Relentless Pursuit

What is Parent-Child Interaction Therapy? (PCIT)

Parent-child interaction therapy also known as, PCIT is a form of play therapy that is aimed at strengthening the relationship between the parent and child. It is one of the most prominent evidence-based treatments world-wide for young children ages 2-7 years old. PCIT can be done with either parent who is able to participate, as well as other adults who are the prominent caregivers of children such as grandparents, aunts, uncles, foster parents, or babysitters. PCIT balances two factors within it which include positive interactions with the child as well as consistent limit setting by the parent.

PCIT is aimed to help children with problematic behaviors such as verbal aggression, noncompliance, anger, lying, hyperactivity, and children who defy authority. Other conduct problems that would be appropriate for referral includes if a child engages in cruelty to animals, destructive behavior, fire setting, stealing, and physical aggression. Some core features of this type of therapy includes active coaching of the parent with their child, emphasis on restricting interaction patterns, and the use of assessment tools, which is all supported by reputable, valid, and empirically supported evidence. Another important aspect of this type of therapy is that it is not time limited. Generally, parents and children who engage in this type of therapy take roughly 12-16 weeks to complete the PCIT sequence, yet it could it could be longer or shorter depending on how often the parent and child complete homework assignments, practice at home, and if they come to the therapy session every week.

The theoretical basis of PCIT is based in attachment theory, parenting styles, behavior modification, and social learning theory. There are two components to PCIT: Child Directed Interaction and (CDI) and Parent Directed Interaction (PDI). Today we will be looking closer at the CDI sequence and how this plays out within the therapy session. The goal fo CDI is to increase the overall relationship and bond between the parent and the child. CDI is something that is learned within a therapeutic setting, and must be practiced everyday at home to strengthen the relationship between the child and the parent. Each day, just for 5 minutes, the parent and child will have “special time” where the child get’s the undivided attention of the parent, and where the parent uses specific skills.

The skills that a parent must master in order to “pass” PCIT is known as the PRIDE skills. P stands for “praise or labeled praise” where the parent erupts in enthusiasm by complimenting the child on what they are doing. An example of this may look like: “I love when you build quietly!” or, “Good job being so gentle with the bear”. R stands for reflection, where the parent directly repeats back what the child says word for word. I stands for imitating, where the parent imitate’s the child’s behavior and the attention/focus is what on the child is doing. D stands for describing what your child is doing, and teaches concepts to the child as well as models speech patterns. Many description statements start with “You are ______” such as “You are moving the red truck”, or “You are playing with the doll”. The final letter in PRIDE is E, which stands for enjoyment. This just means acting happy when you play with your child and can be illustrated through your tone of voice, laughter, and positive touch.

If during this “special time” the child engages in inappropriate behavior, the parent must ignore it completely not giving any attention to that behavior. Like many behaviors of any person, if there is attention given to it, there is a high likelihood that the person will increase that behavior itself, even if it is negative behavior. The only time that the parent disrupts the play is if the child is being violent or aggressive with their play, or towards the parent.

So, how do you begin? First, you must pick a toy for the child to use. The best type of toys to use for CDI is:

• Building blocks
• Legos
• Tinker Toys
• Mr and Mrs Potatoe Head
• Chalkboard and colored chalk
• Play sets such as farms, houses, and garages

Toys to avoid during CDI include:

• Bats, balls, punching bags
• Toy guns, toy swords, super-hero figurines
• Board games
• Card games
• Books
• Video games
• Pretend talk toys

The first steps of beginning this process start within a professional, therapeutic setting with a counselor who has been clinically trained and certified in PCIT. Even though this is the gold standard for play therapy, highlighting these skills may be beneficial and can be implemented by parents and caregivers alike to increase a strong and secure relationship with the child in the end.

As mentioned above, CDI is only the first part of PCIT. Come back to the next blog in a couple weeks to hear and learn about Parent Directed Interactions (PDI) as the second half of PCIT.