Parent–Child Interaction Therapy for Families with a History of Child Maltreatment

  • Allison Cotter
  • Carisa Wilsie
  • Elizabeth Brestan-Knight


Child maltreatment involves actions or omissions resulting in actual harm or the potential for harm to a child’s health, survival, and development that is perpetrated by a person with power or responsibility, such as a child’s caregiver, family member, or teacher. Child maltreatment has been linked to numerous adverse outcomes in childhood and adulthood, including mental health problems. Given that parent–child interaction therapy (PCIT) has been offered as a possible treatment for young children who have experienced maltreatment, the current chapter provides updated information about the use of PCIT with this population. Specifically, this book chapter reviews common characteristics of maltreating families as they apply to the treatment model along with appropriate assessment techniques. It also provides a brief overview of case studies and research using PCIT to highlight support for its use within this population along with findings relevant for clinical application. Tailoring techniques and clinical adaptations for the PCIT treatment protocol are described. A case study is also presented to illustrate the assessment procedures, course of treatment, and challenges associated with conducting PCIT with a maltreated child. Finally, recommendations for future areas of research are offered.


Parent–child interaction therapy Parent–child relations Child maltreatment Assessment Treatment Young children 


  1. Abidin, R. (2012). Parenting stress index (4th ed.). Lutz, FL: PAR.Google Scholar
  2. Azar, S. T., Robinson, D. R., Hekimian, E., & Twentyman, C. T. (1984). Unrealistic expectations and problem-solving ability in maltreating and comparison mothers. Journal of Consulting and Clinical Psychology, 52(4), 687.CrossRefGoogle Scholar
  3. Azar, S. T., & Wolfe, D. A. (1998). Child physical abuse and neglect. Retrieved from
  4. Barkley, R. A. (1997). Defiant children: A clinician s manual for assessment and parent training (2nd ed.). New York: Guilford.Google Scholar
  5. Barth, J., Bermetz, L., Heim, E., Trelle, S., & Tonia, T. (2013). The current prevalence of child sexual abuse worldwide: A systematic review and meta-analysis. International Journal of Public Health, 58(3), 469–483.CrossRefGoogle Scholar
  6. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II (2nd ed.). San Antonio, TX: Psychological Corporation.Google Scholar
  7. Bentovim, A. (2014). Burdens and consequences of child maltreatment. In A. Bentovim & J. Gray (Eds.), Eradicating child maltreatment: Evidence-based approaches to prevention and intervention across services (pp. 17–50). London, UK: Jessica Kingsley Publishers.Google Scholar
  8. Borrego, J., Timmer, S. G., Urquiza, A. J., & Follette, W. C. (2004). Physically abusive mothers’ responses following episodes of child noncompliance and compliance. Journal of Consulting and Clinical Psychology, 72(5), 897.CrossRefGoogle Scholar
  9. Borrego, J., Urquiza, A. J., Rasmussen, R. A., & Zebell, N. (1999). Parent-child interaction therapy with a family at high risk for physical abuse. Child Maltreatment, 4(4), 331–342.CrossRefGoogle Scholar
  10. Briere, J. (2005). Trauma symptoms checklist for young children: Professional manual. Lutz, FL: Psychological Assessment Resources.Google Scholar
  11. Carpenter, A. L., Puliafico, A. C., Kurtz, S. M. S., Pincus, D. B., & Comer, J. S. (2014). Extending parent–child interaction therapy for early childhood internalizing problems: New advances for an overlooked population. Clinical Child and Family Psychology Review, 17(4), 340–356. Scholar
