Parent-Child Interaction Therapy (PCIT) is a structured, evidence-based approach designed to support young children ages 2 to 7 who experience behavioral and emotional challenges. This method focuses on improving the caregiver-child relationship while providing parents with tools to encourage positive behavior and effectively manage difficult behaviors. Decades of clinical research have demonstrated that PCIT can lead to meaningful improvements in children’s functioning and overall family dynamics.
Effectiveness of PCIT
PCIT is supported by a strong body of research and is widely recognized for its success in treating childhood behavior concerns. It has shown positive outcomes for children dealing with issues such as ADHD, autism spectrum disorder (ASD), and emotional regulation difficulties. Families who complete PCIT often report long-term improvements in their child’s behavior, communication, and the overall functioning of their family. Rather than following a fixed timeline, treatment continues until parents show confidence in the strategies they’ve learned and report noticeable improvements in their child’s behavior. Parents and caregivers can continue to incorporate the strategies from PCIT into their parenting practices after finishing formal therapy.
Understanding PCIT
PCIT is an interactive model where therapists coach caregivers in real time during play or structured tasks with their child. Using a one-way mirror and an earpiece, the therapist provides live feedback as the parent interacts with the child, supporting the immediate application of learned skills. This hands-on format fosters confidence and responsiveness in caregivers. PCIT aligns with the ideas of attachment theory which emphasizes the importance of a secure, responsive relationship between child and caregiver.
Two Phases of PCIT
PCIT is delivered through a step-by-step process that teaches essential parenting strategies and behavioral skills.
Phase One: Strengthening the Parent-Child Bond
The first phase, called Child-Directed Interaction (CDI), focuses on building a nurturing and cooperative relationship between parent and child. The parent joins the child in play without directing or correcting. They describe the child’s actions with phrases like, “You’re building a tall tower,” reflect speech, and offer labeled praise by saying things like, “I love how gently you’re stacking those blocks.” Through these interactions caregivers learn specific skills that promote warmth, trust, and shared enjoyment while children begin to feel emotionally supported.
Goals of this phase include:
- Reducing tantrums and outbursts
- Minimizing behaviors that seek negative attention
- Improving self-esteem and social interaction
- Enhancing the emotional bond between caregiver and child
- Supporting better attention and emotional self-control
Phase Two: Establishing Effective Discipline Strategies
The second phase, known as Parent-Directed Interaction (PDI), introduces practical and consistent behavior management techniques. Parents learn to give clear instructions, set boundaries, and respond to misbehavior in a calm, effective manner. For example, during clean-up time, a parent gives a clear instruction like, “Please put your crayons back in the box.” When the child resists or ignores the request, the parent calmly repeats the instruction once and follows up with a consistent consequence, like removing screen time for five minutes or a time-out. Throughout, the parent is coached to stay calm and confident, and over time, the child learns that rules are predictable. This phase helps children learn structure, accountability, and respect for rules across different settings.
Goals of this phase include:
- Decreasing oppositional and aggressive behavior
- Promoting cooperation and rule-following
- Supporting respectful behavior at home and in public
- Building caregiver confidence in managing difficult situations
Conclusion
PCIT is an evidence-based therapy which offers families with young children a practical, relationship-focused approach to managing behavioral challenges. By teaching caregivers how to strengthen emotional bonds and implement clear behavior strategies, PCIT supports long-term change in both child behavior and family functioning. For more information about PCIT visit PCIT International.
References
Allen, B., Timmer, S. G., & Urquiza, A. J. (2014). Parent–child interaction therapy as an attachment-based intervention: Theoretical rationale and pilot data with adopted children. Children and Youth Services Review, 47, 334–341. https://doi.org/10.1016/j.childyouth.2014.10.009
Bodiford McNeil, C., & Hembree-Kigin, T. L. (2010). Parent-Child Interaction Therapy (2nd ed.). Springer.
Images, A. (2025). Child and Parent Engaged in Playdough Activity. Canva. Retrieved from https://www.canva.com
Krukau, Y. (2025). A Woman Playing on the Rain with Her Child. Canva. Retrieved from https://www.canva.com
Olsen, B. (2025). A Woman Talking to her Child in a Park. Canva. Retrieved from https://www.canva.com
Parent-child interaction therapy (PCIT). Boston Child Study Center, Boston, MA. (2021, June 24). https://bostonchildstudycenter.com/child-services/pcit/
Parent Child Interaction Therapy, Incorporated. (2021). Research: Parent child interaction therapy. PCIT – Official Home. https://www.parentchildinteractiontherapy.com/pcit-research
PCIT International Association 2015-2023. (n.d.-a). What is PCIT?. Official website for PCIT International and Parent-Child Interaction Therapy (PCIT). https://www.pcit.org/what-is-pcit.html
PCIT research. Official website for PCIT International and Parent-Child Interaction Therapy (PCIT). (n.d.). https://www.pcit.org/pcit-research.html
Sampaio, K. (2025). Photo of Mother and Child Playing. Canva. Retrieved from https://www.canva.com
Acknowledgements
This blog post was prepared with the help of Rachel Beck, a second year graduate student at Tufts University’s Eliot-Pearson Department of Child Study and Human Development. Rachel is passionate about child development and supporting children and their families. This has manifested itself in all of her professional work, including her experiences in Early Intervention and Healthy Families Massachusetts.