Parent-Child Interaction Therapy (PCIT) Overview

 
Parent Child Interaction
Therapy- PCIT
 
 
 
 
 
 
 
Andrea Carpenter, LPC
Certified PCIT therapist and Level 1 Trainer
Learning Objectives
 
What is PCIT?
Background of PCIT
Research to support PCIT
Appropriate clients/families
Overview of PCIT services
Adaptions for PCIT
Certification in PCIT
 
Acknowledgements
 
Erin Sewell, LCSW- Level 2 trainer- Oregon
Melanie Nelson, Ph.D- Master Trainer- Florida
John Paul Abner, Ph.D- Master Trainer-
Tennessee
PCIT- Background
 
Developed in the 1970’s by Dr. Shelia Eyberg
Training started in Florida using a co-
training/mentor style
Continued to disseminate across labs and
clinical trials
Has expanded Nationally and Internationally
 
Background cont.
 
Countries offering PCIT
Australia
Canada
Cyprus
Denmark
France
Germany
Hong Kong
Indonesia
Jamaica
 
 
Japan
Lebanon
Netherlands
New Zealand
Norway
Singapore
South Korea
Switzerland
Taiwan
Background cont.
 
PCIT is one of the prominent evidence-
based practices (EBPs) and empirically
supported treatments (ESTs) world-wide
for young children with disruptive
behavior problems.
Background cont.
 
Pulls from
Attachment Theory (Bowlby)
Play Therapy
Behavior Modification (Operant
Conditioning- Skinner)
Parenting Styles (Baumrind)
Social Learning Theory (Skinner)
Coercive Cycle- (Patterson)
Outcomes
 
Child:
Significant reductions in non-compliance and
behavior problems
Skills are extended/Generalization to home
and school
Outcomes cont.
 
Parental:
Changes in parents’ interactional style
Parents report less personal distress and more
confidence in their ability to control their
child’s behavior
Generalization to siblings
PCIT- Core Features
 
Direct Coaching with the parent & child
Restructuring parent/child interactions
Assessment driven
Sensitivity to developmental concerns
Intervening early
Targeting a range of behaviors
patterns of interaction rather than
discrete behaviors
Positive, non-judgmental philosophy
Treatment
 
Length of treatment
Typically 12-15 weeks
Siblings referrals
Identify the target child
Comorbid diagnoses
 
Research- Diverse backgrounds
 
Researched to be effective with a diverse group
of backgrounds.
 
Mexican-American
African American
Native American
Puerto Rican
Australian
Dutch
Chinese
Norwegians
 Germans
Russians
Japanese
 
 
 
 
 
 
 
 
https://www.youtube.com/watch?v=Jy8mz4gu2oQ
Client referral/Appropriate clients
 
Children ages 2-7
Diagnosis including disruptive behaviors
At least 1 caregiver
Strongly encourage 2 if possible
Caregiver must have IQ over 75
Child has receptive language above 2 years
Therapist fluent in family’s native language
Case Examples
 
6 year old boy- living with his aunt
5 year old girl- parents separated
6 year old girl- living with father
3 year old boy- living with mother
 
 
Reasons for PCIT referral
 
Presenting Concerns- Child
Temper tantrums
Doesn’t listen or has difficulty following instructions
Aggressive behaviors
Preschool having difficulty managing behaviors
 
Presenting Concerns- Parent
Child won’t listen to them
Suspended/expelled from school/daycare
Conflict between parents
 
 
 
 
 
Referral cont.
Continuum of Severity
Whining
Mild
noncompliance
Bonding in
blended families
Post-divorce
adjustment
Low self-esteem
Lying
Hyperactivity
Verbal
aggression
Classroom
conduct problems
Angry, resentful,
spiteful
Defies authority
Physical
aggression
Cruelty to
animals
Destructive
behavior
Fire-setting
Stealing
 
Relationship
Problems
 
Disruptive
Behaviors
 
Conduct
Problems
 
Typical Diagnoses
 
Adjustment Disorder
ADHD
Depression
Anxiety
PTSD
ODD
Autism Spectrum Disorder
 
Treatment Overview
 
Balances Two Factors…
 
1. Positive Interaction with the Child
 
Increase positive attention
 
Decrease negative attention
 
2. Consistent Limit Setting
 
Consistency
 
Predictability
 
Follow-Through
Components of Treatment
 
Child Directed Interaction (CDI)- attachment
building
Attachment
Parent shapes behaviors
Build pro-social skills
Components of treatment cont.
 
Parent Directed Interaction (PDI)- Effective
Discipline
Structured
Consistent
Uses parental attention rather than material
 
rewards or punishment
Use time out for non-compliance
Establishing house rules
 
Treatment cont.
 