  12. Cerezo, M. A., D’Ocon, A., & Dolz, L. (1996). Mother-child interactive patterns in abusive families versus nonabusive families: An observational study. Child Abuse & Neglect, 20(7), 573–587. Scholar
  13. Chaffin, M., Funderburk, B., Bard, D., Valle, L. A., & Gurwitch, R. (2011). A combined motivation and parent–child interaction therapy package reduces child welfare recidivism in a randomized dismantling field trial. Journal of Consulting and Clinical Psychology, 79(1), 84–95. Scholar
  14. Chaffin, M., Silovsky, J. F., Funderburk, B., Valle, L. A., Brestan, E. V., Balachova, T., … Bonner, B. L. (2004). Parent-child interaction therapy with physically abusive parents: Efficacy for reducing future abuse reports. Journal of Consulting and Clinical Psychology, 72(3), 500–510. Scholar
  15. Chaffin, M., Valle, L. A., Funderburk, B., Gurwitch, R., Silovsky, J., Bard, D., … Kees, M. (2009). A motivational intervention can improve retention in PCIT for low-motivation child welfare clients. Child Maltreatment, 14(4), 356–368. Scholar
  16. Cicchetti, D., & Toth, S. L. (2005). Child maltreatment. Annual Review of Clinical Psychology, 1, 409–438.CrossRefGoogle Scholar
  17. Eyberg, S. M. (2005). Tailoring and adapting parent-child interaction therapy to new populations. Education & Treatment of Children, 28(2), 197–201.Google Scholar
  18. Eyberg, S. M., & Funderburk, B. (2011). Parent–child interaction therapy protocol. Gainesville, FL: PCIT International.Google Scholar
  19. Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child & Adolescent Psychology, 37(1), 215–237.CrossRefGoogle Scholar
  20. Fang, X., Brown, D. S., Florence, C. S., & Mercy, J. A. (2012). The economic burden of child maltreatment in the United States and implications for prevention. Child Abuse & Neglect, 36(2), 156–165. Scholar
  21. Fergusson, D. M., Boden, J. M., & Horwood, L. J. (2008). Exposure to childhood sexual and physical abuse and adjustment in early adulthood. Child Abuse & Neglect, 32(6), 607–619.CrossRefGoogle Scholar
  22. Foote, R. C., Schuhmann, E. M., Jones, M. L., & Eyberg, S. M. (1998). Parent-child interaction therapy: A guide for clinicians. Clinical Child Psychology and Psychiatry, 3(3), 361–373. Scholar
  23. Fricker-Elhai, A. E., Ruggiero, K. J., & Smith, D. W. (2005). Parent-child interaction therapy with two maltreated siblings in foster care. Clinical Case Studies, 4(1), 13–39.CrossRefGoogle Scholar
  24. Gilbert, R., Fluke, J., O’Donnell, M., Gonzalez-Izquierdo, A., Brownell, M., Gulliver, P., … Sidebotham, P. (2012). Child maltreatment: Variation in trends and policies in six developed countries. The Lancet, 379(9817), 758–772.CrossRefGoogle Scholar
  25. Gilbert, R., Widom, C. S., Browne, K., Fergusson, D., Webb, E., & Janson, S. (2009). Burden and consequences of child maltreatment in high-income countries. The Lancet, 373(9657), 68–81.CrossRefGoogle Scholar
  26. Hakman, M., Chaffin, M., Funderburk, B., & Silovsky, J. F. (2009). Change trajectories for parent-child interaction sequences during parent-child interaction therapy for child physical abuse. Child Abuse & Neglect, 33(7), 461–470. Scholar
  27. Harwood, M. D., & Eyberg, S. M. (2004). Therapist verbal behavior early in treatment: Relation to successful completion of parent-child interaction therapy. Journal of Clinical Child and Adolescent Psychology, 33(3), 601–612. Scholar
  28. Herman-Smith, R., Pearson, B., Cordiano, T. S., & Aguirre-McLaughlin, A. (2008). Addressing individual client needs in manualized treatment: Case comparisons. Clinical Case Studies, 7(5), 377–396. Scholar
  29. Herschell, A. D., & McNeil, C. B. (2005). Theoretical and empirical underpinnings of parent-child interaction therapy with child physical abuse populations. Education & Treatment of Children, 28(2), 142–162.Google Scholar
