PCIT
Core Mechanism
Live-coached parent-child interaction reshapes attachment quality and behavioral contingencies simultaneously
Ontology
Child behavior problems maintained by coercive parent-child interaction cycles and insecure attachment
Therapeutic Voice
"Tell him exactly what you see him doing right now. 'I like the way you're sharing those blocks.'"
View of the Person
A parent-child dyad in which the interaction pattern — not the child alone — is the unit of treatment
Evidence
NICE: referenced for conduct problems. APA Div 12: Strong Research Support
20+ RCTs
Multiple meta-analyses
Very strong evidence for childhood behavior problems.
Conditions
Epistemology
Blind Spots
Narrow age range (2-7); requires live coaching setup; less applicable to adolescents or complex family configurations
Contraindications
Active domestic violence in the home, active psychosis in the caregiver, child with active psychosis or severe autism spectrum disorder with minimal verbal capacity, caregiver unwilling to be coached in session
Training
40-hour training + ongoing consultation. Must complete 2 cases to criterion
PCIT International certification
40-hr training + 2 complete cases + consultation
$2K-4K
Philosophical Roots
Bowlby (attachment); Patterson (coercion theory); Baumrind (authoritative parenting); Ainsworth (responsive caregiving)
Related Modalities
PCIT in 1 Comparative Clinical Vignette
Each vignette presents the same client through multiple theoretical lenses side by side — showing how PCIT formulates presenting problems, sets treatment focus, and sounds in the consulting room compared with other approaches. This comparative pedagogy is unique to Epoché Clinical; no other clinical reference systematically formulates the same case across traditions.
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