“Johnny” was on the verge of getting kicked out of preschool. His tearful and exhausted mother, “Angie,” brought him to see me. During his first visit Johnny dumped all the toys in my office into a pile on the floor and stood on the heap with his arms folded, grinning at me. When Angie instructed him to pick them up he took a box of jenga blocks and dumped them out. His eyes never left hers.
Parent Child Interaction Therapy (PCIT) is a relatively new kind of therapy that turns the old model of treatment on its head. It is becoming popular among child psychologists like me for a simple reason: it works.
PCIT is part of a wave of Evidence Based Therapies (EBTs) that are steadily growing in popularity among psychologists and parents. EBT is just a complicated way of saying “research shows that it actually works.” And it does. After using PCIT with dozens of families I’ve become a convert. You can read up on some of the mounds of research showing its effectiveness here.
Here is how it works. Rather than the psychologist playing with the child and using a set of techniques to help the child change behavior and regulate emotions (the way it is usually done), in PCIT the parent gets a crash course in those techniques and learns how to use them at home. When parents and kids come in for their weekly therapy session it is the parent who does the play, not the psychologist.
In fact (and this may be the strangest, and most effective, part of the treatment) the psychologist steps out of the room altogether and coaches the parent on how to use the techniques, live, through a bluetooth earpiece and a video monitor. As one father recently told me, “this is cool, it’s kind of like getting therapy from the future.”
Once parents master a set of play techniques designed to enhance the parent-child relationship they then move on to a harder set of behavior management techniques designed to stop misbehavior in its tracks.
Months later, at the end of the treatment, little Johnny was a very different boy. In his last session he sat calmly at a table with Angie, using jenga blocks to build a house. After lining them up in neat squares he explained that this is “our house now.” He pointed to different rooms, the kitchen, the living room, bedrooms, then he pointed to the largest room in the middle “and this” he explained “is where we play nicely together.” Angie was tearful again, but she wasn’t exhausted.
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