  30. Hughes, M., & Cossar, J. (2016). The relationship between maternal childhood emotional abuse/neglect and parenting outcomes: A systematic review. Child Abuse Review, 25(1), 31–45. Scholar
  31. Jud, A., Fegert, J. M., & Finkelhor, D. (2016). On the incidence and prevalence of child maltreatment: A research agenda. Child and Adolescent Psychiatry and Mental Health, 10(1), 17.CrossRefGoogle Scholar
  32. Kim, J. (2009). Type-specific intergenerational transmission of neglectful and physically abusive parenting behaviors among young parents. Children and Youth Services Review, 31(7), 761–767. Scholar
  33. Lanier, P., Kohl, P. L., Benz, J., Swinger, D., & Drake, B. (2014). Preventing maltreatment with a community-based implementation of parent–child interaction therapy. Journal of Child and Family Studies, 23(2), 449–460. Scholar
  34. Lau, A. S., Valeri, S. M., McCarty, C. A., & Weisz, J. R. (2006). Abusive parents’ reports of child behavior problems: Relationship to observed parent-child interactions. Child Abuse & Neglect, 30(6), 639–655. Scholar
  35. Lee, S., Aos, S., & Miller, M. G. (2008). Evidence-based programs to prevent children from entering and remaining in the child welfare system: Benefits and costs for Washington. Olympia, WA: Washington State Institute for Public Policy.Google Scholar
  36. Lorber, R., Felton, D. K., & Reid, J. B. (1984). A social learning approach to the reduction of coercive processes in child abusive families: A molecular analysis. Advances in Behaviour Research and Therapy, 6(1), 29–45. Scholar
  37. Maguire-Jack, K., & Negash, T. (2016). Parenting stress and child maltreatment: The buffering effect of neighborhood social service availability and accessibility. Children and Youth Services Review, 60, 27–33. Scholar
  38. Masse, J. J., McNeil, C. B., Wagner, S., & Quetsch, L. B. (2016). Examining the efficacy of parent–child interaction therapy with children on the autism spectrum. Journal of Child and Family Studies, 25(8), 2508–2525. Scholar
  39. McCabe, K., Yeh, M., Lau, A., & Argote, C. B. (2012). Parent-child interaction therapy for Mexican Americans: Results of a pilot randomized clinical trial at follow-up. Behavior Therapy, 43(3), 606–618.CrossRefGoogle Scholar
  40. McNeil, C., & Hembree-Kigin, T. L. (2010). Parent-child interaction therapy. New York, NY: Springer Science & Business Media.CrossRefGoogle Scholar
  41. Mersky, J. P., Topitzes, J., Grant-Savela, S. D., Brondino, M. J., & McNeil, C. B. (2016). Adapting Parent–Child Interaction Therapy to foster care: Outcomes from a randomized trial. Research on Social Work Practice, 26(2), 157–167.CrossRefGoogle Scholar
  42. Mersky, J. P., Topitzes, J., Janczewski, C. E., & McNeil, C. B. (2015). Enhancing foster parent training with parent-child interaction therapy: Evidence from a randomized field experiment. Journal of the Society for Social Work and Research, 6(4), 591–616.CrossRefGoogle Scholar
  43. Milner, J. S. (1986). The child abuse potential inventory: Manual. DeKalb, IL: Psytec.Google Scholar
  44. Milner, J. S. (2006). An interpretive manual for the child abuse potential inventory. DeKalb, IL: Psytec.Google Scholar
  45. Milot, T., St-Laurent, D., & Éthier, L. S. (2015). Intervening with severely and chronically neglected children and their families: The contribution of trauma-informed approaches. Child Abuse Review, 25, 89–101.CrossRefGoogle Scholar
  46. N’zi, A. M., & Eyberg, S. M. (2013). Tailoring parent-child interaction therapy for oppositional defiant disorder in a case of child maltreatment. In W. O’Donohue & S. O. Lilienfeld (Eds.), Case studies in clinical psychological science: Bridging the gap from science to practice (p. 3). Oxford, NY: Oxford University Press.Google Scholar
