Frequently Asked Questions
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PCIT Experts is a specialty clinic dedicated exclusively to Parent-Child Interaction Therapy (PCIT) for young children and their families.
The clinic was founded by Dr. Leah Clionsky, a licensed clinical psychologist who was trained directly by the developer of PCIT and has spent her career implementing, teaching, and studying this model across research, community, and private practice settings. PCIT Experts was created with a clear goal: to provide gold-standard PCIT with consistent, high-quality outcomes outside of research settings.
While PCIT is a well-researched and effective treatment, the quality of outcomes depends heavily on how it is delivered. PCIT Experts exists because PCIT works best when it is provided by clinicians who specialize deeply in the model, receive ongoing supervision and consultation, and maintain strict attention to treatment fidelity and clinical nuance.
Unlike general therapy practices where PCIT may be one of many services offered, PCIT Experts focuses exclusively on PCIT. This allows our clinicians to develop advanced expertise, refine their coaching skills, and deliver treatment in a way that closely mirrors — and in many cases exceeds — the level of care families would receive in a research-based setting.
The mission of PCIT Experts is not simply to offer PCIT, but to be exceptionally good at it. Every aspect of the clinic, from clinician training and supervision to matching families with the right level of expertise, is designed to support meaningful, efficient change for families.
Our goal is to help families experience the full potential of PCIT — not as a generic behavior program, but as a relationship-based, evidence-driven treatment that leads to lasting improvements in connection, regulation, and daily functioning.
Because PCIT Experts specializes so deeply in this model, our clinicians also understand when and how PCIT should be thoughtfully adapted, and when a different approach may be more appropriate.
Expertise in PCIT does not mean applying the protocol rigidly in every situation. It means understanding the underlying principles well enough to tailor the intervention to the child and family in front of us, while still maintaining the integrity of what makes PCIT effective. In some cases, this includes adapting pacing, emphasis, or structure to better fit a child’s developmental profile, emotional needs, or family context.
Equally important, deep specialization allows us to recognize when PCIT is not the right treatment. Part of providing ethical, high-quality care is being able to say when another evidence-based approach would better serve a family’s goals. Our intake and matching process is designed to help families understand whether PCIT is the best fit, whether it should be adapted, or whether a different type of support would be more appropriate.
PCIT Experts exists not to apply a single model indiscriminately, but to use deep knowledge, experience, and clinical judgment to help families receive the care that is most likely to lead to meaningful change.
What is PCIT Experts?
What is Parent-Child Interaction Therapy (PCIT)?
Parent-Child Interaction Therapy (PCIT) is an evidence-based treatment for young children with challenging behaviors and emotional regulation difficulties. PCIT works by coaching parents in real time while they interact with their child, helping parents build effective skills that lead to calmer behavior and stronger relationships.
Rather than focusing only on talking about behavior, PCIT helps parents practice specific strategies during sessions and use them consistently at home.
What age range is Parent-Child Interaction Therapy (PCIT) designed for?
PCIT has a strong evidence base for children between the ages of 2 and 7 years old, which is the age range it was originally developed to treat.
There are also well-established adaptations of PCIT that can be effective for toddlers as young as 1 year old and for older children up to around age 10, depending on the child’s developmental level and the concerns being addressed. During the intake process, PCIT Experts carefully evaluates whether PCIT is developmentally appropriate for each child.
PCIT is especially helpful for children with big behaviors, big feelings, or difficulty regulating emotions, and for families who feel stuck and need hands-on guidance rather than general advice.
PCIT is completely dependent on parent implementation. The parent is the agent of change. Treatment focuses on helping parents get back on track, strengthen connection, and learn the foundations of solid, evidence-based parenting strategies that can be used well beyond the end of therapy.
Some families seek PCIT because their child is struggling, while others come specifically to build confidence as parents and learn effective skills before challenges escalate. In both cases, PCIT provides practical, coached support that parents can use immediately in everyday interactions.
Why is Parent-Child Interaction Therapy (PCIT) so effective?
PCIT is supported by more than 40 years of research and has been studied across a wide range of families and child concerns.
PCIT works by transforming the relationship between parents and children, not by changing the child alone. Parents are taught the core skills that make parenting effective, including high warmth, strong connection, and clear, consistent limit setting.
Through live coaching, therapists help parents tailor these skills to fit their child’s temperament, developmental level, and family dynamics. This personalized approach allows skills to generalize beyond sessions and into everyday life.
What kinds of concerns does PCIT help with?
PCIT is commonly used to help children with:
Frequent tantrums or emotional outbursts
Defiance, aggression, or oppositional behavior
Difficulty following directions
Emotional regulation challenges
Parent-child relationship strain
Behavioral challenges at home or school
PCIT can be helpful even when concerns are not severe.
