Parent-Child Interaction Therapy: A Guide for Families Struggling to Manage their Child’s Disruptive Behaviors

By: Abbey Herringshaw, Karina G. Campos, Psy.D., & Suzi Naguib, Psy.D. November 2011                                                                                                               Blog PDF

PCIT, ADHD treatment, ODD ann arborRyan is a 7-year-old 2nd grader whose parents sought help due to his frequent behavioral outbursts. They noted that they have significant difficulty getting Ryan to engage in daily tasks, such as completing his homework, taking a bath on time and helping put his toys away. Specifically, when demands are placed on him, he frequently yells back and refuses to follow directions. This has negatively impacted Ryan’s relationship with his parents and has also put a strain on his parent’s marriage.

Parenting is not always easy, particularly when a child’s temperament negatively affects his ability to adapt to the demands of daily life. Parents of children with behavioral difficulties, often experience increased frustration and higher levels of depression, particularly mothers. Parent Child Interaction Therapy (PCIT) is an empirically-supported treatment approach designed to help parents manage problem behaviors while building a stronger relationship with their child.

What is PCIT?
PCIT is a powerful intervention for families struggling to find harmony in their home. It uses an integration of attachment theory and behavioral therapy approaches to help parents regain confidence in their ability to positively and effectively parent their child.  Treatment is conducted with both the parent and child present in order to allow the clinician to coach the parent while observing from behind a one-way mirror.

Which families can benefit from PCIT?
PCIT is especially effective for children ranging in age from 2-7 years. The treatment addresses a variety of behavior and emotional problems. This includes acting-out behaviors, such as noncompliance and aggression, as well as more internal difficulties like sad mood, poor self-esteem, and anxiety. Principles of PCIT can also be implemented in a school setting in order to improve child behavior as well as a child’s relationship with his or her teachers and peers.

What are the steps involved in PCIT?
Prior to starting treatment, a child is first evaluated to identify specific parent concerns. When PCIT is recommended as the treatment of choice, an initial meeting is scheduled with the parents where a clinician orients them to the treatment model.

  • The first phase of treatment focuses on Child-Directed Interaction (CDI), which involves increasing positive engagement and offering praise in order to strengthen the parent-child relationship and reinforce appropriate behaviors. Parents are also taught to use selective attention to encourage pro-social behaviors while diminishing more problematic ones. After parents have learned the basics of CDI, they practice these skills with their child, while the therapist observes from behind a one-way mirror. The therapist helps parents succeed by unobtrusively coaching them via a small earpiece.
  • The second phase of treatment focuses on Parent-Directed Interaction (PDI), which entails teaching parents how to follow-through and increase consistency and predictability when giving their child directions. After learning this second phase of the treatment, parents practice PDI and CDI skills simultaneously while their therapist observes and coaches them from behind the one-way mirror. This involves having the parent practice giving clear and effective instructions as well as setting appropriate limits to noncompliance while reinforcing positive interactions via the use of their CDI skills.

What benefits has PCIT been shown to have for families?
PCIT has helped improve the everyday lives of many families. Research has found PCIT to be effective in reducing problem behaviors1, both at home and in school2. At the conclusion of treatment, parents report decreased parenting related stress3 and improvedattitudes toward their child. Additionally, child compliance increases1 and parents typically endorse high treatment satisfaction. Given that PCIT is time limited, even busy parents are able to participate.


Eyberg, S. M., & Robinson, E. A. (1982). Parent–child interaction training: Effects on family functioning. Journal of Clinical Child Psychology, 11, 130-137.

McNeil, C. B., Eyberg, S., Eisenstadt, T. H., & Newcomb, K. (1991). Parent-child interaction therapy with behavior problem children: Generalization of treatment effects to the school setting. Journal of Clinical Child Psychology, 20, 140-151.

Schuhmann, E. M., Foote, R. C., Eyberg, S. M., Boggs, S. R., & Algina, J. (1998). Efficacy of parent–child interaction therapy: Interim report of a randomized trial with short-term maintenance. Journal of Clinical Child Psychology, 27, 34-45.

Recommended Readings:

Parent-Child Interaction Therapy by Cheryl Bodiford McNeil and Toni L. Hembree-Kigin

For more information about Sunfield Center for Autism, ADHD and Behavioral Health, and our ADHD & Disruptive Behavior Disorders Center, please visit our website at or call us at (734) 222-9277.