Parent-Child Interaction Therapy (PCIT): Everything You Need to Know

Parent-child interaction therapy (PCIT) is an evidence-based treatment that aims to promote healthy child development and help improve the parent-child relationship through interaction. PCIT is beneficial for children with behavioral issues as it can help reduce these problems. Also, this family-oriented therapy can help parents or caregivers develop more effective parenting strategies.


What is Parent-Child Interaction Therapy (PCIT)?

PCIT approach is grounded in attachment theory and social learning theory. Sheila Eyberg developed it in the 1970s. She integrated behavioral therapy and play therapy techniques by developing a novel theory and structure, today known as PCIT.

Nowadays, her approach is one of the most empirically backed and effective treatments in the world.

Who Can Benefit from Parent-Child Interaction Therapy?

PCIT age range

Parent-child interaction therapy is intended for children between the ages of 2-7 with behavioral challenges and the ages of 8 and 10 who had specific language impairments.

It is effective in treating impulsivity, defiant behavior, disruptive behaviors, and difficulty following instructions. In addition, PCIT helps improve attachment and positive interaction between a child and their parents or caregivers.
In addition, parent-child interaction therapy has proven to help children who have experienced abuse.

What are Challenging Behaviors?

Behaviors that parents and child experts commonly consider disruptive include:

  • Tantrums
  • Excessive anger
  • Defiance
  • Verbal and physical aggression
  • Lying

Such behaviors can have a detrimental effect on the child’s everyday functioning at home and school, relationships with others, and well-being in general.

Various factors can trigger challenging behaviors in children. For example, young kids don’t have the vocabulary and skills needed to communicate their feelings. Therefore, their tantrums or angry outbursts can occur due to intense emotions such as fear, sadness, or shame.

Also, your child’s behavior issues may occur as a reaction to life transitions or changes in the family routine.

Sometimes, a child may use challenging behavior to gain your attention. In some cases, behavior difficulties indicate underlying developmental problems or health issues.

How Does PCIT Treatment Look Like?

Parent-child interaction therapy is done through coaching sessions divided into two phases. PCIT is not time-limited. How long the process will take depends on your family’s needs, as each family is unique. However, you can expect to complete treatment in 12-20 one-hour weekly sessions.

The final goal of PCIT is to:

  • Help parents successfully learn parenting skills to provide a nurturing and caring environment for their child
  • Replace the child’s negative behavioral patterns with positive ones

PCIT can help address the following problems:

  • Tantrums
  • Excessive anger
  • Defiance
  • Verbal and physical aggression
  • Cruelty to animals
  • Lying
  • stealing
  • Self-injuring
  • Low self-esteem
  • Separation anxiety
  • Classroom behavior problems
  • Bonding in blended families
  • Post-divorce adjustment

The First Stage of Paren-Child Interaction Therapy: Relationship Enhancement

The relationship enhancement phase is also called child-directed interaction. During the first stage of PCIT treatment, the therapist will apply skills and strategies to:

  • Help children relax
  • Help them feel good about themselves
  • Help them feel secure in a relationship with their parents or caregivers

This first stage of PCIT aims to establish a warm, responsive parent-child relationship. So, at the beginning of the program, your therapist will introduce you to crucial PCIT principles and techniques.

During the PCIT coaching sessions, you and your child will be in a playroom playing and interacting with one another. At the same time, your therapist will observe this process from an observation room (either through a one-way mirror or live video feed).

You will be wearing an ear bug device through which a therapist provides on-the-spot coaching on parenting skills and your child’s behavior that needs a correction.

They will track and note challenging behaviors to observe the progress that you and your child are making.

At the end of the first phase of your Parent-child interaction therapy, you should see the following results:

  • You have developed new skills that provide support and encouragement
  • Your child’s self-esteem has improved
  • Your frustration has deescalated
  • Your child’s activity levels have decreased
  • Your child feels safe, secure, and attached to you
  • The duration, frequency, and severity of your child’s temper tantrums have decreased
  • Their pro-social behaviors, such as collaboration, sharing, and turn-taking, have improved

Relationship Enhancement Techniques

The PCIT relationship enhancement phase aims to improve and strengthen the connection between you and your child. In this stage, your child will have the freedom to select toys and activities they want to engage with. In addition, the therapist will instruct you to use positive reinforcement strategies (that you previously learned from the therapist) while playing along.

These positive reinforcement strategies are described with the acronym PRIDE, and they include:

  • Praise – you praise the child for positive behaviors
  • Reflection – you reflect on what your child says to foster communication
  • Imitation – you show approval of positive behaviors by copying what your child is doing
  • Description – you describe your child’s behaviors out loud to help them develop vocabulary and encourage expression
  • Enjoyment – you demonstrate enthusiasm for your child’s positive behaviors

The Second Stage of Paren-Child Interaction Therapy: Discipline and Compliance

The second phase of PCIT is also called parent-directed interaction. This stage aims to equip you with safe disciplinary techniques to handle your child’s most challenging behaviors calmly and confidently. During this phase of treatment, you should learn how to be consistent in disciplining your child.

You will learn how to:

  • Set boundaries
  • Help your child accept the limits you set
  • Help your child respect family rules
  • Help them behave appropriately in the presence of others

Also, after your second phase of PCIT is over, you can expect the following improvements:

  • Decreased defiance and aggression in your child’s behavior
  • Decreased destructive behavior
  • Increased compliance with rules and requests
  • High ability to stay calm and composed while you are utilizing disciplinary methods

Discipline and Compliance Techniques

In the second phase of parent-child interaction therapy, you are expected to take the lead and provide direct and simple instructions. During this phase, you will learn to enforce consistent consequences for positive and negative behaviors.


Parent-child interaction therapy is an evidence-based method designed to help parents and caregivers improve parenting and communication skills. Another important goal of PCIT is assisting children in enhancing self-control and replacing negative behavior patterns with positive ones.

Parents are encouraged to practice newly learned parenting skills until they use them habitually. After completing parent-child interaction therapy with child clinical psychologists, many families report significant improvements in their kids’ behavior and the parent-child relationship.

Last Updated on October 2, 2021