Homework 5 minutes per day
Really important for parents to practice
skills daily to learn
They must have access to their child to
practice the skills minimum 3 days a week
Use the ECBI (Eyberg Child Behavioral Inventory)
to track parents report on child’s behaviors
 
Treatment cont.
 
Set up in office:
Parent and Child in one room
One- way mirror
Ear buds
Select toys
Data tracking sheets
Child Directed Interaction
 
CDI Skills- Attachment Building
 
PRIDE
P- Praise
R- Reflect
I- Imitate
D-Describe
E- Enjoy
Child Directed Cont.
 
Don’t skills
Questions
Commands
Negative Talk
 
Ignoring the negative and praising the positive
opposite
Parent Directed Interaction
 
PDI Skills- Effective Commands
Direct vs Indirect
Specific
Positively stated- what to do vs not do
Developmentally Appropriate
One at a time
Neutral tone of voice
Explanation given before command or after
compliance
Only when necessary
PDI cont.
 
Teach the parents how to follow through to
help child be better at listening the first time
Use time out to manage non-compliance
Start with using easy commands and gradually
work to harder commands
Work at child and parents
 
pace to ensure confidence
PDI cont.
 
Time out is a result of child not following
directions
Focus on 5 seconds of quiet to end time out
Ends with them following through with the
original command to teach child to follow
directions the first time
Focus on supporting parent in following
through until the end rather than giving in
PCIT during Covid-19
 
Previously research has been doing on
internet based PCIT
Offered in a variety of ways
Part in office part at home
Fully at home
In a separate clinic from where clinician
was located
Covid-19 cont.
 
Computer screen
Phone/telehealth platform
Services still able to take place
organically
Troubleshoot in the home
Easier to address “real life
behaviors”
Lower drop out
 
After treatment
 
Continued improvement following
graduation
Often don’t need other treatment
Can be referred for more specific treatment
such as TF-CBT if needed
Booster sessions
 
Certification
 
Master’s degree or higher
40 hours of training
Different criteria for type of training based on the
trainer experience
Graduate 2 cases using PCIT protocol
Must remain on consultation calls until the 2 cases
have been completed to graduation
Skills checked off Apply to become a certified
PCIT therapist (PCIT international)
Pass the PCIT Certification Experience test
 
Adaptations
 
PCIT- Toddler
PCIT with older kids
PCIT with kids on the Autism Spectrum
PCIT- Selective Mutism
Internet based PCIT
TCIT- Teacher Child Interaction Therapy
 
Questions
 
 
Resources
 
McNeil, C. B., Hembree-Kigin, T. L., &
Anhalt, K. (2011). 
Parent-Child Interaction
Therapy (Issues in Clinical Child
Psychology)
 (2nd ed. 2010 ed.). Springer.
www.PCIT.org
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Parent-Child Interaction Therapy (PCIT) is an evidence-based practice widely used to address disruptive behavior in young children. Developed in the 1970s by Dr. Shelia Eyberg, PCIT has gained international recognition and is offered in various countries. It combines elements of attachment theory, play therapy, behavior modification, and parenting styles to improve child behavior and parent interactions. PCIT has shown significant results in reducing non-compliance and behavior problems in children, while also enhancing parental confidence and control.


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  1. Parent Child Interaction Therapy-PCIT Andrea Carpenter, LPC Certified PCIT therapist and Level 1 Trainer

  2. Learning Objectives What is PCIT? Background of PCIT Research to support PCIT Appropriate clients/families Overview of PCIT services Adaptions for PCIT Certification in PCIT

  3. Acknowledgements Erin Sewell, LCSW- Level 2 trainer- Oregon Melanie Nelson, Ph.D- Master Trainer- Florida John Paul Abner, Ph.D- Master Trainer- Tennessee

  4. PCIT-Background Developed in the 1970 s by Dr. Shelia Eyberg Training started in Florida using a co- training/mentor style Continued to disseminate across labs and clinical trials Has expanded Nationally and Internationally

  5. Background cont. Countries offering PCIT Australia Canada Cyprus Denmark France Germany Hong Kong Indonesia Jamaica Japan Lebanon Netherlands New Zealand Norway Singapore South Korea Switzerland Taiwan

  6. Background cont. PCIT is one of the prominent evidence- based practices (EBPs) and empirically supported treatments (ESTs) world-wide for young children with disruptive behavior problems.

