Parent-Child Interac tion Therapyllct'erl) W " FunAcrburlt and Sheila Elherg
Parenr-Child lnrerr.rction Therrpy (PCIT) was originally devcloped inrlie l9?0s hy Sheila Eybcrg fbr farnilies of children ages 2 to 7.{iagnosed withtlisruptive bchavior disorders. Sincc that tin-re, PCIT has cvolved into a
w idcly r-rsecl, cvir{ence'basr:d tl'catmcnt.PCIT igctu.les tw() sequentiai phnses and requires lu average of I 5 weekly
sessions. Coals of rhe firsr 1',[ase, the Child-Dirccted ]nteractit>n (CDI), are
tr.l irnprovc the qualiq, rrf rhe parcnt-child relatiorrship and strengthen ittten-ti,rn rind reinforcctnetrr fttr ptxitive chiirl hehavior. In tlre Cl)I, parents learn19 fblftlw their child's lead.irr ,lyadic plty and provic{c positive attenlion cora'bined with activc ignrlring of minor mishelrilvior. Thev are taugtrt to use thePRli)E skills--Praise, Re{lcction, lnritatiou, Dcscriptirln, antl Enthusiasnt*to reinfirrce pqsitive, appropriatc behirvir;rs. Pirrents also lcrarn to avtlid lea,.l-
iug gr intrrrsivc bel"rrrviors-c()lutnanl{s, questioniug, criticism, snrcastn' andrlcgarivc physical lrehavio$. This phasc firrms rhc foundi,rtirln ftrr effc'c:tive dis'cipline tnrining in the sectrtr.l pfirrsc, thc Parent.L)irectcd lutcraction (PDI).ln the PDl, parel-rts learn t,r lead therir child's uctivity, iir*^t in dytrdic play sit'sati{)ns apd larer in real.life situirtions whcn ir is itnptlrtilnt rl"rat their childghrey. Thcy lertrn t,, give effcctive itrsrructions anJ ttt fbllow through withcrtnsisleur colueqttences, includirrg lrraise f()r cotnpliuncc atrd a timeout prr:'ceilure f or noncompliance.
One .listinguishirrg fearule o{ PCiT is its intensivc elelivery-directcgirclring of parent-child interactions. Live skills co,rchingof the parentdttr'ing parenr-chiid interrctir"rns is the hallmark of ['CIT. For both the CDI andPL)i phues, rhe principles and skills are introduced in ,rne teaching sessign
rvifh tfic cilregiver(s) altlne. ln suhse.y-rent cclaching sessi()ns, after a htlme'u'<:rk review, therirpists coitch each $tirrent-chiltl dvad in turn' ln clinic'bascdPCIT, co*clring is cltme via a rvireless earphone tlrrough tl one-way tnirror.The trrirrcnt atrd chiH inreract in the tl'rerap) ror)rn rvhile thc tl"rerapist coacheshom an adjacent rrr,.rm bchintl the txre'way mirt'lrt'.
EARI-Y I)EVELOPMENT OF PCIT
PC'llT rvas dcsigned in r:he errri,v 19?0s nt rhe Qregon l{eahh ScienccsUniversity to inregrate rwo irrominent but theorctically .listinct child rreat-mcnts tlf thc clay into tr st;rund intcrventi.ilrt thilt retained imp<.rrtant therapeu'ric elenrents of each. The firsr freatnrenr wils plty thempV in wlrich, a-s clescribedby virginia Axline (194?), the therapisr fbllowccl and reflectecl the child's
t).s)'( ;HoTllERAl') llEsEARCfl (lltN I'liRs AND r;R()tjPs 415
rhe gzrp betrveen rhe prevailing child and hehavior therrrpie.s t:f che time andadded impottantly to the foundation ,"lf PCIT'
Th; urrifying srrucrurc of PCIT rvas forind in the work of CQnstanceHanf (i969), a'ps1,:ch.rl,rgist whO devel*4:eci a hehavioral program fcrr improv'ing complian.* i.,.l*.,*iopmentally,-iisabled children. She trair"red mothersin-two ri"gur, filst to apply diflbrential attention ftr the child's ccroperaf ive
"o,l ur,a.l.iperativc behavi6r, an.l thcn tt> use "cgntrgliing hehavior"-r() give rhecfiild clirecr c.:mmirn.ls and follow thrtlug]r wirh time out ftrrnon.,rmpliance. Shs usccl bug-in-the-e:rr tcchnrllelgy t0 cue ancl reinftlrcethe [rothers' use of the procedr.rres while they playecl with tl"reir children inthe ciinic.
