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Why is the Child Directed Interaction (CDI) Phase important for PCIT - Kelly Kincaid, LPC

As therapists, families often seek our expertise and advice. Caregivers come to us with worries, concerns, and a list of behaviors they do not understand and want to stop. Caregivers are frequently overwhelmed and frustrated. We often hear things such as: “His tantrums are out of control!” “She’s just so emotionally dysregulated! I can’t get her to do anything I say!” The anger, worry, and frustration are real. Some caregivers make comments full of frustration, fear, or shame: “I feel like such a bad parent. I’m failing.” Caregivers come in the door asking for help, wanting things to be different, but not knowing how to do it.

We as a society move at such a rapid pace - the morning rush, school drop off, then off to work only to rush back to school for pick up, head to after-school activities then home for dinner, bath, and bed only to wake up again and repeat. Simultaneously, caretakers are often multitasking the demands of work and home while being constantly accessible by email and text. We never turn off or are fully present. What impact does this have on us, on our relationships with others and, more specifically, on our relationships with the little ones in our world? Are we ever fully present with them? It’s no wonder children act out or find ways to be seen and heard.

We, as PCIT therapists, can help families find ways to come together in the midst of such busy lives. It’s a recipe for systematic change, with CDI (Child Directed Interaction) at its core. The magic of CDI is caretakers give their child five minutes of their undivided attention while practicing specific skills designed to reduce behavioral challenges. CDI allows the parent to turn off the busyness of their lives and be fully present with their child. The parent sits with the child, let’s the child lead the play, and follows along while noticing and describing their child’s positive behaviors.

When a caretaker gives their child their full attention using this positive lens, the child feels seen, accepted, and valued for who they are. The parent’s awareness of desired behaviors and increased optimism fosters the child’s growing independence, confidence, and improved focus. The caretaker starts seeing the child in a new light—more compliant, less reactive and even fun. With this connection comes cooperation.

CDI gives parents a roadmap, a guide, on how to strengthen the parent-child relationship. It’s the foundation for PCIT and it’s what makes the second phase of PCIT (the Parent-Directed Interaction Phase) successful. When a child feels seen and heard, they are more likely to accept structure and limits set by their caretaker. When caretakers decide to slow down and move with intentionality - praising the positive behaviors they see, reflecting their child’s words, imitating positive behaviors, and narrating their child’s play while remaining animated in the play - they are connecting. This feels good for the child AND the parent!

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