Parent-Child Interaction Therapy
Blueprints Program Rating: Promising
A 12 week treatment for young children with emotional and behavioral problems, with one-half hour parent-child sessions, that places emphasis on improving the parent-child relationship, teaching effective parenting skills, and encouraging effective discipline.
- Antisocial-aggressive Behavior
- Child Maltreatment
- Conduct Problems
- Parent Training
- Social Services
Continuum of Intervention
- Selective Prevention (Elevated Risk)
- Indicated Prevention (Early Symptoms of Problem)
- Early Childhood (3-4) - Preschool
- Late Childhood (5-11) - K/Elementary
- Male and Female
- All Race/Ethnicity
Brief Description of the Program
Parent-Child Interaction Therapy is an intervention for children (ages 2-12 years) and their parents or caregivers that focuses on decreasing externalized child behavior problems (e.g., defiance, aggression), increasing positive parent behaviors, and improving the quality of the parent-child relationship. It teaches parents traditional play-therapy skills to improve parent-child interactions and problem-solving skills to manage new problem behaviors. Parents are taught and practice communication skills and behavior management with their children in a playroom while coached by therapists. The activities and coaching by a therapist enhance the relationship between parent and child and help parents implement non-coercive discipline strategies. The length of treatment can vary, but the standard treatment consists of 12 one-half hour weekly sessions, with a one-hour booster session one month after treatment ends. An abbreviated program has also been found to be effective.
See: Full Description
- Both a standard 12-session treatment and an abbreviated 5-session treatment similarly reduced posttest measures of behavior problems among preschool children with oppositional defiant disorder (Nixon et al., 2003, 2004).
- A treatment group of Puerto Rican children ages 4-6 with diagnosed ADHD and significant behavior problems showed significantly greater improvement than the control group on posttest measures relating to hyperactivity, aggression, disruptive behavior, and positive parental practices (Matos et al., 2009).
- The percent of children classified as having oppositional defiant disorder dropped from 91% to 22% in treatment subjects who completed the training, while the percent dropped from 100% to 57% in treatment subjects who did not complete the training (Boggs et al., 2004).
- Despite holding some cultural beliefs that are inconsistent with PCIT tenets, Chinese parents and children in Hong Kong benefitted from the program. The results suggest the cross-national generality of the program (Leung et al., 2008).
- A package of parent-child interaction therapy combined with a self-motivational orientation significantly reduced the incidence of recidivism among a sample of parents referred to child welfare for child abuse (Chaffin et al., 2004, 2011).
Significant Risk and Protective Factors:
- Significant decreases at posttest for child-related parenting stress and significant increases in parenting practices which included monitoring and supervision, involvement, and discipline (Matos et al., 2009).
- Parents benefitted from the treatment in developing a stronger sense of competence and control in their childrearing (Nixon et al., 2003).
Diverse samples have been included in evaluation studies, including heavy concentrations of both Caucasian and African Americans. One study included Puerto Rican families. Cross-national generality has been demonstrated in a Chinese sample.
Risk and Protective Factors
- Individual: Early initiation of antisocial behavior
- Family: Neglectful parenting*, Parent aggravation*, Parent stress*, Poor family management*, Psychological aggression/discipline*, Violent discipline*
- Family: Attachment to parents, Non-violent discipline*, Opportunities for prosocial involvement with parents, Rewards for prosocial involvement with parents
*Risk/Protective Factor was significantly impacted by the program.
Training and Technical Assistance
PCIT Master Trainers are certified by PCIT International to provide expert training and consultation in the official empirically supported version of PCIT for the treatment of parents and young children with disruptive behavior disorders and for parents at-risk for or requiring rehabilitation of physically abusive parenting and their child. You may contact PCIT International (firstname.lastname@example.org) for assistance in enrolling in a training course conducted at the training facility or for scheduling on-site training for therapists at your agency or practice by a certified Master Trainer within your region. PCIT Master Trainers provide training and consultation in the official version of PCIT, leading to certification as a therapist by PCIT International, the authorized organization for research and training in the empirically supported PCIT protocol.
Initial training for therapists runs from $3,000-4,000 per participant, depending upon the size of the group. It is recommended that at least two therapists from an agency be trained together. It is also suggested that a supervisor or administrator be trained. Each therapist will receive weekly consultation from the purveyor for the first year at a cost of $1,000 per therapist for the year.
Training Certification Process
Sites can choose to build local capacity to train and monitor fidelity. A train-the-trainer approach is available in a one-day training for $750.
Brief Evaluation Methodology
The numerous evaluations of PCIT come from a mix of designs, with the best using randomized control trials. These trials typically solicited families in which young children exhibited severe behavioral problems and then randomly assigned the subjects to the PCIT intervention group or a waitlist control group. Key outcome measures included parent self-reports of child behavior and expert observations of interaction of parents and children in clinical settings.
Some randomized trials focused instead on abusive parents. Parents who had been referred by child welfare agencies after reported abuse were randomized into intervention and waitlist control groups. The key outcome was a re-report of child abuse obtained from a centralized state database.
Use of waitlist control groups compromised the ability to identify strong evidence of sustained program effects over the follow-up period.
Comer et al. (2017) tested the program with a randomized trial comparing the standard clinic-based intervention (n=20) and an internet-delivered iteration of the same intervention (n=20). There was no control group. Participating children were aged 3-5 and had a diagnosis of a disruptive behavior disorder. Assessments occurred at baseline, posttest, and at a 6-month follow-up. Outcomes of interest focused on the frequency and severity of disruptive behaviors.
Boggs, S. R., Eyberg, S. M., Edwards, D. L., Rayfield, A., Jacobs, J., Bagner, D., & Hood, K. K. (2004). Outcomes of Parent-Child Interaction Therapy: A comparison of treatment completers and study dropouts one to three years later. Child & Family Behavior Therapy, 26(4), 1-22.
Chaffin, M., Funderburk, B., Bard, D., Valle, L. A., & Gurwitch, R. (2011). A combined motivation and Parent-Child Interaction Therapy package reduces child welfare recidivism in a randomized dismantling field trial. Journal of Consulting and Clinical Psychology, 79(1), 84-95.
Chaffin, M., Silovsky, J. F., Funderburk, B., Valle, L. A., Brestan, E. V., Balachova, T., ... Bonner, B. L. (2004). Parent-Child Interaction Therapy with physically abusive parents: Efficacy for reducing future abuse reports. Journal of Consulting and Clinical Psychology, 72(3), 500-510.
Leung, C., Tsang, S., Heung, K., & Yiu, I. (2008). Effectiveness of Parent-Child Interaction Therapy (PCIT) among Chinese families. Research on Social Work Practice, 19(3), 304-313.
Matos, M., Bauermeister, J. J., & Bernal, G. (2009). Parent-Child Interaction Therapy for Puerto Rican preschool children with ADHD and behavior problems: A pilot efficacy study. Family Process, 48(2), 232-252.
Nixon, R. D. V., Sweeney, L., Erickson, D. B., & Touyz, S. W. (2003). Parent-Child Interaction Therapy: A comparison of standard and abbreviated treatments for oppositional defiant preschoolers. Journal of Consulting and Clinical Psychology, 71(2), 251-260.
Nixon, R. D. V., Sweeney, L., Erickson, D. B., & Touyz, S. W. (2004). Parent-Child Interaction Therapy: One- and two-year follow-up of standard and abbreviated treatments for oppositional preschoolers. Journal of Abnormal Child Psychology, 32(3), 263-271.