Lauren is a 6-year-old 1st grader whose parents expressed concerns about her impulsiveness and daily temper outbursts. Both parents described significant stress managing Lauren's behavior. They sought help managing Lauren's tantrums and getting her to complete day-to-day tasks with less stress and frustration for everyone involved.
Nicky is a 4-year-old preschooler whose mother expressed concern about his difficulty listening and following adults' instructions. Nicky's mother was worried about the effect Nicky's difficulties were having on his learning and his relationships with adults and other children.
Children are born with different temperaments; some are easy going and some have more difficulty adjusting to the rhythms of everyday life. Parents often find that "common sense" child-rearing practices for children with easier temperaments may not work for a child with behavior problems. The result is increasing frustration and tension between parent and child, as well as decreasing effectiveness with tantrums, defiance, and misbehavior. Parent-Child Interaction Therapy (PCIT) is a research-supported program that aims to improve parent-child relationships and child behavior by working with both parents and children together.
What is PCIT?
This program is a scientifically supported treatment for 2- to 7-year-old children with significant disruptive behaviors. PCIT gives equal attention to the parent-child relationship and to parents' behavior management skills. The goals of the program are to increase positive feelings and interactions between parents and children, to improve child behavior, and to empower parents to use consistent, predictable, effective parenting strategies.
PCIT is unique as it is based on teaching and coaching parents in positive parenting skills from within a supportive environment. Unlike most therapies in which skills are taught in the office yet practiced outside in the "real world," PCIT offers skills practice with real-time therapist guidance and support.
What happens during PCIT sessions?
PCIT consists of weekly, hour-long sessions, typically over a period of 12 to 20 weeks. Teaching sessions involve introduction, modeling, and role-playing of very specific skills. Subsequent sessions involve review of home practice and live coaching of parent-child interactions. Through a one-way mirror and an audio transmitter worn in the parent's ear (a "bug-in-the-ear"), the therapist gives ongoing coaching, advice, and encouragement while the parent interacts with the child. New skills are thus practiced, reviewed and mastered in the office. Home practice sessions of 5 to l5 minutes a day are a critical part of the treatment.
What do parents learn in the sessions?
Parents learn to increase their positive attention when their child's behavior is appropriate and to use differential attention to reduce minor negative behaviors. Parents also learn a specific time-out procedure to use when their child does not comply with a command or demonstrates other rule-breaking behaviors (e.g., back talking, hitting a sibling).
How does the PCIT program involve both parents and children in the treatment?
PCIT is structured in two phases: the Child-Directed Interaction and Parent-Directed Interaction phases. At the beginning of each phase, a teaching session with parents and without the child is held to introduce the skills that will be the focus of that phase. Remaining sessions, or "coaching" sessions, include the child and involve live practice with the parent and child, with assessment and coaching of skills by the clinician.
How is progress determined?
Before beginning each session, parents are asked to complete a behavior rating scale: the Eyberg Child Behavior Inventory (ECBI). This scale provides information on the frequency, severity, and impact of their child's disruptive behavior. Parents must master specific criteria to progress from the Child-Directed Interaction phase to the Parent-Directed Interaction phase (from CDI to PDI to graduation.) Skills are coded, tracked, and reviewed with families each week to inform them of their progress. Families graduate from PCIT after demonstrating CDI and PDI mastery, reporting an average amount of disruptive behavior, and expressing confidence in their ability to manage their child's behavior in real-life settings.
Have the effects been examined long-term?
Research suggests that gains made in PCIT are largely maintained at least 6 years after treatment completion.
After PCIT, Lauren's parents expressed relief that they no longer had to battle Lauren to complete routine activities, and they were thrilled that her chronic interrupting had improved. Both parents also described significantly less stress managing Lauren's behavior and were pleased that they could begin going out to dinner again with Lauren present.
After PCIT, Nicky's mother indicated that she no longer needed to nag or yell at Nicky for him to listen. She commented that the best compliment on their progress was from her own mother who, after visiting from out of town, was amazed at the improvements in Nicky's and his mother's relationship and in Nicky's behavior. Nicky's teacher also observed improvements in Nicky's listening at school.
PCIT at the NYU Child Study Center
The PCIT program at NYU has been developing over the past 10 years. At the CSC, PCIT is available on multidisciplinary training teams that include advanced psychology graduate students, post-doctoral fellows, psychologists, and psychiatrists. PCIT is also available with individual clinicians. PCIT clinicians are supervised by licensed attending psychologists.
PCIT is often augmented with other behavior therapy tools, including Behavioral School Consultation for children with school-based needs.
For more information or to schedule an appointment please contact an intake coordinator at (646) 754-5000 or e-mail us at firstname.lastname@example.org.