Early Childhood Services

Common emotional and behavioral health problems in early childhood

Almost every young child will occasionally break the rules, yell or scream, or say mean things. Although all these behaviors are totally normal, when they become extreme or keep happening over and over, they can disrupt a child’s longer-term social, emotional, and academic development, and can be extremely stressful for their families. 

Effective therapy for early childhood behavior problems

“Parent coaching” is the gold standard psychosocial therapy for young children with challenging behaviors. This parent-focused approach has by far the most scientific support, and it is now considered a “well-established treatment.” Several parent coaching programs have been shown to significantly improve behavior problems and to relieve parenting stress for the majority of families in research studies. Although each of these programs has their own unique qualities, there are a few themes across these therapies:

1. The primary focus is on parent behavior change

2. There is a focus on consistent delivery of effective parenting strategies 

3. These strategies focus on promoting prosocial behavior and minimizing challenging and inappropriate behavior

4. There is a degree of child participation in aspects of therapy

Parent-Child Interaction Therapy

Parent-Child Interaction Therapy (PCIT) is among the most widely tested parent coaching programs for young children with intense challenging behaviors. Parents often really love PCIT because it teaches effective parenting strategies through play time. In PCIT, parents wear an earpiece while playing with their child during structured play scenarios, while a therapist observes and provides feedback and coaching in some specific skills that have been shown to help kids improve their emotion regulation, prosocial behavior, and relationship with their parent.

      PCIT occurs in two phases: Child Directed Interaction (CDI), and Parent Directed Interaction (PDI). During CDI, parents follow along with their child’s play and learn skills to strengthen the bond and support positive behaviors. During PDI, parents learn about giving effective instructions and consistent, fair consequences for misbehavior.

Matching parent coaching to the family

I find it is often helpful to integrate other strategies when implementing PCIT to best match the family values of the parents and kids I am working with. Although PCIT is highly effective and can be flexibly adapted, because there are such a wide range of parent coaching programs, I find it is often useful to explore a slightly wider array of strategies to best match the individual family.