Help for Young Children with Big Feelings and Even Bigger Behaviors

PCIT 101: Everything You Need to Know

What is PCIT? (Quick Overview)

Parent-Child Interaction Therapy (PCIT) is an evidence-based treatment for young children ages 2 to 7 that focuses on improving behavior by strengthening the relationship between parent and child. Instead of working primarily with the child, PCIT teaches parents specific skills and coaches them in real time as they interact with their child. This approach leads to faster, more lasting changes in behavior and a stronger, more connected family dynamic.

This page includes a series of short videos designed to answer the most common questions families have about PCIT. Below, you will find written explanations of each topic so you can easily review, reference, and understand how PCIT works and whether it is the right fit for your family.

Intro to PCIT: Who is Dr. Leah Clionsky?

Dr. Leah Clionsky is a licensed clinical psychologist and nationally recognized expert in Parent-Child Interaction Therapy (PCIT), as well as the founder of PCIT Experts, a specialty clinic within Thriving Child Center dedicated exclusively to this evidence-based treatment.

She trained directly under Dr. Sheila Eyberg, the psychologist who developed PCIT, as a graduate student in her research lab at the University of Florida in 2007. She went on to lead the first randomized controlled trial of PCIT specifically for children with autism, research that helped expand how and for whom this treatment is used. She is a certified Level II Regional PCIT Trainer in Texas, one of a small number of trainers in the state certified by PCIT International to train other therapists in this model.

Dr. Clionsky has guided hundreds of families through PCIT across research, community, and private practice settings. In addition to her clinical expertise, she is also a parent of young children, which informs her practical, real-world approach to helping families.

In this video, Dr. Clionsky introduces herself and explains her background, training, and approach to PCIT so you can better understand who you are learning from and whether this model is the right fit for your family.

What is Parent-Child Interaction Therapy?

PCIT is an evidence-based treatment for children ages 2 to 7 who are struggling with challenging behaviors, big feelings, defiance, aggression, trouble at school, or difficulty with transitions. Families also come to PCIT following a recent diagnosis of autism or ADHD, after a trauma, during a family transition like a new sibling, or when a child is showing signs of anxiety.

PCIT has been around since the late 1970s and is backed by hundreds of research studies. This is not an experimental approach. It is one of the most thoroughly researched treatments available for young children.

What makes PCIT different from other therapy is that your child is not going in to connect with a therapist. Your child is going in to connect more deeply with you. PCIT teaches you two specific skill sets: how to strengthen your relationship with your child through play, and how to set limits calmly and effectively without yelling. A therapist coaches you through an earpiece or AirPod while you actually use those skills with your child in real time, which is what makes the results so fast and so lasting.

How Do I Know if PCIT is Right for My Family?

PCIT is designed for children ages 2 through 7. If your child is in that age range and struggling with any of the concerns described above, they are very likely a good fit based on age alone. A toddler model is also available for younger children.

Beyond age, the families who get the most out of PCIT are those who can commit to weekly or at minimum every-other-week sessions and are willing to practice the skills at home for around five minutes a day. That daily practice is what accelerates results. PCIT does not require hours of homework, but it does require consistency.

The families who tend not to benefit as much from PCIT are those whose schedules are too unpredictable to attend sessions regularly, or where no caregiver is able to be consistent with the treatment at home. If life circumstances make consistency difficult right now, it may be worth waiting until the timing is better rather than starting and struggling to follow through.

How Soon Will I See Results with PCIT?

Most families begin noticing meaningful changes within the first several weeks of treatment, often during the first phase before limit-setting work has even begun. Strengthening the parent-child connection alone tends to reduce conflict at home. By the time families complete both phases, the behaviors that brought them in are typically greatly reduced or resolved entirely.

The pace of progress is closely tied to home practice. Families who practice the skills for five minutes a day between sessions tend to move through treatment more quickly and see results sooner. Your therapist will track your child's progress at every session using standardized measures so you always have a clear, objective picture of how things are changing.

How Many Sessions of PCIT Will I Need?

PCIT generally takes between 12 and 16 sessions. The exact number depends on your child, your goals, and how consistently you practice the skills at home. Families who practice daily tend to move through treatment more quickly.

One of the unique features of PCIT is that you can control the pace. Sessions can be scheduled once a week, twice a week, or even three times a week. More frequent sessions produce the same results in a shorter timeframe. If your child is struggling at school and you want to make progress before the school year begins, an accelerated schedule is entirely possible. PCIT Experts offers an intensive summer program for families who want to complete treatment before school resumes in the fall.

Some children complete treatment in fewer than 12 sessions, particularly those who need only the first phase. Others may take a little longer. The goal is never to keep families in therapy longer than necessary. It is to get you to your goals as efficiently as possible and send you off feeling equipped and confident.

Who is Not a Good Fit for PCIT?

It is just as important to be honest about who PCIT is not right for as it is to describe who benefits most.

Families where no caregiver can commit to regular attendance and daily practice will find it difficult to make progress. PCIT is a skills-based treatment and the skills require repetition to become natural. If your schedule is too unpredictable right now, it may be worth waiting until you can attend consistently rather than starting and stopping.

