I reached Mastery in PHASE ONE of our Parent Child Interaction Therapy. I was so proud of how far we had come in such a short time. Just two months before we were still having four-hour meltdowns, with no way to calm his storm. My dear friends were encouraging, especially since they had seen the change come over our family. I could still see their eyes glaze over when I tried to explain, though. It’s hard to celebrate the small victories when no one knows the battles you had to fight to get there.
So what the heck is PCIT?!?
Here is where I need to post a disclaimer: I am not in any way a professional, Dr, psychologist, or clinician. This is just an account of my own experience with this type of play based Therapy. We are still in the thick of it, so I’m in no way shape or form an expert. Please do not try any of these techniques without consulting a trained PCIT clinician!
P.C.I.T is the common acronym for Parent Child Interaction Therapy. A play based attachment therapy for challenging children. It’s different from other child therapies in that the parent is the one doing the work with the child. This is not a quick fix. There are no lists of helpful catch phrases that we all have seen and reposted on Facebook. It’s hard work, really hard, and emotionally draining.
It can help every kind of challenging child, from a kid who has oppositional defiance disorder to autism and all the dx’s in between. Not every challenging child has a clinical diagnosis or label, PCIT is for these kids too. PCIT focuses on the behaviors and has been scientifically proven to help these special kids learn self-regulation.
Scholarly articles on PCIT are plentiful click Here to read some of the trials and scientific studies directly from the Journal of Clinical Child and Adolescent Psychology
PCIT starts off with an evaluation. Squishy wouldn’t even leave the waiting room during ours. (Read about that HERE->Our PCIT Journey: The Beginning ) After the evaluation the parents, guardians, & caregivers all sit down with the clinician to go over PHASE ONE. It’s kind of like an orientation. We were encouraged to bring any adult who has an influence on Squishy’s life. That was actually really helpful for us. It gave us a support system, and we were not getting sabotaged at family gatherings. If you have a challenging child, you MAY know what I’m talking about here. Well meaning relatives giving all kinds of advice on how to “control” your child, for instance… It really means a lot to know my family has my back.
PHASE ONE is basically child directed play and focuses on building the relationship. PHASE TWO shifts to more parent directed. (We haven’t started phase two yet, so I will be delving into that in a later post.) The whole session lasts anywhere from six months to a year, I’m told. Our clinician didn’t want to put an exact time frame in our minds, because every child is different.
That PCIT takes into account the special-ness of my son was a big reason we chose this approach for Squishy. His clinician’s exact words were “We want to help him regulate and function in society without loosing his SPARKLE.” Her words play back in my head often when I’m struggling with some of my work. She also made it very clear that what was asked of us would go against our natural instincts, that we would just have to trust her. Boy has that been true.
Once a week we go to therapy and have directed “Special Play Time”, and then our clinician’s assistant comes to our house the next day. It’s all about practice and consistency. In between these guided sessions both my husband and I have Special Play Time with Squishy every day.
Parent–child interaction therapy (PCIT) is a form of behavioral-parent training developed by Sheila Eyberg for children ages 2–7 and their caregivers. PCIT is an evidence-based treatment (EBT) for young children with behavioral and emotional disorders that places emphasis on improving the quality of the parent-child relationship and changing parent-child interaction patterns. ~Wikipedia
Special Play Time is probably the single most important part of the PCIT journey. Squishy looks forward to it every day now, but in the beginning it was hard to get him to come play with me. It felt awkward and un-natural for me, and Squish didn’t like that there were rules and conditions placed on my ability to play with him. But with just 5 minutes a day we have slowly changed our family dynamics. Well actually more like 10 since I also give him a 5 minute count down to the end.
For Squishy Special Play Time is a time for us to connect. For me it was a time to learn the PCIT language. Our clinician told me in the beginning, it is almost like learning a completely new language. She was right, I often feel my tongue getting tied up.
As we progressed into PHASE ONE more and more of my role was to model correct behaviors and to gently guide him through Play. Sometimes that looked like “I” speak, “I am sitting on my bottom at the table”. Other times I would model the behavior through my play, “Elephant found his mommy and is giving her a gentle hug”. You have probably heard the phrase “play is a child’s work.” And it’s true. Children use play to learn, which makes PCIT the perfect vehicle to guide them. I must be as descriptive in my talk as possible while keeping it short and direct. Easy right? *sigh, not so much for me. Which is why I find it invaluable that I literally have a couch in my ear during our weekly sessions.
R– use “reflection” to teach your child to listen and communicate
I– model (Imitate and model) the behavior you desire
D– Describe the behavior that you see or want to see
E– “Enjoy” your play time with your child
There is much more to it, but the acronym gives a much clearer picture of what we practice. Once I reach mastery on my pride skills, we are able to move on to phase two.
The hardest part of PCIT, for me, has been using the Selective Attention. For Squishy, I am with him all day everyday. He gets tons of attention. Both for his appropriate behavior, but also for his not so appropriate behaviors. I have needed someone to guide me through it. If he is upset, my natural motherly instincts kick in. I want to hold and soothe him, but that is not helping him learn appropriate behaviors. Instincts aside, that is my job. To help him function outside of our family.
Selective attention, or active ignore as it’s also called, is the act of taking attention away during inappropriate behaviors. So, if I accidentally cut the kiwi in half and it’s the end of the world, I ignore. For an hour I ignore. Then for two hours. This Does Not mean I sit on the couch on my phone. I need to be actively doing MY own thing. I tend to do the dishes very slowly during a melt down, or sweep the floor. I don’t leave him. As soon as he calms his body, and I mean the exact moment, I praise the heck out of him.
We have seen such huge success already using the PCIT techniques. Squishy is using his words much more. We have gone from four-hour blowout meltdowns, to an hour maybe. Sometimes even 15 minutes. I feel so proud of Squishy when I start to see him struggle and he overcomes his rage right before my eyes. If you want more information on PCIT or how to find a certified clinician in your area Click Here