PCIT is built from the attachment theory and social learning theory. Attachment theory shows that sensitive and responsive parenting teaches the child that their parents are there for them and will respond to them when needed.

The idea is that warm, sensitive parents are likely to show their children that their relationship is secure, and the parents will be able to better regulate their children’s behavior. Social learning theory builds on the idea that the behavior of conduct disordered children is inadvertently established by early parent child interactions, and must be remedied.

Various psychotherapies have been used to treat many conditions including mood disorders such as depression and bipolar disorder, Personality disorders, eating disorders, anxiety disorders, and addictions. The problems addressed are psychological in nature and of no specific kind or degree, but rather depend on the specialty of the practitioner.

Psychotherapies are also used to treat people who may not have a diagnosed mental illness, but need help coping with some kind of life stressor, such as stress from work or family, dealing with disease or health problems, or any kind of major life change, such as the death of a parent, divorce or personal trauma.

PCIT, a form of psychotherapy, has been used with success in families where abuse has occurred, in families with children who are afflicted with oppositional-defiant disorder, conduct disorder, and recently children with autism.

PCIT is divided into two components, child-directed interaction and parent-directed interaction. The child-directed interaction portion of PCIT  (or relationship enhancement) aims to develop a loving and nurturing bond between the parent and child through a form of play therapy. Parents are taught a list of "dos" and "don'ts" to use while interacting with their child. Parents are taught an acronym of skills with their children. Although the acronym varies from therapist to therapist, it is generally either "DRIP" or "PRIDE."

DRIP stands for the following:

  • D – Describe
  • R – Reflect
  • I – Imitate
  • P – Praise

Likewise, PRIDE stands for the following:

  • P – Praise
  • R – Reflect
  • I – Imitate
  • D – Describe
  • E – Enthusiasm

These acronyms are reminders that parents should describe the actions of their child, reflect upon what their child says, imitate the play of their child, praise their child's positive actions, and remain enthusiastic throughout Special Time. The parent-directed interaction portion of PCIT aims to teach the parent more effective means of disciplining their child through a form of play therapy and behavioral therapy. Parents are educated and taught how to effectively discipline and manage their child.

Pros for this therapy

At least 30 randomized clinical trials have found PCIT to be useful in treating at risk families and children with behavioral problems. Research findings include:

Reductions in the risk of child abuse – In a study of 110 physically abusive parents, only one-fifth (19%) of the parents participating in PCIT had re-reports of physically abusing their children after 850 days, compared to half (49%) of the parents attending a typical community parenting group (Chaffin et al., 2004). Reductions in the risk of abuse following treatment were confirmed by another recent study among parents who had maltreated their children (Timmer, Urquiza, Zebell, & McGrath, 2005).

Improvements in parenting skills and attitudes. Research reveals that parents and caretakers completing PCIT typically demonstrate improvements in reflective listening skills, use more prosocial verbalization, direct fewer sarcastic comments and critical statements at their children, improve physical closeness to their children, and show more positive parenting attitudes (Hembree-Kigin & McNeil, 1995).
Improvements in child behavior. A review of 17 studies that included 628 preschool age children identified as exhibiting a disruptive behavior disorder concluded that involvement in PCIT resulted in significant improvements in child behavior functioning.

Commonly reported behavioral outcomes of PCIT included both less frequent and less intense behavior problems as reported by parents and teachers, increases in clinic- observed compliance, reductions in inattention and hyperactivity, decreases in observed negative behaviors such as whining or crying, and reductions in the percentage of children who qualify for a diagnosis of disruptive behavior disorder (Gallagher, 2003).

Examining PCIT effectiveness among foster parents participating with their foster children and biological parents referred for treatment because of their children’s behavioral problems, researchers found decreases in child behavior problems and caregiver distress for both groups (Timmer,Urquiza, & Zebell, 2005).

Follow-up studies report that treatment gains are maintained over time (Eyberg et al., 2001; Hood & Eyberg, 2003). Usefulness in treating multiple issues. Adapted versions of PCIT also have been shown to be effective in treating other issues such as separation anxiety, depression, self-injurious behavior, attention deficit hyperactivity disorder (ADHD), and adjustment following divorce (Johnson, Franklin, Hall, & Preito, 2000; Pincus, Choate, Eyberg, & Barlow, 2005).

