired rapidly by caregivers as they practice in the moment with therapist support and caregivers gain confidence.
PCIT consists of weekly sessions conducted in two treatment phases. Child Directed Interaction (CDI) is the relationship enhancement phase of treatment. Parent Directed Interaction (PDI) is the behavior management part of treatment. Both phases equip parents with a skill set to manage the behavior of their child.
After completing the first phase of treatment, caregivers report:
Decreased tantrums and decreased severity of tantrums
Increase in behaviors such as sharing and patience
Decrease in attention seeking behaviors such as yelling, hitting, interrupting
Increased attachment to parent
After completing the second phase of treatment PDI, which is about making sure as a parent you are remaining calm but firm with boundaries with your child, parents report:
Improved behavior at home, in school, and in the community
Increased respect and compliance with rules
Decreased destructive behavior
Increased parental confidence
Decrease in aggressive behavior
PCIT is short term, but not time limited treatment. Proficiency of these skills obtained in treatment typically take 12-20 sessions with regular attendance and practice. PCIT will be considered complete once caregivers reach goals using PCIT skills, the child’s behavior is within normal limits, caregiver/child relationship is enhanced, and the caregiver feels confident in their skill set to help navigate negative-behaviors in their child.
There are proven adaptations of PCIT, including for toddlers, older children, children with depression and/or anxiety, as well as children adjusting to major stressors such as the loss of a loved one or caregiver divorce or separation. PCIT is appropriate for parents, foster parents, kinship caregivers, grandparents, and legal caregivers.
COGNITIVE BEHAVIORAL THERAPY
Cognitive Behavioral Therapy (CBT) is a mode of therapy that helps adults, adolescents, and children understand the relationship between thoughts, feelings and behaviors. Clients develop new ways of approaching how they relate to themselves, others, and the environment by challenging their thoughts, and themselves.
Sessions typically run 45-60 minutes in length, and are once a week. This is flexible based on your needs.
People who seek CBT can expect a very problem-focused and goal-directed type of therapy.
I will work with clients to mutually decide the best course of treatment during the first few sessions of therapy.
In addition to working on what thoughts lead to negative behaviors, clinicians with expertise in CBT also focus on the behaviors themselves and how to best modify them when they are presented. Through CBT, clients gain a strong set of coping tools to handle and adjust problematic beliefs, thoughts, emotions and behaviors.
Cognitive Behavioral Therapy has been found to be very effective for the treatment of a wide variety of mental health issues and disorders including:
Sexuality related disorders
Adjusting one’s approach to work, life, relationships, etc
CBT is most effective when clients combine in-session practice and “homework” outside of session utilizing skills learned during cognitive behavioral therapy. CBT equips clients with tools to tackle issues that come up in your personal life. CBT is like a muscle, the more you practice, the stronger you become.
DIVORCE COUNSELING FOR DIVORCING PARENTS
Divorce is never easy. Especially when children are involved. Divorce counseling can help ease the transition so that naturally occurring rough patches are manageable.
Divorce counseling can include coaching to navigate co-parenting. Regardless of marital status, when children are involved it requires parents to actively work towards finding common ground. Co-parenting coaching is useful in minimizing the negative impact divorce has on the family unit, in children specifically.
Each couple requires a unique treatment plan that is aided by a counselor evaluating the foundational issues. Both parties need to be invested in accomplishing goals, particularly when children are involved. With coaching, separated or divorcing couples can work towards amiable communication.
Coaching lets couples work towards finding common ground despite not being in a romantic relationship anymore which lays the groundwork for successful co-parenting.
The opposite actually; you are working towards healthy communication and improving the romantic connection between the two of you. Couples Therapy is for partners who are stuck in a destructive pattern but want to work towards repairing the interactions between themselves.
Why couples may seek out Couples Therapy.
Disproportionate fighting over minor issues
Differences in parenting styles
Lack of romance in the relationship.
Admitting therapy could be beneficial to your relationship is hard. Bringing a counselor into your relationship is intimidating! The goal is helping each partner feel more confident in expressing their needs. Couples learn how to relate in different ways through specific exercises and enhanced communication skills as they work towards creating safety and nurturing a loving relationship that works for both partners.
Parent Coaching involves one or both of the parental figures in a family unit. This type of treatment helps you identify your own strengths and weaknesses in your behavior and communication with the child. Treatment can either be in conjunction with the child’s treatment or separately for a more individualized, long term approach. Without judgement, the counselor can use evidence-based treatment to aid in improving the relationships in the family unit.
Here are a few issues that parent coaching can be useful for
How to manage your own feelings and stress surrounding discipline.
Behavioral issues such as defiance or aggressive behavior between siblings.
Difficult transitions such as divorce or loss of a loved one.
Strategies to support working through your own trauma to be a better parent.
Issues limiting screen time
Parenting children with Autism, ADHD or eating disorders.
Parent coaching can be solely focused on your family, or done in a group setting with other parents working through similar issues.
TRAINING CLINICIANS IN PCIT MODEL
PCIT Certified Trainers are sanctioned by PCIT International to provide expert training and consultation in the official PCIT protocol, leading to eligibility for certification as a therapist by PCIT International. Please contact for more information.
I love helping my patients develop the tools they need to cope with all of life’s challenges. Contact me today to learn more and book a session.