PCIT: Can It Work for Your Child?

By Cindy Keefe, Psy.D.


Children with ADHD and LD often struggle with low frustration tolerance, compliance, and other problematic behaviors or moods • Parent Child Interaction Therapy helps to strengthen the parent-child bond, decreases parenting stress, and improves child cooperation, behavior, and mood through the use of consistent discipline

The American Academy of Pediatrics recommends that doctors prescribe behavioral interventions (parent training) as the first line of treatment for children under age 6 with ADHD. In a 2010 Treatment Study, Parent Child Interaction Therapy (PCIT) was found to be one of the top parent training programs available today to help reduce the symptoms and problem behaviors associated with ADHD. Following is an introduction to PCIT.

What Is PCIT?

Parent Child Interaction Therapy (PCIT) is an evidenced-based, short-term parent coaching program designed to increase positive parent-child interactions for families with children ages 2 to 7 years old.

In PCIT, a therapist works jointly with the parents and the child to manage the child’s behavior as it occurs during the therapy session. By practicing specific techniques with the help of the therapist, parents gain increased confidence in independently managing their child’s behaviors at home and in public settings. On average it takes 4 months for the parents and the child to complete the PCIT program, with hour-long weekly sessions.

This evidence-based treatment, backed by over 20 years of research, has proven to be highly effective.

How Does PCIT Work?

During the first phase, called Child Directed Interaction Therapy (CDI), PCIT focuses on strengthening the attachment and relationship between the parent and the child. Parents are taught how to “be in the moment” with the child by becoming a calm, supportive presence during play therapy. Parents are taught play therapy and positive reinforcement skills, and learn to ignore negative behaviors and how to follow their child’s lead. Once they reach mastery in their CDI skills, they and their child move onto the second phase.

During the second phase, called Parent Directed Interaction Therapy (PDI), parents learn skills to improve child cooperation such as limit setting, consistency, predictability, following through, establishing household rules, and taking their child into public places. Once parents reach mastery in their PDI skills, they and their child graduate from the program. On average it takes between 12 to 20 sessions to complete the PCIT program depending upon the needs of the family. Follow-up booster and sibling sessions are offered on an as-needed basis.

What is Unique About PCIT?

In PCIT, the therapist coaches the parent through a one-way mirror and/or video camera set-up using a wireless headphone system. In this way, the parent is able to work one-on-one with the child without the therapist being in the room while still being supported and coached by the therapist. This type of coaching helps parents become more aware of what they are saying, increases parents’ attention and motivation, provides parental support in actual difficult situations, encourages parents not to give up, and demonstrates that change is possible.

Is PCIT Supported by Research?

PCIT is considered a highly effective treatment for children who have issues around cooperation and compliance. The PCIT program is backed by over 20 years of clinical research. Results show:

  • Significant decreases in child disruptive and non-compliant behaviors
  • Improvement in child internalizing behaviors (anxiety, depression) and self-esteem
  • Large decreases in parenting stress
  • Treatment effects generalizing into the home and school settings, and untreated siblings
  • High client satisfaction with the process and outcome
  • Improvements maintained at one and two year follow-up evaluations

Additional information on PCIT and certified providers can be found on the PCIT International website at www.pcit.org.

New Developments in PCIT

The traditional PCIT format is being expanded to include adaptations for children with anxiety, depression, autism and other special populations (e.g., language impairment). Another adaptation of PCIT, Teacher-Child Interaction Training (TCIT), is also being administered in the classroom.

Cindy Keefe is a Licensed Clinical Psychologist and a Certified PCIT Therapist. She specializes in working with children, adolescents, and young adults. Dr. Keefe has a private practice in Fairfield, CT.