No doubt about it, Darren* was a bouncy kid. He had an infectious laugh, and the other children in his daycare were mesmerized by him. Whatever he did, it was fun. Darren rarely sat down, he was always moving. And dancing. And running. And even jumping. He never was still. Even during naptime. Then he was talking, singing, giggling, and disrupting others. So much so, teachers had to routinely take him to another area so the others could rest. He had difficulties following instructions at school, and required staff supervision to stay safe. Parents frequently were called to school for one reason or another. Even though Darren was well-liked by everyone, his teachers at times would become frustrated and impatient with his high activity level and his failure to “stop and think” before he acted.
At home, Darren’s parents struggled. He would run off in the grocery store. Then, his mother had to ask the store help to find him on more than one occasion. She was also worried about him in the parking lot, as he would run out in front of cars without looking if she wasn’t careful. In public places, like airports, he required an adult to hold his hand at all times, which he didn’t like. He had difficulties falling asleep, and could not entertain himself well. His parents joked that he was like a “human tornado,” creating havoc (and messiness) wherever he went. His parents felt like they were always putting him in time-out or scolding him, and nothing seemed to work.
Darren was a young child with some significantly disruptive behavior. Although young, he displays many characteristics of ADHD. Darren would be an excellent candidate for PCIT or Parent Child Interaction Therapy. Children with ADHD often struggle with behavior concerns in addition to difficulty focusing and being very active. Children with ADHD often struggle with:
- Impulsive behavior
- Dangerous choices
Children with ADHD also find it hard to slow down and make positive choices, like a stop light that only has a green light.
The best treatment options for most young children includes starting with an evidence based therapy such as Parent Child Interaction Therapy (PCIT).
What is PCIT?
PCIT is an therapeutic treatment that uses the interaction between the parent and child to improve behavior. The parent actually learns how to be a therapist for their child. The parent is taught how they can improve their child’s behavior through play. Parents are also taught effective strategies for handling common situations that can be difficult such as taking a child out to eat or to the store or what to do when siblings are fighting. Strategies are taught in “real time” situations in the clinic.
Parent Child Interactive Therapy is an evidence-based treatment for young children with behavioral problems. PCIT is conducted through “coaching” sessions. During the sessions, parents and children are in a playroom while the therapist is in an observation room. The therapist talks to parents with a tiny microphone called “a-bug-in-the-ear” device. That way, the therapist provides in-the-moment coaching to parents for their child’s behavior.
How PCIT Treats ADHD and Other Concerns
PCIT is empirically supported as an effective treatment for Attention-Deficit/Hyperactivity Disorder (ADHD). It is also an empirically supported technique for Conduct Disorders, Anxiety, Depression, and post-divorce adjustment (Eyberg et al., 2001; McNeil & Hembree-Kigin, 2010).
PCIT treats ADHD and other conditions by teaching a child to improve his behavior, and helps the relationship with his parents. Furthermore, it decreases disruptive behavior, tantrums, and impulsivity. It also is helpful for treating child emotional concerns, as well as the parental stress that can co-occur with attention deficits. As a result, children tend to do better in school, home, and social environments, and have less damage to relationships. They also have reduced school expulsions and physical injuries.
PCIT outcome research finds large improvements in the behavior of young children. After treatment, childrens’s behavior is within the average range. Also, well-designed and well-controlled studies have documented the superiority of PCIT to wait list controls and to parent didactic training. In addition to significant changes on parent ratings and observational measures of children’s behavior problems, outcome studies have demonstrated important changes in the interactional style of the fathers and mothers in play situations with their children.
What are the Benefits of PCIT?
- Many children show improvements in behavior fairly quickly
- The parent is 100% involved in therapy with his or her child
- Children really enjoy PCIT
- Many children show improvements in behavior at home and school
- Parents receive advice in guidance in real time to work on difficult behavor problems
- Families do not need to purchase any special equipment
What Are Some Signs That My Child May Need PCIT?
- Tired of getting phone calls from school about your child’s behavior?
- Is your child destructive? For example, does s/he break things on purpose?
- Are you feeling overwhelmed by your child’s tantrums?
- Embarrassed by your child’s behavior when out in public?
- Love your child but don’t like your child because of challenging behaviors?
- Feel like you’ve tried everything, but nothing has worked to help your child’s behavior?
- Want to improve your relationship with your child?
- Does your child act like they are driven by a motor or have difficulty being still?
- Does your child have a hard time playing by himself?
- Does your child have difficulties getting along with other children?
- Does your child have excessive worry or sadness?
- Does your child struggle with using his words or fail to understand what you say accurately?
If you answered, “yes” to any of the questions above, PCIT may be for you and your child.
What Happens When I Take My Child to PCIT?
The therapist will usually spend the first session having a conversation about your concerns and goals as well as observing your child. At the next session, the therapist will begin teaching you therapeutic skills to use with your child everyday. The therapist will also help you figure out how to work time for doing special therapeutic play into your busy schedule. During the next few sessions, the therapist will coach you as you use therapeutic play skills with your child. Later sessions will focus on how to help your child learn to follow directions quickly.
Do You Offer PCIT as a Treatment for ADHD at Hope Springs Behavioral Consultants?
Ms. Jennifer Luria, LISW is certified in PCIT, and uses this technique in therapy with her patients. Prior to working at Hope Springs, she used PCIT with children and families at the University of Iowa Center for Disabilities and Development for many years. Also, she practices PCIT with very young children, as well as older children. She very much enjoys her PCIT-focused practice.
*Darren is a fictitious example. Any resemblance to any other person is not intentional.
Author: Cindy Anderson
Dr. Anderson is a Board Certified Clinical Child Psychologist. She also owns Hope Springs Behavioral Consultants. Dr. Anderson has achieved a high degree of specialization in working with children and families. She holds a Ph.D. in Clinical Psychology and completed APA Accredited internship and postdoctoral training in Clinical Child and Pediatric Psychology. She prides herself as a life-long student and tries to learn something new every day.
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