PCIT stands for Parent-Child Interaction Therapy and is used to target and address behavioral and emotional challenges in children ages two to seven.
Why is it so popular? PCIT is a popular modality because it is an “evidence-based” intervention. What does this mean? A therapy modality is considered “evidenced-based” when it can be researched, developed, and tested with positive results. It also provides structure- something that is commonly missing in therapy and can bring peace of mind to parents who crave structured, immediate feedback.
What does a PCIT session look like?
During a PCIT session, a parent is fitted with an earpiece that enables them to communicate with their therapist who stands outside of the therapy room. The room typically has a one-way mirrored window, which allows the therapist to observe the parent and child for the entirety of the session. The therapist then speaks to the parent through the earpiece directing them what to say and do, making frequent comments to correct, adjust, and praise the parent with the goal of improving the parent-child relationship.
Sounds great, right? Well, unfortunately, there are some downsides to PCIT. Keep reading to find out why it can potentially cause problems…
Pros of PCIT:
Goal-Oriented & Structured
PCIT is highly structured, focusing on clear goals such as enhancing parenting skills and decreasing disruptive behaviors. This goal-oriented approach works really well for parents who do best with clear and measurable structure!
Solid Feedback Process
The therapist providing feedback in real-time can put some parents at ease. It can take the guesswork out of play, which can be supportive for adults who feel uncomfortable in pretend play.
Evidenced-Based
PCIT is backed by extensive research demonstrating its effectiveness in reducing child behavioral problems (e.g., aggression, defiance) and improving parent-child relationships. (But my question is… at what cost?)
Provides emotion regulation tools
Parents and children learn emotional regulation and communication skills, which can reduce stress and conflict within the family.
Con’s of PCIT:
Doesn’t address the root cause of behavior
I find PCIT to be overly simplistic. Relationships are complex and involve the emotional well-being of both people involved. PCIT doesn’t exactly address this complexity and can leave parents with tools but not with the education and understanding of why these tools are helpful and when to use them outside of the therapy room. (I.E. understanding the root cause of emotion dysregulation.)
Too intense!
At Child Therapy Center, our therapists make sure to deliver feedback at a pace that matches a parent’s readiness because we know feedback isn’t necessarily easy to receive! PCIT fails to attune to a parent’s unique needs and when a therapist dumps too much feedback at once, this can lead to feelings of overwhelm, shame, or frustration, which can delay progress.
Overly Structured
Before writing this article I watched several videos of PCIT in action and If I’m being honest, I could hardly get through them. I physically cringed watching the therapists direct the parents, telling them exactly what to say to their child. The whole process felt very awkward, tense and robotic. Following such strict instructions leaves little room for authenticity, and of course, a child picks up on this.
Limited age range (2-7)
PCIT is only appropriate for children ages 2-7, leaving out older kids and adolescents.
Neglects a parent’s well-being
The coaching aspect of PCIT can be quite intense and I’ve seen it cause discomfort in parents. With the therapist's primary focus on the child, the therapist can unintentionally miss the subtle signs of stress in the parent while they continue to deliver constant and immediate feedback. At CTC we believe that the state of a parent’s nervous system is 10x more important than the tool the parent is using, making this a major flaw of the technique.
Clearly, I’m not a superfan of the approach, BUT I do believe in honoring a parent’s desire for more structure. There is absolutely a time and place for PCIT and it can be a great fit for families who crave structure. If you are interested in finding a PCIT practitioner, use the checklist below to find a therapist who can provide structure and a relationship-based approach so you get the best of both worlds!
A Checklist for finding an exceptional PCIT therapist:
✅They understand the limitation of using PCIT alone
✅They take a relationship-based approach while using the intervention
✅They are trained in nervous system regulation and understand the stress response in children
✅They adjust the approach to the family and don’t fit families (and children!) in a box or chart
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