Hanfs pr{}gram pnrvide,.l trh pverarchir}g strtlcture that wirs well suited
at home ro provide the child plrrv thcrapy expericnce every clay. Plactng playtherapl, skiils wirhin a ditlercntiirl atrention paradigrn pnrvide,,l more guid' Io*.. ,o parents fbr timing skill apphcation as well as a more direct bur srill Inoninrusivc method of chitd behavior change. The salne overarching struc' 'rure provi{eci ll connolled nr.earus of cnsuring rhe correct applicatkrn of chikl*ur,*g*rrr"rrt skills and tlre ccltlsislcncy in lirnit'setting that is ussential toauthoritative parenting.
This perior{ r:f initial dcve krpnrenr of thc trealment rogk place in thecontext t>f reai-iife clinical experiences with icw-income fhmiiics iiving inclifficult, stress{ul circunrsiances anci rvithout excltrsionary crifcria. Thetreatment wa.r named PCIT in 1974 tnan applicatictn lo the Aicohol' DrugAbuse, and Mcnt*i Hcairh Adrrinistrarion t.r conchlct a firtrnai piiot studyof irs eftectiveness. To that pt"rint, individuai cases had heerr assessed r:nlywith behavi{)r counts by parents at htltne irni-l therapists in the clinic, andtew standardized measures of rreatmenr plogress and uutcome existed inthe ljield.
The need ro demonsrrate changc formally lecl to the developn-rent ofthree assessment tools; a behrrvioral coding system to A$sess changes inchildren's behavior and pirrents' skiils in rhe clinic-tire Dyadic Parent-Child Inreraction Onding Systern (Eybcrg & I{obinson, 1983; Eyherg,Nels6n, f)uke, &. Boggs, 2005), a patcnt rating scale to monitor and evaluateparents' feporf. 6f behavic'rr charrge ilt tx)me-the Eybetg Child Be'havitrrinu.n.,lry (Eyberg & Ross, 19?8; Eyberg & Pincus, 1999i' irnd a consuntersatistaction measure te assess the lcceptability of treatmcnt to famiiies-the Therapy Attitucle ilventory (Eyherg, 19?4; 1993). The firsc decade c't{
PCIT research inv6lvecl standtrrdizirtg these ipstrutlent.s ar-rd reportingearly results on PCIT efficacy (Eyberg & Matarazzo, 1980; Eyberg &Robinson, l9BZ).
PSYCHOTTIERAPY REr-tARCFJ C:ENTERS .l"N,l) tiROLJPS 4t7
with several htrndred participants, and rhe Sc"c,-rnd Norwegian Conference onParent-Chilcl Interaction Therapy rvas held in October 2007' The itlcreasiugtlemirncl op chitcl mental health practitionefs ?lnd ?lgencies rvorlc{wide ro pro'vic{e eviclencc-hase.l rre?ttmenili f(rr traubled children likely foretclls increasedu$e ancl research for FCIT irr the decades to come'
REFERENCES
a*lin.', V. ( 194?). Pktr* thr:rcrlr]. llrrstr.rn: I{oughttxr Mitilin'Bagncr., D. M., & Eyfurg, S.M.(200?i. Pr,rrenr-clrild intcradtir)rl thcrapy f,tr.lisruptive lrehrrv'
ior in chiLlrcrr rvith mcnrrrl retilrclari(rn: A nrndornizcd controlled rrial. Joanrol. rriCtinic,li(llrild anl Alolc"scrnr I).slclnrl.o,rp, J6, 4Iti-429'
Biu-rnrripcl, l). (19(r?). l]lriLl care prucriccs auteceding thrce pitmcxns ot prcsch*ol hclravklr'Gcnctic l).srcho!.,"g-r Mrrlr,ryaphr, 75, 43-88.
