Eyberg won federal money for a pilot study in the mid-1970s; over the next three decades, randomized clinical trials began finding large, lasting improvements in child behavior and in parents' skills, attitudes and stress. But PCIT remained largely confined to university settings where Eyberg and her former graduate students taught. The therapy met resistance from some traditional therapists, who had been trained to listen to patients, not to tell them what to do.
The intensive training and supervision required of new PCIT therapists was another impediment. That began to change in the late 1990s, with growing interest among health professionals and public health officials in evidence-based treatments, whose effectiveness had been demonstrated in controlled scientific studies.
Jennifer Wyatt Kaminski, a developmental psychologist at the Centers for Disease Control and Prevention, led a meta-analysis of 77 published studies on evidence-based treatments for early childhood behavior problems. The results, published in 2008 in the Journal of Abnormal Child Psychology, found that one of the most successful strategies was to increase the number of positive everyday interactions between parents and children.
PCIT's live coaching and laserlike focus on the parent-child relationship make it distinctive, but the therapy shares many of the same goals as other highly regarded interventions, such as the Incredible Years and the Triple P: Positive Parenting Program.
"You're relationship-building and providing children with positive attention in such a way that it reduces their need to seek out attention through" undesirable behaviors, Kaminski says.
For parents who have built emotional defenses against their children's rages, that can at first be a challenge. "I realized I had gotten to the point where I was so afraid of sparking yet another tantrum that I barely spoke to my son anymore," said Jennie, the mother from upstate New York. "As much as Alex would complain at first [about PCIT] — 'Stop complimenting me, stop talking to me' — eventually he'd say it less and less. Eventually, he said to me, 'I love my compliments.' "
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Sabar is a writer in Washington. His e-book, "Small Town Renegade," about a maverick psychology professor, will be released as an Amazon Kindle Single in January.