What is PCIT (And Why We Love It!)

“My child gets frustrated so easily, and now I’m always frustrated.”

“My kid has a huge reaction whenever I have to say ‘no.’”

“All the arguing with my child has me worried about our relationship.”

“I give in all the time. I’m not parenting the way I want to.”

If you're a parent of a child with ADHD, challenging behavior, and/or big emotions, statements like these may be daily axioms. One of our favorite approaches to supporting parents (i.e., helping them manage tricky child behavior, parenting in ways that align with their personal goals and values, and building their relationship with their child) is Parent-Child Interaction Therapy (PCIT).

Why do we love PCIT?

The PCIT model focuses on strengthening the parent-child relationship. It allows parents and caregivers to reconnect with the joy of spending time with their child. And even more incredible, PCIT helps kids build greater confidence and self-worth while developing a deeper sense of attachment and trust with their parents/caregivers.

PCIT recognizes the innate strengths and wisdom of families. And it understands that no matter how much you love your child, parenting a child with ADHD or other concerns can be challenging, exhausting, and overwhelming. PCIT honors this reality and helps families feel more confident and effective in their interactions and functioning.

What is PCIT?

The simplest answer is that Parent-Child Interaction Therapy (PCIT) is an evidence-based, parent-focused therapy effective in the treatment of significant behavioral challenges associated with a variety of diagnoses, such as ADHD. By working with kids and parents collaboratively, PCIT equips families with new tools, strategies, and healthier ways of interacting. Through this empowering process, both kids and parents learn and grow together, building stronger, more fulfilling relationships. This therapy is most helpful for kids 2 - 7 years old and typically lasts 14 to 20 weeks. There is also an adaption of PCIT for older kids 8 - 10 years old. 

There are two key components to PCIT - learning and practicing. Parents learn practical skills and strategies and practice these new skills with the support of in-the-moment coaching by the therapist. You may be thinking, “Wait, in-the-moment coaching… what does that mean?” While parents interact with their children, the therapist observes and provides warm and supportive feedback directly to the parent through headphones or earpods. The immediate coaching helps parents solidify their understanding of the skills and hone their abilities to practice them in real time with their child. The coaching that occurs during the therapy sessions is what makes PCIT so unique and effective - and is often parent's favorite part of the therapy!

What do you do in PCIT?

PCIT is divided into two phases. 

The first phase is called Child Directed Interaction (CDI) in which the child leads the play, and the parents follow. During this period, the focus is on enhancing the relationship between the parent and child. Parents use communication skills, such as labeled praise and reflection, to convey that they are interested in their child and want to connect. Once parents demonstrate mastery of the skills, they then “graduate” to the second phase.

The second phase of PCIT is called Parent Directed Interaction (PDI). In PDI, parents are taught ways to effectively manage behavior that increases child compliance and decreases conflict - ultimately supporting child and parent self-worth and self-efficacy. Parents are able to clearly articulate their needs (so that the child understands what is being asked of them) and, if needed, utilize a set of tools when their child is struggling to follow their lead.

Although many families want to jump right to PDI - and we understand why - it’s critical to begin with enhancing child-parent relationships through the CDI phase of treatment. Stronger communication and better parent-child interactions make PDI skills more effective and sustainable. 

How do I get started?

If you are interested in learning more about PCIT, please reach out to us at hello@mindchicago.com or call us at 312.667.3775.

If PCIT is right for you, you will work with a trained PCIT therapist to complete

(1) an intake assessment and

(2) an initial parent/caregiver and child observation.

Your PCIT therapist will then help you understand next steps in the therapy process. PCIT can be completed in the office or virtually, depending on your unique circumstances. PCIT generally ranges between 12 and 25 sessions, depending on your family’s individual needs.

This article was authored by PCIT therapist Niki Aquino, LCSW.