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Parent-child interaction therapy (PCIT)

The Heart Center at Children's Health℠ is one of the first programs in the country to offer parent-child interaction therapy (PCIT) as part of our mission to advance mental health for our young patients and their families.

Children who have congenital heart disease (CHD) are at a higher risk of behavioral problems, according to recent research. PCIT helps families build healthy relationships that support their child’s social-emotional and behavioral development.

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What is parent-child interaction therapy (PCIT)?

Pediatric psychologists (therapists) in our Cardiac Neurodevelopmental Program provide parent-child interaction therapy (PCIT). Through therapist-guided coaching sessions, caregivers learn to interact with their children in ways that strengthen the caregiver-child relationship. PCIT focuses on positive encouragement to help improve a child’s behaviors and relieve caregivers’ stress as they learn to better manage and even prevent behavioral issues.

Behavioral issues, including hyperactivity, inattention, and noncompliance, can affect the caregiver-child relationship and even interfere with the success of a child’s treatment. PCIT can help caregivers manage challenging behaviors while remaining confident, calm, and consistent in their approach to discipline.

What are the benefits of parent-child interaction therapy (PCIT)?

Psychologists originally developed PCIT in the 1970s and have successfully used it to address a wide range of behavioral problems and emotional outbursts in children ages two through seven. The pediatric psychologists at our Heart Center have adapted PCIT techniques to focus on the specific needs of children with CHD and their caregivers.

Behavioral and emotional problems can interfere with successful treatment in children with CHD, which affects their overall health and well-being. Our psychologists tailor PCIT for these children to support their social-emotional and behavioral development. The main goal of PCIT is a stronger, healthier caregiver-child relationship, which supports your child’s health and your family’s quality of life.

Research shows that PCIT can improve a child’s:

  • Self-esteem, attention span and concentration
  • Feelings of security, safety and attachment to their parent or caregiver
  • Social behaviors such as sharing and taking turns
  • Comfort by reducing anxiety during medical procedures and hospitalizations
  • Ability to follow heart and other treatment plans at home

For caregivers, PCIT can enhance:

  • Calmness and confidence
  • Attachment to your child, with more positive interactions
  • Feelings of empowerment as you learn positive ways to improve your child’s behavior, respect for rules and ability to comply with adult requests
  • Stress reduction, especially during your child’s medical procedures and hospitalizations
  • Ability to follow heart and treatment plans at home, including health monitoring and medications

What does parent-child interaction therapy (PCIT) treat?

PCIT can help manage a wide range of behaviors and conditions, including:

What to expect with parent-child interaction therapy (PCIT)

At the Heart Center, our team identifies families who may benefit from PCIT through an assessment.

The therapy consists of two phases.

  1. The first takes place at the Heart Center and focuses on building a stronger parent-child relationship.
  2. The second, which you can do at home via telehealth sessions, teaches techniques for healthy, effective behavior management.

PCIT involves weekly, 50-minute sessions, and most families attend 12 sessions across phases 1 and 2. You and your child may have more or fewer sessions depending on your specific needs.

What to expect before parent-child interaction therapy (PCIT)

Your child’s cardiologist (doctor who specializes in heart care) at the Heart Center will work with you to decide whether your family could benefit from PCIT. If you have any behavioral concerns, speak with your child’s cardiologist, who will refer you to our pediatric psychologists for an assessment in our Cardiac Neurodevelopmental Outpatient Program. This assessment will screen for social-emotional and behavioral concerns that we can help you and your child work on and identify baseline skills you’re already using.

What to expect during phase 1 of parent-child interaction therapy (PCIT)

In the first session, our psychologist will ask you about your child’s current behaviors, their developmental history and your level of stress about the behaviors. We’ll show you the "bug-in-the-ear" device that you’ll wear during sessions, and we’ll use toys to demonstrate what your sessions will look like.