Children who are outside the age range are generally not appropriate candidates, though a toddler model is available for younger children and adaptations exist for children slightly older than seven depending on developmental level.

Children with a diagnosis of PDA, pathological demand avoidance, are not good candidates for the second phase of PCIT. The limit-setting phase can trigger an overwhelming stress response in children with PDA, so in those cases treatment focuses exclusively on the connection phase and alternative strategies. This is not a failure of the treatment. It is the treatment being applied thoughtfully and appropriately.

Occasionally a child simply does not enjoy the format. In many hundreds of families this has happened perhaps once. Most children take to PCIT quickly and genuinely enjoy the play-based sessions. But it is worth knowing that no treatment works for every child in every situation.

What Does a PCIT Session Look Like?

PCIT looks very different from traditional therapy. Most of the session is not spent talking. It is spent doing.

Your therapist will check in with you briefly at the start of each session, ask about your week, and find out how home practice has been going. Then fairly quickly you will put in an AirPod and begin playing with your child. Your therapist will observe for several minutes to get a clear sense of where things stand, and then will begin coaching you directly through the earpiece as you interact with your child in real time.

That real-time coaching is where the change happens. Parents consistently describe it as the most valuable part of the process because guidance arrives exactly when they need it rather than in a debrief after the fact. At the end of the session your therapist will wrap up with you, discuss how it went, and give you a specific focus for home practice during the week.

Most of the interaction during the session is between you and your child. Your therapist interacts very little with your child directly. That relationship belongs to you. The therapist's job is to strengthen it.

Not every session follows this format. At the beginning of each phase of treatment there is a teach session without the child present where your therapist explains the new skills before you begin practicing them. But the majority of sessions are coaching sessions structured as described above.

Does Virtual PCIT Work?

Yes, and in many ways it works better than in-person PCIT.

This surprises some families, particularly those who associate teletherapy with the compromised care of the early pandemic period. PCIT is different. The reason virtual PCIT works so well comes down to something fundamental about how the treatment is structured.

In traditional in-person PCIT, the therapist spends most of the session in a separate room watching through a two-way mirror or camera while you play with your child. The therapist is deliberately removed from the room because your child's connection with the therapist is not the goal. Your connection with your child is the goal.

Virtual PCIT takes this one step further. Instead of approximating your home environment in a clinic playroom, your therapist joins you directly in your home. They see your actual environment, your actual routines, and your child's actual behavior in the place where it matters most.

In clinical experience, families often need fewer sessions when treatment is delivered virtually because there is no translation required between the clinic setting and real life. The therapist hides the screen during coaching so they become a voice in your ear rather than a presence in the room.

Virtual PCIT Demo

This short demo shows exactly what a virtual PCIT session looks like in practice. You will see the simple technology setup, how the earpiece works, and a real example of a parent being coached in the moment while playing with their child. Most families are surprised by how natural and easy the setup is.

How Does PCIT Work if My Child Has Siblings?

Yes. You only need to do PCIT with one child for your entire family to benefit.

Treatment focuses on the child in the right age range who is struggling most. As you learn and master the skills with that child, those same skills transfer directly to your other children.

Later in treatment, sibling sessions are available as an option. These sessions help you apply your skills with multiple children together, strengthening sibling relationships directly. Toward the end of treatment, additional sessions are also available to address specific situations such as managing behaviors in public places or establishing consistent house rules.

Why Choose PCIT Experts?

There are PCIT therapists across the country. What sets PCIT Experts apart is not just certification. It is the depth of training, research, and real-world experience behind every clinician on our team.

PCIT Experts was founded by Dr. Leah Clionsky, who trained directly under Dr. Sheila Eyberg, the psychologist who developed PCIT at the University of Florida. Dr. Clionsky went on to lead the first randomized controlled trial of PCIT for children with autism, and is one of a small number of certified Level II Regional PCIT Trainers in Texas. That means she does not just deliver PCIT. She trains other therapists to do it.

The clinicians at PCIT Experts have been selected for their advanced training and hands-on experience with this specific model. Several hold trainer certification through PCIT International. Others are actively involved in PCIT research. This is not a generalist practice that offers PCIT as one of many services. It is a specialty clinic where PCIT is all we do, delivered by people who have dedicated their careers to doing it well.

When you work with PCIT Experts, you are not getting a therapist who completed a weekend training. You are getting access to some of the most experienced PCIT clinicians in the country.

What if I Am Still Not Sure if PCIT is Right for Me?

That is completely understandable and there is no pressure to commit before you feel ready.

If you want to get to know us better first, you can explore the Educated Parent Podcast or the PCIT Experts newsletter, both of which provide evidence-based parenting guidance at no cost.

When you are ready, you can schedule a free matching call or book directly with a clinician. Either way, we are here to support your family in whatever way works best for you.

How Do I Schedule a Session with PCIT Experts?

Getting started is straightforward and we work hard to get families in quickly.

You can schedule a free matching callwith Tim, our client services specialist, who will guide you through the process and recommend the right clinician. Or you can go directly to a clinician’s profile and book an appointment yourself.

Our goal is to remove every obstacle between you and the help your family needs and to get you started as quickly as possible.