What is Parent-Child Interactive Therapy?

The need-to-know for parents of kids with behavioral challenges.

By Michelle Kopkash

Frequent tantrums. Non-stop whining. Shows of aggression. Constant complaining. Acts of defiance. Deliberate attempts to annoy others for attention. If any of these negative behaviors sound painfully familiar to you as a parent, there’s good news. With the right parenting tools and skills, these negative interactions and attitudes can be greatly reduced, a more peaceful household can be established, and parental and sibling relationships can improve with the child who exhibits these types of behaviors. Whether you’re raising a child with a mental health challenge or one who frequently displays emotional or behavioral difficulties, Parent Child Interactive Training (PCIT) can successfully coach caregivers through some of parenting’s biggest struggles.

During this training, parents and caregivers are equipped with tools and training to properly reinforce positive behaviors, set clear limits on their child’s negative behaviors, effectively discipline, re-establish familial bonds of attachment and cope with their child’s specific behavioral challenges. As a result, the child’s negative behaviors are reduced and replaced with positive behavioral interactions and attitudes.

Dr. Tanda Almont, Psy.D., Licensed Clinical Psychologist, was trained at UC Davis Children’s Hospital in PCIT and has been on the forefront of the evolution of this program for nearly two decades. She worked as one of the clinical psychologists at the UC Davis Children’s Hospital in the early 2000s and observed the positive and long-lasting results of PCIT for the families and kids she worked with first-hand. In 2006, she founded the Monarch Center in Roseville, a specialized mental health services center for struggling children and parents, in order to bring the practice of PCIT to the private insurance sector, which until then, was out of reach financially to many families in our area.

To learn more about this highly touted program, I spoke with Dr. Almont at great length. Below is an excerpt from our interview.

Describe the program to those of us who are unfamiliar with this treatment plan.
Essentially, this is a training program for parents who are challenged by behaviors that their children routinely display; rather than a therapy program for children, one of the main results is that they’ll see a reduction in their child’s negative behaviors and an increase in compliance and positive attitudes.

During the sessions, a trained therapist sits behind a one-way mirror while parents work with the child on the other side to learn new parenting strategies for behavioral problems. The parents get trained in real-time, wearing an earpiece, as the therapist coaches them through their child’s behaviors and gives the parents tools to reduce troublesome behaviors and encourage positive interactions with their child. After the session, the parent is given homework to practice with their child for five minutes each day. Every week, we build on that material. It’s a very intensive program. Depending on the family, the program may be completed in 10 to 15 sessions, which occur about once per week.

What types of skills do you work on during the training sessions?
We provide the parent with a “tool belt” of tailored techniques that they can use to improve their parenting skills and better manage their child’s specific behaviors. Then, they have a skill for whatever their child does. Not only does the child become more compliant, but the parents feel more confident and learn how to effectively work with their child in a more encouraging, calmer manner. It’s a win-win.

There are two parts to the program. The first phase teaches positive parenting skills which include reinforcements, rewards, reflective listening skills and inactive discipline strategies. The second part to the program teaches active discipline techniques, such as the proper way to do a time out and other consequences that matter to the child. Every kid is different. In the end, children feel more accepted by their parents as well.

What kinds of issues might lead a parent to seek you out for PCIT services?
There are a wide range of behavioral challenges and struggles that might cause a parent to seek help for their child and family, but typical issues that can be reduced by PCIT include difficulty managing negative behaviors such as whining, dawdling, tantrums, aggression, defiance, noncompliance and the like. Many children have mental health issues such as ADHD, oppositional defiance disorder, anxiety or emotional challenges that contribute to these behaviors. I also see a large number of families whose children just simply have behavioral issues and parents want to become better parents to these kids.

Perhaps the parents are bribing, spanking or yelling in an effort to reduce their child’s negative behaviors, or they have no tools to deal with a child who has emotional outbursts and the negative cycle is becoming more ingrained in their family’s interactions.

What types of improvements might a family expect to see after completing the PCIT program?
The program is really meant to improve three areas—the first being behavioral issues, the second being that many parents just want to figure out how to parent their child better, and the third is that they have sibling issues within the home, which often result from the behavioral issues and repetitive negative cycles that have been established within the family’s dynamics.

We also get referrals from schools when teachers have ongoing problems with a child. In those cases, we will work with the staff to train them on how to better work with that child’s personality to improve classroom and school behavior.

What age group benefits most from this form of help?
Research indicates that the best success comes from kids who are between the ages of two to eight years old developmentally, not chronologically. However, in my practice I always involve the siblings and those children can be any age.

How and why do you incorporate the sibling into the training program?
It differs per family. Some parents can easily multitask and we work with the whole family at one time. Other families have problems multitasking and so we bring in the sibling after a few sessions.

We always include sibling in the trainings at some point because there’s always a level of dysfunction between the child who struggles to behave and the sibling who doesn’t. We teach parents how heal the whole family so that they’re not reinforcing bad behavior, but giving positive attention to the sibling and the child who needs extra help.

To learn more about the PCIT program, visit www.PCIT.org or the www.MonarchCenter.net, which include research findings from a number of studies.

Michelle Kopkash is a local freelance writer. She’s got two spunky kids and loves being in nature with her family. Visit her website at www.michellekopkash.com to view her writing portfolio, services and blog.

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