Parent-child Interaction Therapy (PCIT)

PCIT is an evidence-based treatment for young children with behavioral problems. The program serves families in which the parents and children may have a broad range of behavioral and emotional problems. PCIT uses direct coaching of the parent to positively influence the parent’s interactions with their child, and, as a result, positively influence the child’s behaviors. The parent wears a “bug-in-the-ear" device through which the therapist provides in the moment coaching.

The program is conducted in two stages. The first stage focuses on establishing a warmer, more loving relationship between the parent and child. Parents are taught basic skills in recognizing their children’s positive qualities, and coached in play time sessions to apply positive attention while ignoring negative behaviors. During the second stage of the program, parents are taught skills in how to direct their children and are coached in how to provide safe and effective discipline in response to non-compliance. PCIT provides, on average, once weekly contact in the family’s home and in the community.

Population Served

Program serves parents with children 2-7 years of age referred through the child welfare system. PCIT can be used as part of a reunification plan when the parents and child have daily contact.

Research and Outcomes

Research has demonstrated statistically and clinically significant improvements in child disruptive behaviors and noncompliance of children following PCIT interventions. Improvements have been found in oppositional child behaviors, parent report of activity level, parental stress, child internalizing problems, and child self-esteem. In addition, PCIT has been found to stimulate language skills in developmentally delayed preschoolers.

These positive outcomes have also been shown to generalize to daycare, preschool and elementary classroom settings. Teacher report measures have shown clinically significant improvements in noncompliance and disruptive behaviors in the classroom, such as disobeying the teacher, talking back, teasing, hitting, whining, yelling, and breaking rules.


David and Katrina’s* two children were both in foster care after their infant child was found to have bone fractures at differing stages of healing. The parents went through various parenting classes in order to be reunified with their children and reported not finding them helpful in being able to handle the children. The reunification process began with the start of Parent-Child Interaction Training (PCIT) in the home. The parents were experiencing significant behavior problems with the children and were overwhelmed with how to handle their 2- and 3-year-old children.

During the initial stage of PCIT, the parents began learning how to focus on their children’s positive behaviors, and practiced these skills in play sessions. This helped build a bond between the parents and children and to create a warm and trusting relationship after being separated for two years. The parents learned strategic attention giving, or shaping the children’s behavior by only giving attention to those behaviors they wanted to improve. They learned to ignore the whining and crying that the children often used to get attention. The parents practiced these skills daily in play sessions with the parent coach and the children. The coach taught the parents in what to say and how to play with the children. Eventually the skills the parents learned in the play sessions were used throughout the day with the children.

David and Katrina soon developed competence in these skills and graduated to the discipline portion of the program. They then learned safe and effective means of handling unacceptable behaviors of the children that could not be ignored. The children learned to follow their parents’ directions and rules. With commitment to practicing the skills they were learning, David and Katrina developed confidence in handling the children.

David and Katrina expressed an appreciation for PCIT, as it taught them effective skills and helped them practice the skills with real life problems in the home. This gave them confidence to repeat what they practiced with the family coach on their own. With the help of PCIT, the reunification of the children with their parents was successful.

*Client names have been changed to protect their identity.