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Home > Parent-Child Interaction Therapy With At-Risk Families > What Makes PCIT Unique
Parent-Child Interaction Therapy With At-Risk Families
Issue Brief
What Makes PCIT Unique Introduced in the 1970s as a way to treat children with serious behavioral problems, PCIT has since been adapted successfully for use with populations who have experienced child maltreatment. The distinctiveness of this approach lies in the use of live coaching and the treatment of both parent and child together. In randomized testing, including families identified by the child welfare system, it has consistently demonstrated success in improving parent-child interactions. Benefits of the model, which extend to physically abusive and at-risk biological parents as well as foster parents, are described below. Reduces Behavior Problems in Young Children by Improving Parent-Child Interaction PCIT was designed to treat serious behavior problems in children ages 2 to 7. This includes children with disruptive or externalizing behavior problems, including conduct and oppositional defiant disorders. These children are often described as negative, argumentative, disobedient, and aggressive. PCIT addresses the negative parent-child patterns that may contribute to the disruptive behavior of young children (Bell & Eyberg, 2002). Through PCIT, parents learn to bond with their children and develop more effective parenting styles that better meet their children's needs. For example, parents learn to model and reinforce constructive ways for dealing with emotions, such as frustration. Children, in turn, respond to these healthier relationships and interactions. As a result, children treated using PCIT typically show significant reductions in behavior problems at home and at school (Brinkmeyer & Eyberg, 2003; Gallagher, 2003; Hembree-Kigin & McNeil, 1995; McNeil, Eyberg, Eisenstatdt, Newcomb, & Funderburk, 1991; Nixon, Sweeney, Erickson, & Touyz, 2003; Schuhmann, Foote, Eyberg, Boggs, & Algina, 1998). Decreases the Risk for Child Physical Abuse and Breaks the Coercive Cycle PCIT also has been found effective for physically abusive parents with children ages 4 to 12 (Borrego, Urquiza, Rasmussen, & Zebell, 1999; Chaffin et al., 2004). PCIT is appropriate where physical abuse occurs within the context of child discipline, as most physical abuse does. While child behavior problems and child physical abuse often co-occur, PCIT may help change the behavior of physically abusive parents regardless of child behavior problems. Many complex factors contribute to abusive behaviors, including a coercive relationship between the parent and child (Fisher & Kane, 1998; Patterson, 1995). Abusive and at-risk parents frequently interact in negative ways with their children, use ineffective and inconsistent discipline strategies, and rely too much on punishment. These same parents rarely interact in positive ways with their children (e.g., rewarding good behavior). At the same time, some physically abused and at-risk children tend to be aggressive, defiant, noncompliant, and resistant to parental direction (Kandel, 1992; Larzelere, 1986). The reciprocal negative behaviors of the parent and child create a harmful cycle that often escalates to the point of severe corporal punishment and physical abuse. The negative behaviors of the parent—screaming and threatening—reinforce the negative behaviors of the child—such as unresponsiveness and disobedience, which further aggravates the parent's behavior and may result in violence. PCIT helps break this cycle by encouraging positive interaction and training parents in how to implement consistent and nonviolent discipline techniques. Parents and caretakers completing PCIT typically:
In addition, parent satisfaction with PCIT is typically high (Chaffin et al., 2004; Schuhmann et al., 1998). Offers Support for Caregivers Including Foster Parents Children in foster care often exhibit high levels of behavior problems (Clausen, Landsverk, Ganger, Chadwick, & Litrownik, 1998). Foster parents frequently need help in managing the difficult behavior of foster children and infrequently receive training on how to deal with such problems (McNeil, Herschell, Gurwitch, & Clemens-Mowrer, 2005). PCIT is currently being recognized as a way to help support foster parents caring for children with behavioral problems by enhancing the relationship between foster parents and foster children and by teaching foster parents behavior management skills. In addition to reporting decreases in child behavior problems, foster parents frequently report less parental stress following PCIT and high levels of satisfaction with the program (McNeil et al., 2005; Timmer, Urquiza, & Zebell, 2005). Uses Live Coaching PCIT is a behavioral parent-training model. What makes PCIT different from other parent training programs is the way skills are taught, using live coaching of parent-child interactions. Live coaching provides immediate prompts to parents while they interact with their children. During the course of this hands-on treatment, parents are guided to demonstrate specific relationship-building and discipline skills. The benefits of live coaching are significant:
Treats the Parent and Child Together While many treatment approaches target either parents or children, PCIT focuses on changing the behaviors of both the parent and child together. Parents learn to model positive behaviors that children can learn from and are trained to act as “agents of change” for their children's behavioral or emotional difficulties (Herschell & McNeil, 2005). Adaptations for Various Populations PCIT has been adapted for use with various populations and cultures, including:
Limitations of PCIT 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:
This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare Information Gateway. |
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