  47. N’zi, A. M., Lucash, R. E., Clionsky, L. N., & Eyberg, S. M. (2017). Enhancing parent–child interaction therapy with motivational interviewing techniques. Cognitive and Behavioral Practice, 24(2), 131–141.CrossRefGoogle Scholar
  48. Niec, L. N., Barnett, M. L., Gering, C. L., Triemstra, K., & Solomon, D. T. (2015). Differences in mothers’ and fathers’ readiness for change in parent training. Child & Family Behavior Therapy, 37(3), 224–235.CrossRefGoogle Scholar
  49. Nock, M. K., & Photos, V. (2006). Parent motivation to participate in treatment: Assessment and prediction of subsequent participation. Journal of Child and Family Studies, 15(3), 333–346. Scholar
  50. Patterson, G. R. (1982). Coercive family process (Vol. 3). Eugene, OR: Castalia Publishing Company.Google Scholar
  51. Pollio, E. S., Glover-Orr, L. E., & Wherry, J. N. (2008). Assessing posttraumatic stress disorder using the trauma symptom checklist for young children. Journal of Child Sexual Abuse, 17(1), 89–100.CrossRefGoogle Scholar
  52. Proctor, K. B. (2016). Assessing parental readiness to change: A psychometric evaluation of the READI-SF in a community sample. Retrieved from
  53. Puliafico, A. C., Comer, J. S., & Pincus, D. B. (2012). Adapting parent-child interaction therapy to treat anxiety disorders in young children. Child and Adolescent Psychiatric Clinics of North America, 21(3), 607–619. Scholar
  54. Reid, J. B., Taplin, P. S., & Lorber, R. (1981). A social interactional approach to the treatment of abusive families. In R. Stuart (Ed.), Violent behavior: Social learning approaches to prediction, management, and treatment (pp. 83–101). New York, NY: Bruner-Mazel.Google Scholar
  55. Reijman, S., Bakermans-Kranenburg, M. J., Hiraoka, R., Crouch, J. L., Milner, J. S., Alink, L. R. A., & van IJzendoorn, M. H. (2016). Baseline functioning and stress reactivity in maltreating parents and at-risk adults: Review and meta-analyses of autonomic nervous system studies. Child Maltreatment, 21(4), 327–342. Scholar
  56. Rodriguez, C. M. (2015). Parental discipline reactions to child noncompliance and compliance: Association with parent–child aggression indicators. Journal of Child and Family Studies. Scholar
  57. Ryan, K., Lane, S. J., & Powers, D. (2017). A multidisciplinary model for treating complex trauma in early childhood. International Journal of Play Therapy, 26(2), 111.CrossRefGoogle Scholar
  58. Sansbury, L. L., & Wahler, R. G. (1992). Pathways to maladaptive parenting with mothers and their conduct disordered children. Behavior Modification, 16(4), 574–592. Scholar
  59. Stith, S. M., Liu, T., Davies, L. C., Boykin, E. L., Alder, M. C., Harris, J. M., … Dees, J. E. M. E. G. (2009). Risk factors in child maltreatment: A meta-analytic review of the literature. Aggression and Violent Behavior, 14(1), 13–29. Scholar
  60. Stoltenborgh, M., Bakermans-Kranenburg, M. J., IJzendoorn, M. H., & Alink, L. R. (2013). Cultural–geographical differences in the occurrence of child physical abuse? A meta-analysis of global prevalence. International Journal of Psychology, 48(2), 81–94.CrossRefGoogle Scholar
  61. Stoltenborgh, M., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2013). The neglect of child neglect: A meta-analytic review of the prevalence of neglect. Social Psychiatry and Psychiatric Epidemiology, 48(3), 345–355.CrossRefGoogle Scholar
  62. Straus, M. A., Hamby, S. L., Finkelhor, D., Moore, D. W., & Runyan, D. (1998). Identification of child maltreatment with the parent-child conflict tactics scales: Development and psychometric data for a national sample of American parents. Child Abuse & Neglect, 22(4), 249–270. Scholar
  63. Susman, E. J., Trickett, P. K., Iannotti, R. J., Hollenbeck, B. E., & Zahn-Waxler, C. (1985). Child-rearing patterns in depressed, abusive, and normal mothers. American Journal of Orthopsychiatry, 55(2), 237.CrossRefGoogle Scholar
