We humans are always seeking the warmest attachments we can imagine.
― Bonnie Badenoch, PhD
Fortifying the all-important parent-child bond
Parent-Child Interaction Therapy (PCIT) is a leading therapy for emotional or behavior issues in children under age 8. Unlike some other forms of therapy, PCIT elevates the caregivers to the position of expert by equipping parents with therapeutic play skills.
Children thrive when caregivers show high levels of warmth and high levels of authority. PCIT occurs in two important phases to build warm, authoritative parents. The Child-Directed Interaction phase occurs first, and emphasizes relationship enhancement between parent and child. The Parent-Directed Interaction phase occurs second, and emphasizes consistency and predictability in discipline.
A typical PCIT session involves a brief check-in and then 35-40 minutes of live coaching using an earpiece and a two-way mirror. Live coaching helps parents gain insight into parent-child dynamics that are observed by a third party. Parents then become confident in their new skills far more rapidly than simply practicing at home with limited feedback.
Until it is safe to be together in the office again, I am providing PCIT services via Telehealth. Parents have responded quite positively to this change, and even said that it helps to receive live coaching in their "natural environment."
What you need:
Wifi-connected laptop or tablet
WHO IS PCIT DESIGNED FOR?
PCIT is designed for kids age 2-7 with disruptive behaviors such as tantrums, whining, defiance, hitting, saying unkind things, etc. PCIT is also effective for anxious children. PCIT kids typically have very big feelings which sometimes come out as very big behaviors!
PCIT is great for parents who feel frustrated, hurt, disconnected, worried, or guilty about their child's behavior.
WHO ATTENDS PCIT SESSIONS?
PCIT requires consistent attendance by the same caregiver each week, although multiple caregivers are able to participate if desired. For children with multiple caregivers, it is recommended that all of the caregivers (nannies included) attend the skill teaching sessions which occur three times during treatment. This empowers the whole parenting team to be consistent, which helps the child improve.
WHAT SETS PCIT APART FROM OTHER TYPES OF THERAPY?
Decades of scientific research shows that PCIT is one of the most effective treatments for disruptive behavior, defiance, anxiety, clinging, whining, or tantrums. Parents are the most important people in a child's life, so it makes sense that effective therapy for young children centers around the parent-child relationship. Live coaching through a two-way mirror helps parents master new skills much faster than simply practicing at home. Plus, the two-way mirror often allows for the therapist to get a better sense of how your child behaves when you are at home, allowing for in-vivo coaching of real life situations.
WHAT IF MY CHILD DOESN'T MISBEHAVE AT THE CLINIC?
Some kids do show defiance during early sessions, but many kids strap on their angel wings during PCIT! While this can frustrate parents because they deal with a very different kid at home, it is actually not a bad thing for treatment. PCIT works just as well for the kids who are on their best behavior during the first phase of therapy, because we are able to "catch them being good" and give tons of positive attention to those enjoyable interactions. (As a bonus, it shows us what your child is capable of when the circumstances and motivations are right!)
HOW WILL I WORK ON DISCIPLINE SKILLS IF MY CHILD IS BEHAVING WELL DURING PCIT SESSIONS?
During the second phase (which teaches consistent discipline techniques), we will introduce more challenging situations such as turn-taking, clean up tasks, parents choosing the less fun toy option despite the child wanting a different toy, etc. Typically, these situations do allow for opportunities for live coaching of parenting techniques during tantrums and defiance. There is also the option for in-home or community sessions in the second phase of treatment.
HOW LONG DOES PCIT LAST? WHEN WILL I SEE RESULTS?
Of course the answer to both questions is “it depends!” A typical course of PCIT lasts 15-20 sessions. Some families move more quickly through the curriculum if the particular child responds fast and the parents practice daily. Every parent is different, and every child is unique. Here is an example of how an average course of PCIT might look:
Week 1: Intake meeting (90 minutes)
Week 2: Pre-treatment baseline observation/assessment
Week 3: Parent-only relationship-enhancement skill teaching meeting
Weeks 4-9ish: Coaching sessions
Week 10: Mid-treatment assessment of progress
Week 11-12: Parent-only discipline skill teaching meetings (x2)
Weeks 12-15…20: Coaching sessions
Most families see a shift in child behavior within the first couple of coaching sessions.
IT SOUNDS SUPER AWKWARD TO BE COACHED THROUGH A TWO-WAY MIRROR...
Nah, you'll be fine! Although it sometimes feels uncomfortable, real-time feedback leads to the richest growth. (Plus most parents find the awkward feeling goes away in the first few sessions!) The purpose of live coaching is to make you feel empowered and capable, not to point out what you are doing "wrong."
HOW MUCH DOES A PCIT SESSION COST?
Currently, a 45-minute PCIT session costs $200.