Parent-Child Interaction Therapy (PCIT)
Category
Child & Family Health
Child's Age
2-3 years, 3-4 years, 4-5 years
Participant
Children, Parents/Guardian
Languages
English, Spanish, German
Brief Description
Behavior management program for families with young children experiencing behavioral or emotional difficulties. Assists parents/caregivers in building stable, positive relationships with their children through decreasing problem behaviors, increasing pro-social behaviors, and helping improve the parents' confidence in working through behavioral issues with their children.
Expected Impact
- General decrease in externalizing and internalizing problematic behaviors
- General decrease in child-related and parent-related stress
- General increase in parental use of positive communication
- General decrease in parental use of negative communication
- General decrease in child abuse potential
- General increase in parental sensitivity
Core Components for Model Fidelity
- Two-Phase Approach:
- Positive relationship building
- How to use positive reinforcement (praise, showing excitement, imitation
- Child-led
- Discipline and compliance
- How to give clear directions
- Following through with positive and negative consequences
- Parent-led
- Positive relationship building
- Sessions: The therapist will go over new skills and tools to use during the play session (between the parents and child) with the parents beforehand. The parent will then practice these skills while being observed by the therapist who is able to give immediate feedback through an earpiece in the parent's ear.
- Observations: The therapist may observe through a one-way mirror or live video feed.
Languages Materials are Available in
English, Spanish, German
Delivery Mode
Parents and children participate in a playroom while they are coached by the licensed therapist.
PCIT can also be delivered in a group setting with 3-4 families (requires 90-minute sessions vs. 1-hour).
Dosage
PCIT is an assessment-driven, criterion-based intervention. This means that families and their therapists work to achieve criterion goals for each phase of PCIT. Total treatment time is on average 20-24 weeks.
Infrastructure for Implementation
Space: Playrooms need to include either a one-way mirror or a live video feed. PCIT Playroom Set Up
Materials: Materials are outlined in greater detail on the PCIT Treatment Materials webpage.
- PCIT 2011 Treatment Protocol ($44)
- Clinical Manual for the Dyadic Parent-Child Interaction Coding System: DPICS-IV ($40)
- DPICS-IV Workbook ($15)
- ECBI (See measure below)
- Therapy Attitude Inventory
- Appropriate PCIT toys ($300-$500)
- Storage tubs for clean-up and storage
- Sanitizing materials for toys
Staffing Requirements
Parent-Child Interaction Certified Therapist - staff requirements, visit the PCIT Certified Therapist Requirements webpage or email pcitcertify@gmail.com.
Full agency participation is recommended. This requires multiple clinicians to be trained and hiring a senior leader within the agency.
Training for Model Fidelity
Staff training is available through Duke’s Center for Child and Family Health.
At a minimum, PCIT therapists must complete the PCIT Fundamentals training, which requires:
- Minimum of 40 hours of face-to-face training (two multiday sessions, 3-4 months apart)
- One hour, bi-weekly consultation calls throughout two cases and the completion of clinical training
- Session-level reviews
During the Fundamentals training, PCIT trainees often take a caseload of at least 6 PCIT clients.
Additional training courses are available for those who have completed the Fundamentals training.
Senior Leaders are encouraged to include the senior leader training portion.
Contact Information
https://www.ccfhnc.org/programs/pcit-care-training/
Darden White, MEd, LCMHCS: Associate Director of PCIT & CARE Training; also PCIT International Regional Trainer, CARE Trainer at the North Carolina Child Treatment Program – Center for Child & Family Health; darden.white@duke.edu
Cost Estimates
For NC clinicians, Duke offers training for $1,500 per trainee (includes manuals, 40 hours of direct training, 1 year of bi-weekly consultation, video reviews, and the agency specific implantation and sustainability training track – direct training and monthly consultation).
Additional considerations for the implementation of PCIT include space, technology, materials, and other start-up costs. These expenses typically range from $1,000 to $5,000, depending on the agency/site’s needs and budget.
Purpose Service Code (PSC)
5415 – Health Care Access and Support
Program Identifier (PID)
Parent-Child Interaction Therapy (PCIT)
Minimal Outputs for NCPC Reporting
FY 24-25:
- Number of children receiving therapeutic interventions
- Number of parents receiving therapeutic interventions
Minimal Outcomes for NCPC Reporting
FY 24-25:
- More children on track for typical and/or enhanced development
Minimal Measures for NCPC Reporting
FY 24-25:
- Eyberg Child Behavior Inventory
NCPC Evidence Categorization
Evidence Based- 2 randomized control trials, one of which has a follow-up.
