There are many factors to consider when implementing PCIT in an agency.
The biggest factors include: space, materials, and staff training.
It is imperative to have a PCIT room set-up (sometimes referred to as a PCIT suite) in your clinic to implement PCIT. Having the room set-up before staff is trained is highly recommended.
The basic set-up for a PCIT suite includes three adjacent rooms (therapy/play room, observation room, and time-out room). Average-sized treatment rooms are preferred rather than larger conference rooms. The parent and child play in the therapy room, while the therapist coaches from the observation room, looking through a one-way mirror. The time-out room is used in the second phase of treatment as a back-up consequence to the time-out chair.
In the playroom, there should be:
an adult sized table with two chairs to accommodate a caregiver and child
a sturdy adult-sized time-out chair
at least three choices of appropriate toys.
In the observation room, there should be:
A one-way mirror
A sound system (microphone and amplifier) to hear the interaction between caregiver and child while you (the therapist) stand on the other side of the one way mirror
A "hearing helper" system for speaking to the caregiver through a microphone and earpiece device (bug-in-the-ear)
A timer for timing the parent-child observation and coaching
Optional video recording of sessions allows for session review by consultant or supervisor, your review of caregiver skill level, and as a reference as the sessions progress.
A time-out room is highly recommended but not required. A time-out room is ideally approximately 4X6 feet or so - no smaller than 4X4 and no larger than a small office - and it must have adequate light. When designing a time-out room, consider having a "dutch door" cut off approximately 5 feet high and/or a safety glass window into the timeout room to permit visual contact. Including a one-way mirror or other means of observing the time-out room from the observation room is helpful as well.
PCIT 2011 Treatment Protocol (one per therapist) $44
Clinical Manual for the Dyadic Parent-Child Interaction Coding System (DPICS-IV; one per therapist) $40
DPICS-IV Workbook (one per therapist) $15
Appropriate toys (a selection of PCIT-appropriate toys, including toys for younger and older children available) estimate $300-$500
Fantasy play sets (farm scenes, airport, castle, zoo, Potato Heads, etc.)
Arts & Crafts (washable crayons and markers, coloring pages or paper, Play-Doh with tools,etc.)
Large sets of construction toys (Duplo's, foam blocks, LEGO's, alphabet blocks, tinker toys, etc.)
Plastic storage tubs or bags for each toy for easy clean-up and storage!
Bug-in-the-ear (Hearing Helper)
Williams Sound PFM Motiva --rechargable transmitter and receiver
Williams Sound microphone
Williams Sound Earbud
Williams Sound replacement pads for Earbud
We’ve used older models from this brand heavily for over 10 years now and they are still working for us with rare exception. The only disadvantages are that they have a wire leading from the earpiece to the transmitter unit and they do not have a mute button. Newer models come with a mute button.
Other agencies have investigated using walkie-talkies, Bluetooth receivers and cell phones, etc. to cut down on costs. More expensive wireless systems are also available (generally designed for the hearing impaired).
Adult sized table and three chairs (one will be the time-out chair)
One-way mirror (shatter-resistant) between observation and therapy room (costs vary)
Some agencies have investigated the use of video baby monitors or more sophisticated video equipment to take the place of the observation window. We still recommend a window because it never fails and is less hassle. Plus, there are times when it important for the therapist to re-enter the therapy room quickly, so being right next door is a plus.
Sound system to allow sound between observation and therapy rooms
Microphone such as Audio Technica ES945W boundary mic
Amplifier such as Behringer Ultracoustic AT108
Cables such as 30' mic cable or 6' mic cable
Some agencies have used baby monitors, but the sound quality can be an issue if it’s hard to understand what the parent and child are saying due to static or distortion.
Best Buy for Business was able to set up a great sound system for one of my previous offices. They can be reached at 1-800-373-3050, Monday –Friday between 7:30 a.m. and 6:30 p.m. CST
Video Camera with tripod
Eyberg Child Behavior Inventory (ECBI; one per week per caregiver) $42/pk of 25 from PAR, Inc.
Training is one of the biggest expenses involved in PCIT implementation. There are about 16 Master Trainers certified by PCIT International, Inc. All trainers set their own fees and training dates. Please see www.pcit.org for a list of Master Trainers and the current PCIT Training requirements.
Trainees must be licensed to provide therapy services to children and families or under supervision for licensure, and have at least a master’s degree in a counseling-related field to meet current PCIT International training guidelines.
To become a fully trained PCIT therapist takes about 1 year. The steps are as follows:
Set-up a PCIT suite
Attend 5-day basic training
Start seeing cases (preferably at least 2-4 to begin with)
Consider Therapist Certification through PCIT International
Other Training Considerations
Costs for training extend beyond the initial workshop and consultation. Agencies should be aware that therapists will need time to learn the PCIT model and implement it with fidelity. In addition to the time set aside for workshops, therapists need to be able to attend weekly consultation (usually one hour) for at least one year, or until they complete two cases. Also, for new PCIT therapists, sessions will likely require more preparation time, and may take longer to complete as well. Allowing new therapists to budget 1.5 hours for PCIT cases at first can be helpful in giving therapists the time they need to be successful in implementing a new therapeutic model. It is also recommended to allow therapists to observe other therapists’ PCIT cases or see cases together as a co-therapy team whenever possible.
We highly recommend that agencies adopting PCIT invest in training two or more therapists to allow for peer support and protect against therapist attrition. Agencies should also consider carefully which therapists will be best suited to implementing PCIT. Therapists who have a behavioral or cognitive-behavioral orientation, enjoy working with young children and their parents, and are favorable to empirically-supported treatments are often good candidates. That being said, anyone with a desire to learn and openness to trying something that may be new to them can be very successful in implementing PCIT! Agencies that have a "champion"—that is, someone who is dedicated to implementing PCIT and able to overcome barriers within the agency—tend to be most successful in PCIT implementation.