12 MayADHD & Parent-Child Relationships: How PCIT Therapy Improves Behavior by Dr. Konstantin Lukin Parent-Child Interaction Therapy provides an effective framework for addressing children’s challenging behaviors. An effective method of improving behavior for children with ADHD, PCIT empowers parents with proven techniques designed to create strong parental bonds and minimize unwanted behaviors. Here’s how the process works and how your family can benefit from PCIT. Are you having trouble dealing with your child’s ADHD? Contact The Lukin Center for an appointment to explore therapy options like PCIT. What Is PCIT? PCIT stands for Parent-Child Interaction Therapy. ADHD creates a challenge for children as well as their parents. With this treatment modality, a child with ADHD can learn to behave more appropriately. However, it is the parent who facilitates this change through training provided by the PCIT therapist. Parent-Child Interaction Therapy is used for children with conduct disorders, which is often the case with children who have ADHD. PCIT is typically used for younger children up to age seven. Evidence-Based Therapy Parent-Child Interaction Therapy for ADHD is an evidence-based treatment. It combines components of attachment theory, social learning theory, and play therapy. Each of these theories, including PCIT, has been studied and proven effective. Together, the components of the treatment work together to give parents tools and skills for positive parenting and to help their children with ADHD thrive in the parent-child relationship. Developing a Healthy Attachment Style Attachment theory recognizes the benefits of having a strong, healthy relationship between a parent and a child. When the parent-child bonds improve, the child’s behavior naturally improves. The healthiest type of bond comes from an authoritative parenting style. Parents with an authoritative style nurture their children, respond to their needs, and support them in learning how to interact in the world. Yet, at the same time, the parents set firm boundaries. They listen to their children but do not automatically agree. Instead, they discuss and explain the rules in ways their children can understand. Parent-Child Interaction Therapy for ADHD aims to help parents develop that authoritative style. PCIT Coaching Decreases Unwanted Behaviors Ultimately, the goal of Parent-Child Interaction Therapy for ADHD is to reduce challenging behaviors. When the child engages in behaviors like the following, PCIT trains you to respond in the most effective ways. Breaking thingsHaving tantrumsBeing disruptive in public settingsMaking too much noise in a quiet environmentClimbing on things when asked not to do so As the therapist coaches you, you learn how to train your child to behave in more appropriate and less disruptive ways. They still have ADHD, of course, but the therapist empowers you to help them behave better even within that experience. What Happens in a Parent-Child Interaction Therapy Session? During Parent-Child Interaction Therapy for ADHD-related behavior problems, therapists guide parents through two phases of training. The first phase sets the stage for the second phase of treatment. When the second phase is completed successfully, the child’s behavior has improved, typically after 14 to 20 sessions. Now, the parent knows how to work with their child on their own. Phase 1 In the first phase, the therapist teaches the parent play therapy techniques. The parent learns to talk to their child in positive ways as the child plays. They also learn how and when to use various techniques to change the child’s unwanted behaviors. For example, they learn when it is best to ignore or praise the child and how to do so effectively. Phase 2 Phase two of Parent-Child Interaction Therapy is a more intensive training process for parents. In this part of the treatment, the parents learn how to manage problem behaviors. The therapist trains them to give clear directions to their child. Then, if the child does not comply, the parent learns how to respond in ways that encourage better behavior. The therapist teaches the parent what types of consequences they can use to help their child learn to behave more appropriately. For instance, the parent might use time-outs or withhold privileges when the situation calls for it. Over time, the child comes to learn which behaviors their parents will accept. Parent and Child Together with Therapist Observing One of the most interesting things about Parent-Child Interaction Therapy is the setting where it is often conducted. The parent and child are alone in a room together. The therapist looks on through a camera or a one-way mirror. However, the parent and therapist stay connected via technology. The parent wears an earpiece to hear the therapist’s suggestions. This setup allows the parent to learn while giving the child the sense that it is their parent who is making decisions rather than a person outside their relationship. The result is that the parent-child bond is strengthened even as the parent learns to influence their child’s behavior for the better. Play Sessions in PCIT Play sessions can involve playing with blocks, toy cars, dolls, slides, or any other ordinary toys. As the child is engaged in play, the parent encourages them. Then, if the child behaves in disruptive or harmful ways, the parent gently guides them to behave more appropriately. How does the parent know what to say and do? The therapist guides them based on sound psychological concepts. With the therapist’s expertise, it is as if the parent has become an expert in working with a child who has ADHD. Over time, the parent learns these methods to the point that they truly do know how to manage their child’s behavior on their own. Parent-Child Interaction Therapy and ADHD PCIT can be used to help children with a variety of disorders. For one, children with anxiety can learn to be less fearful and stop avoiding challenges. However, with Parent-Child Interaction Therapy for ADHD, the goal is typically to reduce unwanted behaviors that are related to their ADHD. For instance, the parent and therapist may make a goal to reduce the child’s impulsivity. Or the aim may be to reduce the hyperactive behavior. Although the learning process may take some time, PCIT can bring about dramatic improvements. The Importance of Setting Limits Parent-Child Interaction Therapy for ADHD provides one of the most important tools these children need. They need parents who will set limits firmly within a nurturing relationship. However, limit-setting can be challenging, and many parents over-set or under-set limits without realizing it. During PCIT sessions, the therapist trains the parent on how to set these important limits in the most effective and positive ways. Children with ADHD often have a very hard time sticking within the limits required by school and society. Therefore, this therapy can benefit them in their relationship with their parents now as well as help them do well in school later. Where to Find a PCIT Therapist in New Jersey At the Lukin Center for Psychotherapy, we provide many types of evidence-based therapy for individuals, families, parents, and children. We’re here to support you in your life journey, whether you come to one of our eight locations in New Jersey or connect with us via our teletherapy options. Our team of experts can help you face the challenges of daily living through treatments like Parent-Child Interaction Therapy for ADHD or other proven treatment methods. When you come to us, we find the ideal therapist for you and your situation. Then, we provide treatments that make your life more manageable and improve your relationships with your children and others in your life. In the end, your child’s mental health improves and you build a more satisfying life together. Are you having trouble dealing with your child’s ADHD and related behaviors? Contact us today at The Lukin Center to begin building a better parent-child relationship.