Parent-Child Interaction Therapy

About the program

Parent-Child Interaction Therapy (PCIT) is an individualised, evidence-based treatment program for preschool children displaying disruptive, oppositional and defiant behaviour. The intervention is founded in social learning, attachment and behavioural theory, and incorporating play therapy. PCIT was developed for children aged between 3 and 7 years and their parents. The goal is for parents to strengthen the parent-child bond and increase the prosocial behaviour of the child. It also aims to decrease child externalising and internalising symptoms, caregiver stress, depression, abuse potential and negative communication, and to increase observed maternal sensitivity and positive communication.

Who does it work for?

The program is targeted at preschool children displaying disruptive, oppositional and defiant behaviour, and their parents.

One QED study was conducted in Hong Kong with a matched comparison group of 130  Chinese Hong Kong parents with children aged 2 - 8 years (final sample 110) (Leung et al. 2009). Around half of the parents were educated to only lower secondary school level.

One RCT was conducted in Australia with 151 female caregivers (mean age 33.9 years) and their children (mean age 4.57 years) (Thomas & Zimmer-Gembeck 2012). In this study, 74% of parents were born in Australia, and 1.4% of parents identified as Aboriginal or Torres Strait Islander. Most mothers had completed some high school (81%) and 16.5% had some tertiary education. Participants were referred from child protection authorities (34.2%), government health services (19.7%), and education and nongovernment social service organisations (18.4%). Parent self-referrals were also accepted (27.6%), but the pre-assessment interview had to reveal prior parenting interventions, high risk for child maltreatment and significant levels of child behavioural problems.

What outcomes does it contribute to?

Positive outcomes:

Parental stress: Both studies reported significantly lower parenting stress in the intervention group than in the control group (Thomas and Zimmer-Gembeck, 2012; Leung et al. 2009).

Corporal/physical punishment/discipline: Leung and colleagues (2009) found a reduction in corporal punishment after the intervention, measured by the number of instances of corporal punishment in the last month as reported by the participant.

Dyadic reciprocity: Leung and colleagues (2009) found a significant improvement in parent-child interaction. There were decreases in the number of questions and criticisms, and increases in the number of descriptions, reflections, instances of praise, and instances of compliance.

Positive communication: Thomas and Zimmer-Gembeck (2012) found an increase in parental communication in the intervention group, with larger effects observed for PCIT participants compared to waitlist control group for praise, and descriptions and reflections, and medium-to-large effects in decreasing questions, commands, and negative talk.

No effect:

None.

Negative outcomes:

None.

Is the program effective?

Overall, the program has a positive effect on client outcomes.

How strong is the evidence?

Supported research evidence:

• At least two high-quality RCT/QED studies report statistically significant positive effects for at least one outcome, AND
• Fewer RCT studies of similar size and quality show no observed effects than show statistically significant positive effects for the same outcome(s), AND
• No RCT studies show statistically significant adverse effects

How is it implemented?

One-hour long weekly treatment sessions are delivered over a period of 12 weeks. PCIT skills are taught via didactic presentations to parents and direct coaching of parents while they are interacting with their children. While parent–child dyads are observed through a one-way mirror, parents wear a bug-in-the-ear device and are coached to attend to the child’s behaviours consistently and predictably. Parents are taught behaviour management strategies that focus on positive reinforcement rather than power assertion to reduce child oppositional and disruptive behaviours. The behaviour management techniques in PCIT are designed to aid children’s emotional regulation by providing parents with developmentally appropriate language and skills. The program is delivered in social service and clinical centres by Masters and Doctoral-level psychologists or social workers trained in PCIT.

How much does it cost?

Information not available.

Where does the evidence come from?

One QED study with a matched comparison group of 110 parents with children aged 2-8 years conducted in Hong Kong (Leung et al. 2009)

• One RCT with 151 female caregivers and their children conducted in Australia (Thomas and Zimmer-Gembeck, 2012)

Further resources

• http://www.pcit.org/
• Leung, C et al. (2009). “Effectiveness of Parent-Child Interaction Therapy (PCIT) among Chinese families.” Research on social work practice 19(3): 304-313.
• Thomas, R. and M. J. Zimmer-Gembeck (2012). “Parent–Child Interaction Therapy: An Evidence-Based Treatment for Child Maltreatment.” Child maltreatment 17(3): 253-266.