MARIA PISTORIO LPC, NCC

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: 

• Increased compliance

• 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.