An Introduction to PCIT-T: Integrating Attachment and Behavioral Principles

Abstract

"Jack," aged 19 months, was referred to the PCIT-T clinic by his pediatrician for assistance with tantrums and aggressive behaviors. Strategies implemented by the pediatrician had not led to any change in his behavior. Jack attended the initial assessment session with his mother, "Rachel," and his father, "Tim." On assessment, Rachel and Tim said that Jack had been displaying difficult behaviors on a daily basis including biting, hitting, hair pulling, head banging, and tantrums (screaming, flopping to the floor, and swinging his head back and forth during the tantrum). His anger and frustration appeared to be primarily directed at his mother and older brothers. Rachel and Tim did not know the origin of the challenging behaviors and found it difficult to identify any specific triggers or precipitants for Jack's aggression and tantrums. Rachel expressed significant distress at being unable to manage Jack's behavior and said that she did not feel emotionally connected to him. She said that she often became overwhelmed and struggled to control Jack's behavior, especially in public places. Rachel and Tim had both spanked Jack in the past and had also tried to ignore his behaviors, but they had not found these techniques to be effective. Discouraged and frustrated, the parents reached out for help and were referred for PCIT-T.