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Monday, July 23, 2018

PCIT: Improving Child Behavior, Transforming Parent-Child Relationships

From NESCA Notes

By Ryan Ruth Conway, Psy.D.
Clinical Psychologist, NESCA

July 23, 2018

First developed in the 1970’s by Sheila M. Eyberg, Ph.D., Parent-Child Interaction Therapy (PCIT) is a scientifically proven treatment program for young children (ages 2-7) who display challenging behaviors (e.g., noncompliance, defiance, temper tantrums, aggression) and difficulty regulating their emotions.

PCIT therapists work with both the child and the parent together. Goals of treatment are to develop warmth and positivity in the parent-child relationship and teach parents how to effectively deal with behavioral problems both at home and publicly.

While this efficacious treatment has been around for almost 50 years and is practiced both nationally and internationally, it is not widely known among parents and professionals in Massachusetts.

The video above provides brief illustrations of the treatment in action at the University of Miami’s PCIT program. Watching the video, you will see clips of a PCIT therapist “coaching” the parent through a one-way mirror, as the parent listens to the therapist’s instructions about interacting with his or her child through an earpiece while they play.

PCIT is unique in that it is “in vivo,” or in real time, which helps the therapist directly observe parent-child interactions and also greatly enhances the caregiver’s learning of new skills that promote positive behaviors in children.

The video depicts the first phase of PCIT treatment called Child-Directed Interaction (CDI), which is the relationship enhancement phase. In CDI, parents follow the child’s lead in play while practicing specialized parenting skills. One of the skills applied by the parents in the video is praise. But not just any praise – this is labeled praise (e.g., “Great job playing gently with the toys”).

Labeled praise communicates to the child specifically what it is that they did well, which increases the likelihood that this behavior will happen again, bolsters the child’s self-esteem and also promotes positive feelings between the parent and child. Praise feels good to give and to receive!

Another skill practiced in CDI is reflection, or repeating what the child says during the play (e.g., Child says “The kangaroo is jumping”; Parent says “He is jumping very high!”) Reflections show that the parent is listening to the child, that the parent approves of what the child is doing and has also been shown to improve speech.

Labeled praise and reflections are just two of the many skills taught to parents in CDI.

While positive behaviors are reinforced in CDI, inappropriate behaviors (e.g., whining, crying, talking back) are intentionally ignored to reduce their occurrence. While ignoring disruptive behaviors, parents are coached to use distraction and redirection skills.

CDI then sets the foundation for the next phase of PCIT, called Parent-Directed Interaction (PDI), which continues to encourage appropriate play while also focusing on a structured and consistent approach to discipline.

There have been numerous studies documenting the effectiveness of PCIT (http://www.pcit.org/literature.html). Results have shown improvements in child behavior as well as reduced stress and increased confidence amongst caregivers. In addition to these outcomes, we see a stronger, happier parent-child bond!

To learn more about PCIT, visit http://www.pcit.org/

Ryan Ruth Conway, Psy.D. is a licensed clinical psychologist who specializes in Cognitive Behavioral Therapy (CBT), behavioral interventions, and other evidence-based treatments for children, adolescents and young adults who struggle with mood and anxiety disorders as well as behavioral challenges. She also has extensive experience conducting parent training with caregivers of children who present with disruptive behaviors and Attention-Deficit/Hyperactivity Disorder.

Dr. Conway has been trained in a variety of evidence-based treatments, including Parent-Child Interaction Therapy (PCIT), Dialectical Behavior Therapy (DBT), and Exposure with Response Prevention (ERP).

Dr. Conway conducts individual and group therapy at NESCA utilizing an individualized approach and tailoring treatments to meet each client’s unique needs and goals. Dr. Conway has a passion for working collaboratively with families and other professionals. She is available for school consultations and provides a collaborative approach for students who engage in school refusal.

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