Do behavior problems have to be severe for PCIT to help?
No. Children do not need to have extreme behavior problems for PCIT to be effective.
PCIT can be helpful during periods of transition or stress, such as starting school, changes in family structure, or increased emotional demands. Many families seek PCIT because they feel stuck or disconnected and want to build a calmer, more positive relationship with their child.
Many PCIT therapists also use PCIT skills with their own children because of how effective the strategies are in building connection and cooperation.
How do I know if PCIT is right for my family?
PCIT is often a strong fit for families who are struggling with acting-out behavior, frequent power struggles, or emotional dysregulation. It is also a good fit for parents who think, “I love my child, but I don’t know how to connect with them,” or “I don’t know how to manage these behaviors in a way that feels both effective and safe.”
PCIT works best when parents are open to learning new strategies and willing to practice them consistently. Daily practice typically takes about five minutes and plays a key role in treatment success.
When might PCIT not be the right fit?
PCIT is designed for young children and is generally not recommended for children over the age of 10.
PCIT may also not be the best fit when parents are unable to participate consistently or practice skills between sessions. Because PCIT is a parent-coaching model, caregiver involvement is essential.
When PCIT is not appropriate, families are guided toward other evidence-based options.
PCIT is a structured treatment that unfolds in phases, and sessions look different at different points in the process.
Early sessions typically involve the parents and clinician meeting without the child present. During these sessions, the therapist takes time to understand the child, family dynamics, and specific challenges, and teaches the core PCIT skills. This allows the intervention to be thoughtfully tailored to the child’s developmental level, temperament, and family needs rather than applied in a generic way.
PCIT also includes observation sessions, where the clinician observes parent-child interactions to understand how behaviors show up in real life. These observations help the therapist identify patterns that may not be obvious through conversation alone and guide how coaching is structured.
As treatment progresses, many sessions focus on live coaching, which is the core of PCIT. During coaching sessions, parents interact with their child while the therapist provides real-time guidance through an earpiece. A helpful way to think about this is like working with a personal trainer. Rather than talking about what to do later, the therapist is there in the moment, helping parents adjust how they respond, refine their “form,” and strengthen skills as they are being used.
This real-time coaching is where much of the change happens. Parents receive immediate feedback, children experience consistent responses, and patterns begin to shift more quickly than they would through discussion alone.
Progress is monitored throughout treatment using weekly measures of behavior and functioning. This allows both the family and clinician to see whether the intervention is working and to make thoughtful adjustments when needed.
What does a PCIT session look like?
How many PCIT sessions will my family need?
The number of PCIT sessions varies depending on the child’s needs, parent involvement, and consistency of practice.
Research often describes PCIT as taking approximately 16–20 sessions. In our clinic, many families complete treatment in around 12 sessions, although this cannot be guaranteed. We believe this is influenced by clinician expertise, focused treatment, and strong parent engagement.
Progress is monitored throughout treatment, and sessions continue until families demonstrate skill mastery.
How soon will I see results with PCIT?
Many families notice changes within the first few weeks, particularly when skills are practiced consistently at home.
Early improvements often include calmer interactions, improved compliance, and reduced intensity of challenging behaviors. Continued progress builds as parents gain confidence and consistency.
Completing the full course of PCIT is important, even when early gains occur, to ensure lasting change. Progress is tracked using weekly behavior measures so that treatment can be adjusted as needed.
Can PCIT be done more intensively to make progress faster?
Yes. PCIT can be offered in a more intensive format when families want to make progress more quickly.
While PCIT is often scheduled once per week, treatment does not need to follow a weekly pace. Some families choose to meet multiple times per week, an approach often referred to as a PCIT intensive.
Families may choose an intensive schedule for many reasons, including wanting progress before the school year begins, preferring a faster pace, managing parental stress, or simply not wanting to stretch treatment over a longer period.
Because PCIT Experts operates as a private-pay practice, we are able to offer flexible scheduling that is not restricted by insurance requirements. When clinically appropriate, increased session frequency can accelerate skill development and behavior change.
Parent-Child Interaction Therapy (PCIT) is different from standard play therapy in both structure and purpose.
In traditional play therapy, the child typically meets one-on-one with a therapist, and change happens primarily within the therapy room. In PCIT, the parent is the primary agent of change. Therapists coach parents in real time so that parents learn how to strengthen the relationship and manage behavior during everyday interactions at home.