Research Summary
The following publications include two randomized controlled trial studies and a follow up study. First, in Luby et al. (2018)1 children in the PCIT group showed significant reductions in the severity of their MDD symptoms and were more likely to be in remission. They also showed improvements in their ability to regulate their emotions, handle guilt, and have emotional stability. Parents saw decreases in their depressive symptoms and parenting stress. Parents also used more positive parenting skills that focused on reflecting and processing emotions. Thomas and Zimmer-Gembeck (2011)2 found that at the preassessment parents were considered stressed with heightened chances of child abuse and reported clinical levels of externalizing behaviors, intensity, and problem behaviors in their children. At 12 weeks the PCIT group showed decreases in externalizing behaviors and parental stress and increases in positive parent communication, with decreases in negative communication. By PCIT completion, the results from the 12-week assessments continued to strengthen. Analysis also showed improvement for internalizing symptoms, reductions in child- and parent-related stress, decreases in child abuse potential, and increases in parental sensitivity. At 1 month post treatment these positive changes were maintained, and results showed that the families that completed PCIT were less likely to receive notifications to child services compared to those who dropped out. In a follow up study (Thomas & Zimmer-Gembeck, 2012),3 the same data set was analyzed to study the standard form of PCIT and its relationship to child behavior, parental stress, and positive parenting practices in high-risk families. The S-PCIT group showed greater improvements in externalizing and internalizing behaviors, and child-related stress. The parents also improved their use of positive verbal communication and their maternal sensitivity levels. A decrease was reported for child abuse potential, but no significant differences between the groups were found.
- ^ See Luby et al. (2018). The authors of this randomized controlled trial study examined the use of PCIT with an added emotional development module to see if it was effective in reducing Major Depressive Disorder (MDD) in young children that met criteria for early childhood MDD. Adding this module to standard 12-week PCIT increased the timeline to 20 weeks. A waitlist group was used for comparison. PCIT-ED was created to help enhance the children’s ability to recognize, regulate, and understand their emotions using their parents' support. Measures used include: K-SADS-EC, Preschool Feelings Checklist (Screening and Scale Versions), Children’s Global Assessment Scale, Clinical Global Impression-Global Improvement, Preschool and Early Childhood Functional Assessment Scale/Child and Adolescent Functional Assessment Scale, The Emotion Regulation Checklist, My Child, Parenting Stress Index, Coping with Children’s Negative Emotions, Beck Depression Inventory-II.
- ^ See Thomas & Zimmer-Gembeck (2011). This randomized controlled trial studied PCIT and the relationship between the intervention and maltreatment outcomes in families referred from agencies for being at high-risk for child maltreatment. The parents completed a pre-assessment before being randomly placed on the waitlist or in the PCIT group. The next assessment was completed at 12 weeks and then again at the end of treatment (when mastery criteria was met). Measures included the Eyberg Child Behavior Inventory, the Sutter-Eyberg Student Behavior Inventory-Revised, the Child Behavior Checklist (CBCL) and the CBCL/Teacher Report Form, the Parenting Stress Inventory, the Child Abuse Potential Inventory, and the Dyadic Parent-Child Interaction Coding System III.
- ^ See Thomas & Zimmer-Gembeck (2012). This study was conducted as a follow up to the RCT completed by Thomas & Zimmer-Gembeck (2011). Participants included families who were referred due to being high-risk or having engaged in child maltreatment. The caregivers all noted that they used corporal punishment and were frequently very frustrated and distressed by their child’s behavior. Analysis compared data collected from families placed on the waitlist, those completing S/PCIT (12 weeks), and those completing time variable PCIT (TV/PCIT). Comparison between the 12-week S/PCIT and the time-variable option showed that S-PCIT had similar or significantly more positive outcomes. Measures used include the Eyberg Child Behavior Inventory, the Child Behavior Checklist, the Parenting Stress Inventory, the Beck Depression Inventory II, and the Child Abuse Potential Inventory, and the Dyadic Parent-Child Interaction Coding System III.
Researched Population
- Parents/caregivers of children ages 2-7 that struggle with problem behaviors due to emotional or behavioral disorders, or trauma
- Families from a diverse range of racial/ethnic populations, disorders, and family builds.
- Children that have been or at risk of maltreatment/abuse
- Parents that are or have been physically abusive towards their children (PCIT may be appropriately used when the abuse takes place as a form of punishment/discipline)
Clearinghouse and Compendium References
California Clearinghouse - rated 1 Well-supported by Research Evidence
National Child Traumatic Stress Network
Blueprints Programs - rated Certified promising program
Luby, J. L., Barch, D. M., Whalen, D., Tillman, R., & Freedland, K. E. (2018). A randomized controlled trial of parent-child psychotherapy targeting emotion development for early childhood depression. American Journal of Psychiatry, 175(11), 1102-1110. https://www.doi.org/10.1176/appi.ajp.2018.18030321
Thomas, R., & Zimmer-Gembeck, M. J (2011). Accumulating evidence for Parent-Child Interaction Therapy in the prevention of child maltreatment. Child Development, 82(1), 177-192. https://www.doi.org/10.1111/j.1467-8624.2010.01548.x
Thomas, R., & Zimmer-Gembeck, M. J (2012). Parent-Child Interaction Therapy: An evidence-based treatment for child maltreatment. Child Maltreatment, 17(3), 253-266. https://www.doi.org/10.1177/1077559512459555
Local Partnerships Currently Implementing
Local Partnerships in purple have adopted Parent-Child Interaction Therapy (PCIT). Local Partnership contact information can be found here.