treating behavior problems

There are several options for treating behavior problems in children, all of which heavily involve the parent(s) or caregiver(s).
  • Parent Management Training
  • Parent-Child Interaction Therapy (PCIT)
  • Individual Therapy with the Child (will still heavily involve parent/caregiver)

We are happy to discuss all of these options with you and help you decide which will be the most helpful for your family.

Parent-Child Interaction Therapy (PCIT)


PCIT is an evidence-based treatment originally developed for young children with disruptive behaviors and their caregivers. PCIT is used with children ages 2-7 who have ADHD or other disruptive behavior problems such as Oppositional Defiant Disorder (ODD). Adaptations of PCIT can also be helpful for young children experiencing symptoms of anxiety and depression (PCIT-SM and PCIT-CALM).

PCIT is a two phase treatment:
  1. The first phase (the Child Directed Interaction-CDI) involves strengthening the relationship between the child and caregiver and showing the adult how to reinforce the child's positive behaviors. For the first phase of treatment the parent is taught skills that play therapists use with young children based on attachment theory as well as positive reinforcement skills drawn from behavior theory. 
  2. The second phase (the Parent Directed Interaction-PDI) involves setting limits and following a structured and consistent procedure when the child is non-compliant. Skills taught in the second phase are based on behavior theory. 
Sessions involve the caregiver and child meeting together with the therapist acting as a live coach to the parent. This is often done from behind a one-way mirror, via electronic means, but can also be done outside of the office setting via telehealth using computers or other devices in the home. Goal criteria are set as a measure of when a family is ready to move from one phase of treatment to the next, and when the family is ready to graduate from treatment.

PCIT always starts with a comprehensive assessment involving a parent intake and a parent-child observation session.

Many families are wondering whether PCIT is as effective through telehealth. It is! Watch the video below by our owner Dr. Gibson to learn more!

PCIT Adapted for Older Children (ages 7-10)


We offer an adaptation of the original version of PCIT with adjustments made for developmental changes as children get older. This is still a two phase treatment involving CDI and PDI as well as live parent coaching. The child is made a part of the treatment team with the therapist having individual check-ins with the child during each session. The discipline phase is introduced gradually with three modules in this phase. 

Our own Dr. Kate Gibson and staff therapist Tara Motzenbecker, NCSP, LMHC are first and second author of the manual for this PCIT adaptation: "Parent-Child Interaction Therapy (PCIT) Adapted for Older Children: A Research Development Manual."

PCIT with Toddlers (~12-24 months)


Dr. Gibson is rostered to provide this PCIT adaptation for parents/caregivers and their toddlers dealing with big emotions and/or behavior challenges. Parent-Child Interaction Therapy with Toddlers (PCIT-T) is an early intervention program that involved coaching parents while they interact with their 12 to 24-month-old children. Utilizing play therapy and teaching listening practice skills, parents are coded and coached in the use of therapeutic parenting practices proven to decrease problematic behaviors, improve children's language, and encourage young children to follow directions. Parents over-practice the "PRIDE" skills (praise, reflection, imitation, description, and enjoyment) until they display mastery. Numerous controlled studies have shown that these PRIDE skills improve children's behavior problems to within normal limits.

pcit parent testimonials

PCIT has been such a blessing to our family.  Not only does it provide the concrete tools to work with problematic behavior but it also fostered an overall air of positivity in our home which was a benefit to us all.
(Mother of 6 year-old boy who graduated from PCIT)
Getting to practice the techniques in the office is extremely helpful. Has helped us to be better parents and in a very short time has helped us to shape our children in a positive manner.
(Mother of 5 year-old girl who graduated from PCIT)
PCIT is by far the most helpful therapy that our son has done.  He has participated in several different therapies, and PCIT was the only one that made an immediate, obvious and quantifiable difference.  From the first session, my husband and I learned simple strategies for communicating with our son, and found it easy to implement these strategies through the day.  These minor changes on our part caused an immediate change in our son's behavior towards us.  He was happier, more engaged, and less anxious because he felt his parents were really listening to him.  And although PCIT requires daily homework, this quickly became reliably enjoyable quality time with our son. Once we moved through the first phase of PCIT, he was happier and less anxious, and it was easier to set up consistent expectations and consequences using the PCIT methodology.  While our previous attempts at behavior modification were met with silliness or anger and defiance, the PCIT program of consequences has virtually eliminated defiant behavior in our household. 
​(Parents of a 6 y/o boy who graduated from PCIT)​



​When I was referred to Dr. Gibson for PCIT, I was desperately seeking solutions to my son’s troubling behavior. I thought I had been doing everything “right” and couldn’t understand why he was acting out the way he did... 
When I was first introduced to “special time”, I was skeptical about it providing us with a solution for my son’s behavioral problems. However, we were diligent with Dr. Gibson’s instructions, and our hard work paid off.
Before PCIT, my son would get in trouble at school every day. My son would have violent temper tantrums that would last for HOURS. After PCIT, my son is getting behavior awards from his teacher. I can take my son out on errands without the fear of him misbehaving. I enjoy being around my son more than ever before, and our relationship has improved significantly. I am overjoyed that PCIT, which seemed to be so simple, has made such a huge impact on our lives.
If I could offer some words of advice to other parents working with PCIT it would be to be patient, as change happens over time, not overnight. We worked in PCIT from the end of the school year until right before the new school year started. Also, practice! Even if you’re not having “special time”, practicing skills during everyday interaction will help perfect them for “special time”.
 (Mother of 7 year-old boy who graduated from PCIT)