Have You Heard of PCIT?

I hadn’t! As someone who thought I’d seen or heard it all when it came to therapy, this one was new to me. PCIT stands for Parent-Child Interaction Therapy, and it’s designed to strengthen the parent-child relationship while addressing behavioral challenges. It originally emerged in the 1970s, developed by Dr. Sheila Eyberg, a clinical psychologist, with the goal of helping families manage disruptive behaviors in young children. Today, it's widely used for children aged 2 to 7 to improve both behavioral outcomes and emotional regulation. Research shows it’s particularly effective with children exhibiting ADHD-like behaviors, trauma, or attachment difficulties.

Recently, my youngest son, Henry, was diagnosed with “sensory attention disorder, unspecified” after a full psychological evaluation. I didn’t have any specific concerns about autism, but since I have ADHD myself, I knew there was a chance we might have another “neuro-spicy” individual in the family. Henry is full of life and charm—he loves being the center of attention, and I definitely see a lot of myself in him. However, he has his own agenda, struggles to sit still, and often doesn’t listen. Between Henry and William (my other son, who has autism with a higher level of need), it can sometimes feel like absolute chaos in our house.  

This is where PCIT comes in. It helps with these challenges by strengthening the parent-child relationship first, under the belief that once a positive foundation is built, better boundaries and behavioral improvements follow naturally.  

Phase One: Child-Led Play 

We are currently in the first phase of PCIT, which focuses on following the child’s lead. This phase is all about "special playtime," where we play together for 5 minutes a day, 4 times a week at home, along with one weekly clinic session. During special playtime, we use creative and constructive toys—think blocks, Legos, Magna-Tiles, Mr. Potato Head, crayons and paper, cars, and trains.  

To guide the interactions, PCIT uses the PRIDE skills:  

- Praise: Give specific praise (e.g., “I love how gently you’re stacking the blocks!”)  

- Reflect: Repeat what your child says to show you’re listening.  

- Imitate: Mirror their play to show you’re engaged.  

- Describe: Narrate what they’re doing (e.g., “You’re building a tall tower!”).  

- Enjoy: Express your enjoyment being with them (e.g., “I love spending time with you at the table!”).  

Although it sounds simple, there’s a catch: during child-led play, you’re not allowed to give commands, ask questions, or correct behavior. This can be tricky since most of us do these things without even realizing it—like saying, “Let’s play with the farm!” (command), “What animal is this?” (question), or “That’s not where the triangle goes” (correction). 

In-Clinic Coaching Sessions 

In the clinic, special playtime happens with me and Henry in one room, while the therapist (and sometimes my husband) observes from behind a two-way mirror. The therapist listens and tracks how often I use the PRIDE skills, as well as any challenging behaviors that arise. After the first few minutes, the therapist begins coaching me through an earpiece, reminding me to use specific skills and giving encouragement—like a personal parenting coach!  

For example, when Henry was building a tower, I used descriptive statements like, “You’re building a tower!” and “You’re putting the red block on the green block.” I also praised him: “Thank you for being so gentle with the blocks,” and shared positive emotions: “I love sitting at the table with you.”  

When challenging behaviors came up—like Henry jumping on a chair, shouting, “Look at me!” and knocking the blocks off the table—I ignored the behavior and moved to another activity, like playing with cars and having fun. When Henry joined me at the new activity, I praised him for making the transition without mentioning the disruptive behavior. 

How PCIT Compares to Other Therapies 

Some aspects of PCIT feel familiar to us since we’ve used floor time therapy and ABA therapy with William. However, the experience is different because Henry’s play and communication skills are more developed, so the focus shifts to strengthening our relationship and managing behavioral challenges in a way that works for him.  

The biggest takeaway for me? It’s not about me failing as a parent or being unable to control my child. Instead, it’s about learning a new parenting language—one that isn’t intuitive but can make a big difference. The truth is, we don’t naturally know how to respond in these ways, and that’s okay. What’s important is that there are experts here to help us along the way. 

Results and Why PCIT Matters

PCIT has shown great results for families dealing with ADHD, trauma, anxiety, and behavioral challenges. Studies have found that children who complete PCIT often show improved emotional regulation, fewer tantrums, and better listening skills. At the same time, parents report feeling more confident and less stressed. This isn’t just about behavior management—it’s about building a stronger bond with your child that lasts long-term.  

For us, it’s still early in the process, but I’m already seeing small wins. More importantly, I feel hopeful that we’re learning the tools we need to navigate the chaos with more patience and love.