Abusive parents
Children with disruptive behavior are at risk for
physical abuse. The therapist addresses the question
of abuse in the pretreatment assessment and
responds to ethical and legal obligations to ensure
the child’s safety at any time during treatment that
abuse is suspected. Parents with a documented
physical abuse history are often referred for PCIT.
In these cases, the child may or may not have
significant behavior problems, and the primary
focus of treatment may be the parent. Frequently,
the child is not living with the parent during
treatment, limiting the parent’s opportunity to practice
the PCIT skills outside the treatment session.
Whenever possible, the therapist tries to arrange
supervised parent-child visitation for the purpose
of PCIT practice. Typically, the CDI phase of
treatment leads to dramatic changes in the child’s
affect and behavior as well as the parent’s perceptions
of their child’s behavior. During the PDI phase
of treatment, therapists routinely incorporate relaxation
training and anger-control training into their
coaching, and make a special point of commenting
on the child’s responsiveness to differential social
attention as a method of discipline for the child