Studies support the benefits of PCIT across genders and across a variety of ethnic groups (Capage, Bennett, & McNeil, 2001;
Chadwick Center on Children and Families, 2004; McCabe, 2005).

Cons for this therapy

While PCIT is very effective in addressing certain types of problems, there are clear limitations to its use. For the following populations, PCIT may not be appropriate, or specific modifications to treatment may be needed:

  • Parents who have limited or no ongoing contact with their child
  • Very young children (less than 2½ years old)
  • Parents with serious mental health problems that may include auditory or visual hallucinations or delusions
  • Parents who are hearing impaired and would have trouble using the ear bug device, or parents who have significant expressive or receptive language deficits
  • Sexually abusive parents or parents engaging in sadistic physical abuse

Source: Child Welfare Information Gateway. Available online at www.childwelfare.gov/pubs/f_interactbulletin/

Psychoanalysis was perhaps the first specific school of psychotherapy, developed by Sigmund Freud and others through the early 20th century. Trained as a neurologist, Freud began focusing on problems that appeared to have no discernible organic basis, and theorized that they had psychological causes originating in childhood experiences and the unconscious mind. Techniques such as dream interpretation, free association, transference and analysis of the id, ego and superego were developed.

Behaviorism developed in the 1920s, and behavior modification as a therapy became popularized in the 1950s and 1960s. Notable contributors were Joseph Wolpe in South Africa, M.B. Shipiro and Hans Eysenck in Britain, and John B. Watson and B.F. Skinner in the United States. Behavioral therapy approaches relied on principles of operant conditioning, classical conditioning and social learning theory to bring about therapeutic change in observable symptoms. The approach became commonly used for phobias, as well as other disorders.

During the 1950s, Albert Ellis originated Rational Emotive Behavior Therapy (REBT). A few years later, psychiatrist Aaron T. Beck developed a form of psychotherapy known as cognitive therapy. Both of these generally included relatively short, structured and present-focused therapy aimed at identifying and changing a person's beliefs, appraisals and reaction-patterns, by contrast with the more long-lasting insight-based approach of psychodynamic or humanistic therapies. Cognitive and behavioral therapy approaches were combined and grouped under the heading and umbrella-term Cognitive behavioral therapy (CBT) in the 1970s. Many approaches within CBT are oriented towards active/directive collaborative empiricism and mapping, assessing and modifying clients core beliefs and dysfunctional schemas. These approaches gained widespread acceptance as a primary treatment for numerous disorders. A "third wave" of cognitive and behavioral therapies developed, including Acceptance and Commitment Therapy and Dialectical behavior therapy, which expanded the concepts to other disorders and/or added novel components and mindfulness exercises. Counseling methods developed, including solution-focused therapy and systemic. During the 1960s and 1970s Eugene Heimler, after training in the new discipline of psychiatric social work, developed Heimler method of Human Social Functioning, a methodology based on the principle that frustration is the potential to human flourishing.

Postmodern psychotherapies such as Narrative Therapy and Coherence Therapy did not impose definitions of mental health and illness, but rather saw the goal of therapy as something constructed by the client and therapist in a social context. Systems Therapy also developed, which focuses on family and group dynamics—and Transpersonal psychology, which focuses on the spiritual facet of human experience. Other important orientations developed in the last three decades include Feminist therapy, Brief therapy, Somatic Psychology, Expressive therapy, applied Positive psychology and the Human Givens approach which is building on the best of what has gone before.

PCIT was Originally developed by Dr. Sheila Eyberg, based on the play therapy work of Virginia Axline and Bernard Guerney, and the work of Diana Baumfind, which showed that authoritative parenting led to the healthiest outcomes. 

Parent-Child Interaction Therapy (PCITT is a form of psychotherapy developed by Sheila Eyberg for children ages 2–7 and their caregivers. Psychotherapy is a general term referring to therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group. The problems addressed are psychological in nature and of no specific kind or degree, but rather depend on the specialty of the practitioner.

Psychotherapy aims to increase the individual's sense of his/her own well-being. Psychotherapists employ a range of techniques based on experiential relationship building, dialog, communication and behavior change that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family).

Parent-Child Interaction Therapy (PCIT) is an empirically-supported treatment for young children with behavioral problems such as aggression, non-compliance, tantrums, and defiant behavior that emphasizes improvement of the parent-child relationship and changing parent-child interaction patterns.

Review Date: 
February 15, 2012