Bresrirl, E. V., Evhcrg, S. |vl., l)oggs, s. 11., & Algina, l. (1997). Parcnt*c,'hil.l InteractionThcr;.,1.y: Pirrcrrs'Fer(-cpri(lns (d:unrrcrucJ sihlings. (.lhtu a Fanu'I1 Behtrd,ri.n'Theru!ry, 19.I 3'-2f'1.,hi: 1 0. I 100/j0l 9v1 9n01*C2
Clratlwick Celre r. (20C4), (il rsin* lhe qurrlirl clmsnt irr chik) ahu^se ffeatmtnt: Idcnrr.$ing and
cii.r'icmiturring hesI lxi(ulicc'\' Rc'tricvcd fr':m lrttl':/fwwn'chirdrvickcentcr'r>rg()rnftin, M., Silovsky, l. F., Ftrndcrlrtil'k, li', V',rlle, L., Brcsttrn, E., Brtlattht:t'rr, T', ' ' ' Bonncr,
Ii. L. (lt\J4). Prrrclrt-(lfiil,,l lnr.:mcti rn "ilcrnp1, with ph1'sically abusirc 1r:rrents: Eflicnclfrrr redrLcing tur(rte :rhu.$c rcllolts. ,forrnra.lolOonsulring and Clirric:a,l Ps1chol.r,g, 72' 50LLi 10.
drri: i r-'t. l0l?10022-006X.?2. ). t0lrEisen.srarlt, T. H., Eyberg, S. M., McNcil, C. l]., Ncwcr:nrh, K., & Fundr'rhurk, B. ( 1991). Parent-
Ohil.l lntcracr:ir>rr Thcral'y rvirlr l.chrrvior pr,rblerl chil.lren: Rclutive cffectivettess of trvo
stagrs irr.rd .rr',irull trc,rtrncnt uLrrc{.)r}lc. Journal r{ Cfinical ChiLl Prlcdolrgly, 22 , 4?-.51.d<,i: I 0. I 2071s I 5 ]?44l4jccpl20l-'1
Eyhcrg, $. ivl. ( l9i4). Thenp--r Arcinds hrrtnr,4. l"inpul.lislrcJ instntnrcnt. Qregon l-lealdr an.l
Scictrccs Universir,.v. Avirilablt ()niittc ilr lrrrp:liwww.pcit'orgEyherg, S. [,1. (199]). Crrnsurlcr si-rtisincrion n:msurts tirr'assessitrg parent training p(\gram$.
ln l-. VnrrdeCrcck, s. Knalrp, {i. T. L. Jockson (Eds.), lrno{,<rturnr m cftnlcul fu'aJc';ke: Asout'.,e borik (V(r[' 12, r'p' ]??*-1S2)' Silrirsot'l, Fl': Profbssional Rcsotrtcc Press'
L.vbcrg,5. M., lloggr, s. R., & Alginn, I ( 1995). Frrrcnr-chilcl inrcrirction therirpy: A psych.r.sticinl rr-rrxlcl firr r\e treatme nr t,f ytrung clriltlrcn wirh ctxrtlucr ltrithlem behavior at:dthcir farriIies- I).s'*r:hr.tph.tnnacologl'Brllcrin, -l j' I j*9i.
E.vherg, S. 1r4,, & Matara::o, R.(). (19$0)^ Ttaining pnrLlllls as thc'r'.rpists: A.crrmprtrisonl-'er,,vr.*n inrlividual parent--child inrcnrcti(rn training and pirlerrt group didactic rraining..lournrrl rf Clinfcal l'srcholrg, 36,497'499
Eylrcrg, S. Vl,, Ncls,tn, M. M., f)uke, M,, &' lrr'rgqs, S. R. (2005)' Manilol/r:r $e <\adic p*rent-chlll riueracti(rl e,r,ling,1sron (lrcl ecl )' l\ctrieved fiom httlrt//g'wrv'PCIT'org
EySerg, S. l"{., {i l.'inctrs, t). t 1999). E1b*g Chil.l lJirhnvior ln+errrrrry anrlSuac,-E}beig StrdcntBehotiry Jrh,r,ruory: Prtfcssiorral rncnunl. L)tlessir, FL: Psych.rlogical As'icssmu'lrt Re$ourc€$'
Evlrcrg, S. M., & Robins.,t-,, f. (t9tiZ). Purent-child intcrttcrion traitring: Effecrs on familyftrnctioning, Jorrnral ry' Clinicrr.l C'hill Psycholr:',9i, I I , I 3tl--11?.
Eyberg, S. lv{., & Robinson. E. { 1983). l)i.adic parent-child interafiion coc{ins systefir: A man'ual. l).sychologrcrd l)o';zments' 13,2424, MS. No' 25112
P-sYCl"loTi I ERAPY R ESEI\RL'1"{ CEN'f ERS AND O ROI'.rPS 419