PCIT is designed to change the parent-child relationship itself. Parents learn skills that allow them to provide therapeutic, relationship-building interactions every day, not just during sessions. This is especially important for families dealing with challenging behaviors that occur outside the therapy room.
Many families come to PCIT after trying play therapy and finding that it did not lead to the level of behavior change they were hoping for. PCIT is specifically structured to address disruptive behaviors through skill building, consistency, and coached practice, rather than relying on general emotional expression alone.
How is PCIT different from standard play therapy?
Why does PCIT often lead to faster or more noticeable behavior change than play therapy?
PCIT is designed specifically to treat challenging behaviors by teaching parents how to respond in ways that are both warm and effective.
Rather than focusing only on insight or emotional expression, PCIT provides concrete tools for increasing positive behavior, improving compliance, and reducing disruptive patterns. Because parents are coached directly and practice skills daily, changes often generalize more quickly to real-life situations.
This structure allows PCIT to address behaviors that may not improve through less directive or more generalized therapy approaches.
PCIT looks like parents and children are just playing. Is there more happening?
Yes. While PCIT sessions may appear simple on the surface, there is a great deal happening beneath the play.
Play is used intentionally as a therapeutic context where parents practice specific skills that shape behavior, emotional regulation, and relationship patterns. Therapists coach parents moment-by-moment to reinforce effective interactions and reduce patterns that contribute to challenging behavior.
This structured, coached play is very different from unstructured playtime and is carefully designed to produce measurable change.
Yes. PCIT is often a very good fit for young children with ADHD, especially when families are dealing with impulsivity, emotional reactivity, frequent power struggles, or difficulty following directions.
PCIT does not change a child’s underlying neurodevelopmental profile or their core capacity for attention. However, it can make a meaningful difference in the parts of family life that are most impacted by ADHD, including parent-child connection, self-esteem, and day-to-day behavior patterns.
A major benefit of PCIT for ADHD is that it helps parents learn how to sort out the difference between behaviors that are outside of a child’s control (because of attention, impulsivity, or regulation differences) and behaviors that reflect true defiance, limit testing, or learned patterns. That clarity helps parents respond with empathy when a child is struggling and with confident, consistent limit setting when boundaries are needed.
Over time, families often experience less conflict, fewer escalations, and a calmer home environment because the parent is coached to respond in ways that are both warm and effective.
Is PCIT appropriate for children with ADHD?
Is PCIT appropriate for children with autism spectrum disorder?
PCIT can be appropriate for some children with autism spectrum disorder, particularly when goals include strengthening parent-child connection, reducing disruptive or unsafe behaviors, and improving daily cooperation.
PCIT Experts carefully evaluates whether PCIT is a good fit based on the child’s developmental profile, communication level, sensory needs, and family goals. When PCIT is appropriate, strategies are adapted thoughtfully so the approach is supportive and affirming of the child’s neurodevelopmental framework rather than rigid or one-size-fits-all.
In addition to addressing behavior and relationship patterns, PCIT can support social communication and interaction skills that often develop through coached parent-child play. This can include turn-taking, shared attention, positive interaction routines, and other foundational social skills that are strengthened through consistent, warm, structured parent engagement.
Families often appreciate that PCIT provides a clear structure while still allowing room for individualized tailoring based on how their child learns and connects best.
Is PCIT appropriate for anxiety, selective mutism, or trauma?
Yes. PCIT is not only appropriate for anxiety, selective mutism, and trauma-related concerns in young children, but there is also a strong and growing body of research supporting its effectiveness for these presentations.
PCIT has been adapted and studied specifically for anxiety disorders, selective mutism, and trauma-related symptoms. These adaptations maintain the core structure of PCIT while tailoring how parents are coached to support a child’s sense of safety, confidence, and emotional regulation.
For anxiety and selective mutism, PCIT focuses on strengthening the parent-child relationship, increasing a child’s sense of security, and helping parents respond in ways that reduce avoidance while supporting gradual engagement. Coaching helps parents reinforce brave behavior without pressure, punishment, or unintentionally reinforcing anxiety.
For trauma-related concerns, PCIT emphasizes predictability, emotional safety, and sensitive limit setting. Parents are coached to provide consistent, calm responses that help children regulate their emotions and rebuild trust in relationships following stressful or traumatic experiences.
PCIT Experts carefully evaluates whether PCIT alone or PCIT in combination with other evidence-based treatments is the best fit for a child. When PCIT is appropriate, the treatment is thoughtfully tailored to the child’s specific emotional needs, history, and family context rather than applied in a rigid or one-size-fits-all way.
How does PCIT work when there are siblings?
PCIT typically begins with the child who is experiencing the most difficulty. Parents are then coached on how to generalize skills across sibling interactions.