In the remaining phase 1 sessions, you and your child will play together in one room while our psychologist observes and coaches from another room, watching through a one-way mirror. The psychologist will provide in-the-moment coaching, through the ear device, on the skills and techniques to manage your child's behavior.

You’ll follow your child’s lead during play therapy and use positive attention to create more pleasant interactions. Phase 1 will help your child feel calm and secure in their relationship with you, and help you feel empowered as you learn constructive ways to improve your child's behavior.

What to expect during phase 2 of parent-child interaction therapy (PCIT)

In this phase, you and your child will interact together at home while our psychologist provides in-the-moment coaching via phone or video. Our psychologist will teach you how to make commands effectively and show consistent expectations for your child. Phase 2 provides you with real-time coaching and feedback on strategies to help your child accept your limits, comply with directions, respect rules and demonstrate appropriate behavior in public.

In the second phase, you’ll learn proven behavior management techniques such as:

  • Planned ignoring
  • Effective commands
  • Consistent consequences
  • Structured timeouts

What to expect after parent-child interaction therapy (PCIT)

Our psychologists will assess your mastery of the skills in each phase before you can move from phase 1 to phase 2, and from phase 2 to completion. Your family’s course of treatment is complete when you have mastered both sets of skills and rate your child’s behavior within normal limits on a behavior rating scale.

Learn more about parent-child interaction therapy (PCIT) at Children’s Health

Our PCIT program is part of our Cardiac Neurodevelopmental Program at the Heart Center, which aims to provide comprehensive, accessible neurodevelopmental care for children with congenital heart disease and their families. Our goal is to provide the therapies your family needs, as early as possible, to improve your child’s development and overall health and support your family’s quality of life.

Parent-child interaction therapy (PCIT) doctors and providers

Our pediatric psychologists have advanced training and experience in PCIT and other therapies to support children’s development, health and well-being. In the Cardiac Neurodevelopmental Program at the Heart Center, we work closely with children and families affected by congenital heart disease.

Frequently Asked Questions

  • How effective is parent-child interaction therapy (PCIT)?

    PCIT is a highly effective therapy for improving the parent-child relationship and reducing child behavior problems. An analysis of 23 research studies found that PCIT was much more effective than other approaches in reducing behavior problems. Research also shows that PCIT reduces stress in caregivers and children and improves the relationship among them.

  • How is parent-child interaction therapy (PCIT) different from other types of therapy?

    Some key differences between PCIT and other types of family therapy include:

    • Setting - PCIT takes place in a playroom where caregivers and children interact with each other during play, whereas family therapy usually takes place in an office.
    • Focus - PCIT focuses on improving the caregiver-child relationship and child behavior, whereas family therapy can address a variety of mental health issues, such as anxiety, depression, or trauma.
    • Method - PCIT uses a combination of coaching and modeling to teach caregivers new parenting skills, whereas family therapy is more likely to involve talk therapy.
    • Time frame - On average, families master PCIT techniques and skills within 12 to 16 weekly sessions. The length of treatment depends on each family’s specific needs. Other types of therapy can last much longer.

  • What are some common misconceptions about PCIT?

    Some common misconceptions about parent-child interaction therapy (PCIT) include:

    • PCIT is only for children who have behavioral problems - PCIT also helps children with anxiety, autism or developmental delays.
    • Most of the work happens outside the therapy sessions - During sessions, the psychologist serves as a coach and identifies skills for the caregiver to improve. Most of the work happens outside the therapy sessions as parents and children work together on the skills and behaviors at home and in public settings. 
    • PCIT is not a quick fix (or) progress takes time - On average, sessions total 14 to 20. However, treatment has no time limit and largely depends on caregiver ability to master PCIT technique and adhere to daily practice. Therapists provide instructions and feedback to caregivers to reinforce the skills learned in each phase. 

  • Is parent-child interaction therapy (PCIT) covered by insurance?

    Yes, most health insurance companies and Medicaid cover PCIT as family or individual therapy. Please contact your health insurance company to verify your plan’s coverage, or speak with one of our team members.

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