Parenting the difficult child with PCIT.

Children between the ages of two and six are learning how to regulate their emotions and how to meet their needs. They often struggle with big emotions that lead to tantrums, aggressive behavior, and power struggles with their caregivers. Parenting can be demanding, and parenting a child struggling with these emotional and behavioral issues can be additionally challenging. However, with a few simple skills, you can better manage everyday problems and create a more peaceful home for you and your family.

PCIT or Parent Child Interactive Therapy is a form of therapy where the parent and child meet together in parent-child sessions with a PCIT therapist. During these sessions, the parent is coached in real time by the therapist while the child and parent play. This is effective as the therapist is able to directly observe the child’s behavior instead of relying solely on parent reports. This enables the therapist to coach the parent through any challenging interactions with the child.

There are two treatment phases in PCIT. The first phase focuses on establishing and strengthening warmth and attachment in your relationship with your child. This is done through learning and applying a set of skills proven to help your child feel calm, secure in their relationship with you, and good about themselves.

This phase of treatment has several desired outcomes, including:

  • Decreased frequency, severity, and/or duration of tantrums
  • Decreased hyperactivity levels
  • Decreased negative attention-seeking behaviors (such as whining and bossiness)
  • Decreased parental frustration
  • Increased feelings of security, safety, and attachment to the primary caregiver
  • Increased attention span
  • Increased self-esteem
  • Increased pro-social behaviors (such as sharing and taking turns)

The second phase of treatment equips you with the ability to manage the most challenging of your child’s behaviors. Mastering these skills will enable you to remain calm, confident, and consistent in your discipline approach. This phase teaches you proven strategies to help your child accept your limits, comply with your directions, respect house rules, and demonstrate behavior in public that is appropriate.

In this second phase of treatment there are several desired outcomes, including:

  • Decreased frequency, severity, and/or duration of aggressive behavior
  • Decreased frequency of destructive behavior (such as breaking toys on purpose)
  • Decreased defiance
  • Increased compliance with adult requests
  • Increased respect for house rules
  • Improved behavior in public
  • Increased parental calmness and confidence during discipline

PCIT may often be completed in 12-20 sessions, though treatment is not time-limited. This is best accomplished with consistent attendance and homework completion. Treatment is considered complete when you have mastered the set of skills in both phases of treatment and when you rate your child’s behavior within the normal limits on a behavior rating scale known as the ECBI.

With love and gentle guidance, your child will develop confidence, mastery, and self-acceptance. They will learn to follow the expectations of you and their teachers, and you will see a decrease in undesirable behaviors.  If this attachment focused therapy sounds like a good fit for you and your child, please contact me to schedule an appointment at or by calling 503-880-7190.

I am a marriage and family therapist who is passionate about helping children become less stressed by giving them and their parents tools, support and encouragement. I received my Master’s of Arts in Counseling Psychology in Marriage and Family Therapy from Pacifica Graduate Institute. I am trained in PCIT and am working towards certification. I am also trained in play therapy working towards certification with the American Play Therapy Association.