Families often see improvement in all children in the household, even when only one child is formally participating in PCIT treatment.
PCIT Experts focuses exclusively on PCIT. This specialization allows for deep expertise, rigorous training, and strong treatment outcomes.
Families seeking meaningful change often benefit from working with clinicians who understand the model thoroughly and know how to tailor it effectively. When PCIT is delivered with expertise and fidelity, progress can happen more efficiently.
Why choose PCIT Experts for Parent-Child Interaction Therapy?
Who provides PCIT at PCIT Experts?
PCIT Experts includes clinicians who are certified by PCIT International as well as clinicians who are in advanced training toward certification.
Clinicians in training receive intensive supervision within our clinic, including live observation, structured feedback, and regular case consultation.
Many senior clinicians have treated hundreds of PCIT cases and serve as trainers themselves. Our clinic trains beyond minimum certification standards because excellence in PCIT is a core priority.
How does PCIT Experts ensure high-quality treatment?
Quality control is central to our model.
PCIT Experts emphasizes ongoing consultation, supervision, and fidelity monitoring to ensure treatment meets or exceeds what families would receive in a research-based setting. Even experienced clinicians participate in consultation to maintain high standards.
How does PCIT Experts match families with the right clinician?
Before services begin, PCIT Experts completes a personalized matching process.
Our intake specialists take time to understand:
The challenges you and your child are experiencing
Your goals for treatment
The level of support and structure your family needs
Your location and telehealth eligibility
Families are matched with clinicians based on relevant PCIT expertise, case complexity, and fit, not simply availability.
For families facing more complex or long-standing challenges, we may recommend a senior clinician who has treated hundreds of PCIT cases. For more straightforward concerns, families may be matched with a clinician who is advancing their PCIT specialization and receiving intensive supervision within our clinic.
This intentional approach allows PCIT Experts to provide high-quality care while ensuring families receive the level of expertise that best fits their needs.
Who handles the matching process at PCIT Experts?
Matching is handled by skilled intake specialists who understand both PCIT and the differences in clinician training and experience.
They work closely with clinical leadership to ensure each family is paired with the most appropriate PCIT provider based on clinical needs, location, and treatment goals. This reduces trial-and-error and helps treatment begin with clarity and confidence.
Does PCIT Experts require a diagnosis for treatment?
No. A diagnosis is not required unless it is clinically appropriate or helpful.
Because PCIT Experts operates as a private-pay practice, clinicians are not required to assign diagnoses solely for insurance billing purposes. This allows care to focus on skill-building, relationship change, and behavior improvement rather than labels.
No. PCIT Experts does not use artificial intelligence tools to generate therapy notes or clinical documentation.
All documentation is completed directly by licensed clinicians to protect family privacy, ensure accuracy, and uphold ethical standards.
Does PCIT Experts use artificial intelligence (AI) in clinical documentation?
Why doesn’t PCIT Experts use AI for therapy notes?
Clinical records contain highly sensitive personal and family information. By not using AI-generated documentation, PCIT Experts maintains tighter control over confidentiality, clinical judgment, and data security.
Documentation reflects the clinician’s professional expertise rather than automated systems.
Yes. Virtual PCIT is highly effective, and in many cases, it offers meaningful advantages over in-person treatment.
Research has shown that PCIT delivered via telehealth is effective, and this aligns with what we see clinically. PCIT focuses on coaching parents rather than relying on the child to engage directly with a therapist. Because of this structure, the treatment translates especially well to a virtual format.
One of the key benefits of virtual PCIT is that coaching happens in the child’s real-life environment. Therapists are able to observe parent-child interactions as they naturally occur at home, rather than in an unfamiliar office setting. This allows clinicians to see the challenges families are actually facing and intervene in ways that are directly relevant and immediately usable.
Parents sometimes worry that virtual therapy may not work for young children, and that concern makes sense. Traditional individual therapy for a toddler or preschooler does not translate well to telehealth. PCIT is different. The child does not need to engage with a screen or therapist. The parent is the one being coached, and the parent-child interaction is the focus of treatment.
Virtual PCIT also offers practical benefits for families, including reduced travel time, increased scheduling flexibility, and easier participation for caregivers. Many families find that these factors make it easier to stay consistent with treatment and complete the full course of PCIT.
At PCIT Experts, virtual PCIT is delivered with the same level of structure, expertise, and fidelity as in-person care, with thoughtful consideration of what format will best support each family’s success.
Does virtual (telehealth) PCIT work?
Why doesn’t PCIT Experts offer in-person PCIT?
PCIT Experts intentionally provides PCIT virtually because we believe it leads to better outcomes for many families.
