The goals of play therapy pretty easily translate into the goals of parenting: to have a good relationship with your child and create a safe environment in which he or she can be themselves. Parents can utilize some of the techniques in a specific play therapy intervention within their own home.
What Is Parent-Child Interaction Therapy (PCIT)?
Play therapy is a form of psychotherapy designed for children. The general goals are pretty simple: help the child to bond to the therapist, enact conflicts in a safe place and heal through the accepting relationship.
Parent-child interaction therapy is a wonderful therapy intervention aimed at helping families when a child has a behavioral health issue, such as Attention-Deficit Disorder or Conduct Disorder. It is designed for children aged 2-7 years. Rather than treat the individual child, this therapy aims to coach the parents to improve their relationship with the child. Research demonstrates that a strong attachment or bond between caregiver and child improves behavioral outcomes and increases compliance.
This form of therapy places the relationship between the caregiver and child as primary. This is an important distinction as often in other forms of therapy, the relationship between the therapist and client is primary. The client is either the child in therapy or the parent, often in parent-education groups. In this therapy, the “client” is the all-important relationship between the parent and their child. Therapists often stay out of the room! They provide coaching to the parent via an earbud while they observe the parent and child through a one-way mirror.
Parent-Child Interaction Therapy has been shown to be very effective in research studies. When used with preschoolers with Conduct Disorder, symptoms abate and their behavior is within normal range in follow-up studies.
How Can it Help Me?
The principles taught in PCIT can help every parent. That’s because it’s based on Baumrind’s theory of parenting styles and attachment theory. It aims to teach Authoritative Parenting, meaning parenting that has a good mix of responsiveness and nurturance, balanced out by clear communication and firm boundaries. Parents who utilize this style have high expectations for their children and provide them with the support and guidance they need to meet those expectations. Children of authoritative parents have been found to be socially and academically skilled. Attachment theory posits that a responsive, attuned caregiver results in a strong attachment between that caregiver and child. The strong attachment makes child compliance an intrinsically motivated behavior. The child naturally desires to please a caregiver who seems to care for and understand him or her.
What Can I Learn From It
PRIDE Parenting Skills
The first phase of PCIT involves helping a parent learn how to follow child-directed play. While this may be a simple skill; it is not necessarily an easy one. Parents are likely to use the parenting scripts their parents used with them. If their parents were not effective or comfortable with child-directed play, it is likely that they as parents are not either. And many adults are not accustomed to giving a child the reigns for anything, including play. However, allowing a child to guide their own play can result in increases in executive functioning and build self-esteem. When a parent is a willing participant in this play, the emotional bond between the parent and child is undeniably strengthened.
To set up a child-directed play session, simply pull out some toys, sit down with your child for 15 minutes and tell them they get to choose what the two of you will do together during this “special play time.” During this child-directed play, parents are taught how to implement the PRIDE parenting skills. Here’s what you need to know about that:
Praise: Praise appropriate behavior from the child. Acknowledge hard work. “Wow, you are working hard to balance those blocks!”
Reflection: Just reflect back what your child says to you. This demonstrates that you have their full attention and is naturally calming. If your child says, “I built a big tower,” you say, “I see you built a big tower.”
Imitation: This allows your child to lead and shows that you can follow and are engaged. If the child says, “I am going to build a big tower,” you say, “I will build a big tower too.” Follow their lead in the play.
Description: Describe what your child is doing. This shows you are paying attention and helps build the connection during play. “I see you are using a pattern of red and blue to build your tower.”
Enthusiasm: Demonstrate interest in playing with your child. “Wow! This is fun!” Show that you enjoy playing with them.
While some of these skills may seem obvious and simplistic, they are designed to keep the parent’s attention on the child. The whole purpose is to allow the child to lead the play and for the parent to demonstrate their interest and attention in their child. Research has demonstrated that relationships become stronger and more connected when parents regularly do just five minutes of special play time using the PRIDE skills.
Avoid Micromanaging and Intrusive Behaviors
Have you ever seen a child burn out from all the commands and redirections they receive in a day? I recently saw this in the library with a caregiver of a child. The child walked into story time and was followed by a slew of commands which didn’t end until they left the library. “Don’t put your jacket there. Hang it up. Sit on a square like the other kids.” (Before the child had even surveyed the room). “Move closer or you won’t be able to hear. Stop fidgeting. Look at the book. Answer her question.” (During the story) “Do you want to glue that nose there? The nose should be under the eyes. You want to make the face look regular. You don’t want to waste the glitter.” (During the craft). It sounds exhausting right? Too many questions, commands and critiques can undermine the bonds in any relationship. During special play time (and as often as possible), try to avoid the following:
Commands: During special play time, the goal is to follow your child. Don’t guide your child with commands, follow their play. The giving of commands is disruptive to the child’s flow. In general, limiting the number of commands you give your child during the day will increase their compliance. Don’t command something unless it is really necessary.
Questioning: Questions often require an answer or are an attempt to redirect play. Allow your child to lead.
Criticism: Allow your child to lead. Don’t criticize the way they are playing or what they are doing. You can actively ignore behaviors you don’t like during this time period (i.e., whining).
It’s intentional that the child-directed play and skills come first. This follows the “connect before you correct” rule. It’s important that your child feel connected to you before you attempt to take charge. After the connection is well-established, a parent can begin to learn how to lead effectively, which in PCIT includes the use of effective communication and consistent consequences. Effective communication means providing a child with a clear, simple, developmentally appropriate instruction when necessary. The consequences used in PCIT are a timeout. My preference is for naturalistic consequences and the use of timeout only when absolutely necessary.
Try it Out
Start your day off with 15 minutes of special play time per child. See how it sets the tone for the day, for both you and your child.
I Need More.
If you feel your child has a behavioral health issue, I recommend you seek out a PCIT therapist and not attempt the therapy independently. This article is meant to boil down some of the principles from this therapy that can be helpful to all parents, but not to use to treat any condition.
About the Author: Meghan Owenz
Screen-Free Mom is a psychologist, writer and a university psychology instructor. She has her Doctorate in Counseling Psychology from the University of Miami and Masters in Clinical Psychology from Pepperdine University. She is happily raising her two kids sans screens. She runs a website: www.screenfreeparenting.com where she writes about tech-wise parenting and provides tons of screen-free activities. She has developed psychologically-based system to help organize the activities young children learn and grow from: the S.P.O.I.L. system (http://www.screenfreeparenting.com/introduction-spoil-system/ ). Before you turn on the screen, she asks, “Have you S.P.O.I.L.-ed your child yet today?
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Thanks for this article. How would one adapt and engage these principles for a child 7 – 10?
Thanks for this article. How would you adapt and engage these principles with a child between 7 -10?
Great Techniques!! Spend time with your child to have some fun and do this on daily basis. Every moment spent in the fun will work positively as your child will start loving your company.
Thank you so much for this article! I’d like to add that it’s a good idea to watch how they play, and what they play with. Autistic children use toys as “voices” to express what they normally cannot. So by understanding and playing along with this metaphor the child is creating with the toys, you can understand how they are feeling, or their wants and desires.
This technique is quite similar to Child Centered Filial Play Therapy developed by the Guerneys at Penn State in the 1970’s and I have been practicing for the last 15 + years.