  64. Thomas, R., & Herschell, A. D. (2013). Parent–child interaction therapy: A manualized intervention for the therapeutic child welfare sector. Child Abuse & Neglect, 37(8), 578–584.CrossRefGoogle Scholar
  65. Thomas, R., & Zimmer-Gembeck, M. J. (2011). Accumulating evidence for parent–child interaction therapy in the prevention of child maltreatment. Child Development, 82(1), 177–192.CrossRefGoogle Scholar
  66. Thomas, R., & Zimmer-Gembeck, M. J. (2012). Parent–child interaction therapy: An evidence-based treatment for child maltreatment. Child Maltreatment, 17(3), 253–266.CrossRefGoogle Scholar
  67. Timmer, S. G., Borrego, J., & Urquiza, A. J. (2002). Antecedents of coercive interactions in physically abusive mother-child dyads. Journal of Interpersonal Violence, 17(8), 836–853.CrossRefGoogle Scholar
  68. Timmer, S. G., Urquiza, A. J., Herschell, A. D., McGrath, J. M., Zebell, N. M., Porter, A. L., & Vargas, E. C. (2006). Parent-child interaction therapy: Application of an empirically supported treatment to maltreated children in foster care. Child Welfare: Journal of Policy, Practice, and Program, 85(6), 919–939.Google Scholar
  69. Timmer, S. G., Urquiza, A. J., & Zebell, N. (2006). Challenging foster caregiver-maltreated child relationships: The effectiveness of parent-child interaction therapy. Children and Youth Services Review, 28(1), 1–19. Scholar
  70. Timmer, S. G., Urquiza, A. J., Zebell, N. M., & McGrath, J. M. (2005). Parent-child interaction therapy: Application to maltreating parent-child dyads. Child Abuse & Neglect, 29(7), 825–842. Scholar
  71. Topitzes, J., Mersky, J. P., & McNeil, C. B. (2015). Implementation of parent–child interaction therapy within foster care: An attempt to translate an evidence-based program within a local child welfare agency. Journal of Public Child Welfare, 9(1), 22–41.CrossRefGoogle Scholar
  72. Urquiza, A., & Timmer, S. (2014). Parent-child interaction therapy for maltreated children. In S. Timmer & A. Urquiza (Eds.), Evidence-based approaches for the treatment of maltreated children: Considering core components and treatment effectiveness (Vol. 3, pp. 123–144). New York, NY, US: Springer Science + Business Media.CrossRefGoogle Scholar
  73. Urquiza, A. J., & McNeil, C. B. (1996). Parent-child interaction therapy: An intensive dyadic intervention for physically abusive families. Child Maltreatment, 1(2), 134–144. Scholar
  74. US Department of Health and Human Services. (2017). Child maltreatment 2015. Retrieved from
  75. Ware, L. M., Fortson, B. L., & McNeil, C. B. (2003). Parent-child interaction therapy: A promising intervention for abusive families. The Behavior Analyst Today, 3(4), 375–382. Scholar
  76. Wilsie, C., Campbell, C., Chaffin, M., & Funderburk, B. (2017). Parent-child interaction therapy in child welfare. In D. M. Teti (Ed.), Parenting and family processes in child maltreatment and intervention (pp. 107–125). Cham, Switzerland: Springer International Publishing.CrossRefGoogle Scholar
  77. Wilson, S. R., Rack, J. J., Shi, X., & Norris, A. M. (2008). Comparing physically abusive, neglectful, and non-maltreating parents during interactions with their children: A meta-analysis of observational studies. Child Abuse & Neglect, 32(9), 897–911. Scholar
  78. World Health Organization. (2006). Preventing child maltreatment: A guide to taking action and generating evidence. Geneva, Switzerland: Author.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Allison Cotter
    • 1
  • Carisa Wilsie
    • 2
  • Elizabeth Brestan-Knight
    • 1
  1. 1.Auburn UniversityAuburnUSA
  2. 2.University of Oklahoma Health Sciences CenterOklahoma CityUSA

Personalised recommendations