  7. Background cont. Pulls from Attachment Theory (Bowlby) Play Therapy Behavior Modification (Operant Conditioning- Skinner) Parenting Styles (Baumrind) Social Learning Theory (Skinner) Coercive Cycle- (Patterson)

  8. Outcomes Child: Significant reductions in non-compliance and behavior problems Skills are extended/Generalization to home and school

  9. Outcomes cont. Parental: Changes in parents interactional style Parents report less personal distress and more confidence in their ability to control their child s behavior Generalization to siblings

  10. PCIT-Core Features Direct Coaching with the parent & child Restructuring parent/child interactions Assessment driven Sensitivity to developmental concerns Intervening early Targeting a range of behaviors patterns of interaction rather than discrete behaviors Positive, non-judgmental philosophy

  11. Treatment Length of treatment Typically 12-15 weeks Siblings referrals Identify the target child Comorbid diagnoses

  12. Research-Diverse backgrounds Researched to be effective with a diverse group of backgrounds. Mexican-American African American Native American Puerto Rican Australian Dutch Chinese Norwegians Germans Russians Japanese

  13. https://www.youtube.com/watch?v=Jy8mz4gu2oQ

  14. Client referral/Appropriate clients Children ages 2-7 Diagnosis including disruptive behaviors At least 1 caregiver Strongly encourage 2 if possible Caregiver must have IQ over 75 Child has receptive language above 2 years Therapist fluent in family s native language

  15. Case Examples 6 year old boy- living with his aunt 5 year old girl- parents separated 6 year old girl- living with father 3 year old boy- living with mother

  16. Reasons for PCIT referral Presenting Concerns- Child Temper tantrums Doesn t listen or has difficulty following instructions Aggressive behaviors Preschool having difficulty managing behaviors Presenting Concerns- Parent Child won t listen to them Suspended/expelled from school/daycare Conflict between parents

  17. Referral cont. Disruptive Behaviors Relationship Problems Conduct Problems Lying Hyperactivity Verbal aggression Classroom conduct problems Angry, resentful, spiteful Defies authority Whining Mild noncompliance Bonding in blended families Post-divorce adjustment Low self-esteem Physical aggression Cruelty to animals Destructive behavior Fire-setting Stealing Continuum of Severity

  18. Typical Diagnoses Adjustment Disorder ADHD Depression Anxiety PTSD ODD Autism Spectrum Disorder

  19. Treatment Overview Balances Two Factors 1. Positive Interaction with the Child Increase positive attention Decrease negative attention 2. Consistent Limit Setting Consistency Predictability Follow-Through

  20. Components of Treatment Child Directed Interaction (CDI)- attachment building Attachment Parent shapes behaviors Build pro-social skills

  21. Components of treatment cont. Parent Directed Interaction (PDI)- Effective Discipline Structured Consistent Uses parental attention rather than material rewards or punishment Use time out for non-compliance Establishing house rules

  22. Treatment cont. Homework 5 minutes per day Really important for parents to practice skills daily to learn They must have access to their child to practice the skills minimum 3 days a week Use the ECBI (Eyberg Child Behavioral Inventory) to track parents report on child s behaviors

  23. Treatment cont. Set up in office: Parent and Child in one room One- way mirror Ear buds Select toys Data tracking sheets

  24. Child Directed Interaction CDI Skills- Attachment Building PRIDE P- Praise R- Reflect I- Imitate D-Describe E- Enjoy

  25. Child Directed Cont. Don t skills Questions Commands Negative Talk Ignoring the negative and praising the positive opposite

  26. Parent Directed Interaction PDI Skills- Effective Commands Direct vs Indirect Specific Positively stated- what to do vs not do Developmentally Appropriate One at a time Neutral tone of voice Explanation given before command or after compliance Only when necessary

  27. PDI cont. Teach the parents how to follow through to help child be better at listening the first time Use time out to manage non-compliance Start with using easy commands and gradually work to harder commands Work at child and parents pace to ensure confidence

  28. PDI cont. Time out is a result of child not following directions Focus on 5 seconds of quiet to end time out Ends with them following through with the original command to teach child to follow directions the first time Focus on supporting parent in following through until the end rather than giving in

  29. PCIT during Covid-19 Previously research has been doing on internet based PCIT Offered in a variety of ways Part in office part at home Fully at home In a separate clinic from where clinician was located

  30. Covid-19 cont. Computer screen Phone/telehealth platform Services still able to take place organically Troubleshoot in the home Easier to address real life behaviors Lower drop out

  31. After treatment Continued improvement following graduation Often don t need other treatment Can be referred for more specific treatment such as TF-CBT if needed Booster sessions

  32. Certification Master s degree or higher 40 hours of training Different criteria for type of training based on the trainer experience Graduate 2 cases using PCIT protocol Must remain on consultation calls until the 2 cases have been completed to graduation Skills checked off Apply to become a certified PCIT therapist (PCIT international) Pass the PCIT Certification Experience test

  33. Adaptations PCIT- Toddler PCIT with older kids PCIT with kids on the Autism Spectrum PCIT- Selective Mutism Internet based PCIT TCIT- Teacher Child Interaction Therapy

  34. Questions

  35. Resources McNeil, C. B., Hembree-Kigin, T. L., & Anhalt, K. (2011). Parent-Child Interaction Therapy (Issues in Clinical Child Psychology) (2nd ed. 2010 ed.). Springer. www.PCIT.org

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