We previously offered PCIT in person, and through both research and clinical experience, we found that virtual PCIT often works more effectively. Coaching parents in their home environment allows therapists to observe real-life interactions, address challenges as they actually occur, and help parents practice skills in the exact context where they are needed.
Families frequently complete PCIT in fewer sessions when treatment is delivered virtually. This is likely because skills generalize more quickly when parents are coached in their everyday routines rather than in an office setting.
Virtual PCIT also reduces barriers such as travel time and scheduling challenges, which makes it easier for families to stay consistent and complete treatment. Consistency is a key factor in successful outcomes.
In addition, offering PCIT virtually allows PCIT Experts to match families with highly trained clinicians regardless of geographic location. This expands access to experienced providers and ensures that families can work with clinicians who have the right level of expertise for their needs.
In-person PCIT can be effective, but our model is designed to offer families what we believe works best. Rather than providing an option that is “good enough,” we choose to provide the format that supports stronger engagement, faster progress, and more durable change for many families.
Where do families need to be located to receive PCIT from PCIT Experts?
Families can receive PCIT from PCIT Experts if they are located in Texas or in a PSYPACT-authorized state at the time of treatment.
Many of our clinicians are based in Houston, and we work with a large number of families in the Houston area. At the same time, PCIT Experts is designed to serve families beyond a single city or state through virtual PCIT.
Because our clinicians hold licenses that allow them to practice across multiple states through PSYPACT, families can receive PCIT from PCIT Experts even if they are not physically located in Texas. Services are provided virtually when clinically appropriate and legally permitted.
At the time of writing, families may receive PCIT from PCIT Experts if they are located in the following states:
Alabama
Arizona
Colorado
Delaware
Georgia
Idaho
Illinois
Indiana
Kansas
Kentucky
Maine
Maryland
Michigan
Minnesota
Missouri
Nebraska
Nevada
New Hampshire
New Jersey
North Carolina
North Dakota
Ohio
Oklahoma
Pennsylvania
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Washington
West Virginia
Wisconsin
PSYPACT participation and licensure rules can change over time. During the intake and matching process, our team confirms eligibility to ensure services are provided appropriately and legally.
PCIT Experts operates as a private-pay practice so clinicians can provide high-quality, individualized PCIT without insurance-driven constraints.
Private pay allows us to:
Match families with the most appropriate PCIT clinician based on expertise and case complexity
Determine treatment length and structure based on clinical need
Avoid assigning diagnoses when they are not clinically appropriate or helpful
Maintain greater confidentiality by not sharing detailed clinical information with insurance companies
Many families choose private pay because it supports privacy, flexibility, and care guided by what truly helps the child and family. This structure also supports greater continuity and depth of treatment, which is especially important in skill-based interventions like PCIT.
Why does PCIT Experts use a private-pay model?
What payment options does PCIT Experts accept?
PCIT Experts operates primarily as a private-pay practice.
Families pay directly for services, which allows us to offer flexible scheduling, thoughtful matching, and treatment that is guided by clinical need rather than insurance requirements.
In addition to private pay, some clinicians at PCIT Experts are able to accept Lyra or Modern Health benefits. Availability varies by clinician, and families are encouraged to check their benefits and ask during the intake process whether these options apply.
Does PCIT Experts accept insurance?
PCIT Experts is considered out-of-network with insurance plans.
We do not bill insurance directly and do not communicate with insurance companies on a family’s behalf. This includes prior authorizations, treatment updates, or claims processing.
For families who wish to pursue out-of-network reimbursement independently, we can provide a superbill upon request. Families are responsible for submitting superbills to their insurance company and determining eligibility for reimbursement.
Why doesn’t PCIT Experts work directly with insurance companies?
Working directly with insurance companies often requires assigning diagnoses, limiting session structure, and sharing detailed clinical information that may not be in a family’s best interest.
By remaining private pay, PCIT Experts is able to:
Focus treatment on skill-building and relationship change rather than insurance criteria
Avoid assigning diagnoses when they are not clinically appropriate
Maintain greater confidentiality by not sharing treatment details with insurance companies
Offer flexible scheduling options, including PCIT intensives
This approach allows care to remain centered on what best supports the child and family.
Will PCIT Experts provide documentation or communicate with my insurance company?
No. PCIT Experts does not communicate directly with insurance companies and does not provide clinical documentation to insurers.
All clinical records are kept confidential within the practice. Families who choose to submit superbills to insurance do so independently.
How do I schedule a session with PCIT Experts?
Getting started begins with contacting PCIT Experts to complete an intake and matching process. Our team will guide you through next steps and scheduling.