How to Manage Difficult Behaviors with Children in the Time of Covid by Kristen Estrella, LCSW

Updated: Jul 10



It is often said that it “takes a village to raise a child” and that’s because child rearing is incredibly hard work! It is even harder when your village has become smaller or even inaccessible because of a global pandemic. Parenting can be lonely work on a “normal” day, let alone a period of forced isolation. How does a parent deal with tantrums, refusal to follow directions, talking back, hitting, calls from school, and public meltdowns with little respite?


Thankfully, Parent-Child Interaction Therapy (PCIT) addresses these parenting challenges both during a pandemic and afterwards. Here are five facts that every parent should know about Parent-Child Interaction Therapy in the time of Covid:

1. It is an Evidence-Based Practice

PCIT has been heavily tested and is well supported by evidence-based research as a therapy for children ages 2-7 who have behavioral difficulties. PCIT promotes interactions that are characterized by warmth, clear communication and healthy limits that set children and families up for success both during therapy and beyond. PCIT has been proven to strengthen the parent-child relationship and decrease non-compliance, defiance, and oppositionality.

2. PCIT is Unique in its Methodology, Making it Compatible with Telehealth

PCIT uses coaching to empower parents to learn and practice skills in real time with their child. PCIT therapists typically provide coaching using a “bug-in-the-ear” approach in which they observe interactions through a one-way mirror and teach skills and strategies using a wireless earpiece. In telehealth, the screen on your device becomes the one-way mirror. When a one-way mirror or telehealth is not available, PCIT therapists use an “in-room” approach where they sit behind the parent to observe and coach to ensure that the parent is the agent of change rather than the therapist.

3. Treatment typically takes 14-20 sessions

PCIT consists of two phases of treatment, averaging 14-20 sessions total. While there is no time limit to treatment, therapy progresses rapidly because coaching allows parents to receive immediate feedback. As a result, parents are able to implement strategies effectively and gain mastery. Once families meet mastery, 1-2 sessions focus on generalizing PCIT skills to other settings in which problematic behaviors may occur. Once goals are met, families celebrate their success and graduate from treatment!

4. PCIT Strengthens Relationships

The first phase of treatment is called Child-Directed Interaction (CDI) and aims to enhance the parent-child relationship. During this phase, the parent learns play therapy skills that allow them to follow their child’s lead in session while also learning how to reinforce positive behaviors, cope with difficult feelings, increase their child’s self-esteem, and create a sense of security.

5. PCIT Increases Effective Parenting Skills

The second phase of treatment is called Parent-Directed Interaction (PDI) and focuses on managing difficult behaviors confidently and calmly. During this phase, the parent learns how to effectively communicate and set their child up for success when it comes to listening and following instructions. The parent also learns how to provide consistent, developmentally appropriate rules, expectations, and consequences.

While you may not have a village to help raise your child, or are limited in access, Parent-Child Interaction Therapy may be the village you seek. PCIT was created by a community of people who strive to build strong, secure relationships for both children and parents. These skills will help parents during these challenging times and beyond.


Lukin Center Psychotherapy Offers Tele-Therapy

To help support our community, we are offering a 15% discount for new patients that are interested in getting started with tele-health to help manage feelings of anxiety and isolation during this time.



Kristen Estrella, LCSW, a Psychotherapist at Lukin Center Psychotherapy, earned her B.A. in Psychology from American University and her Master of Social Work from Boston University. During Kristen's studies, she practiced Cognitive Behavioral Therapy (CBT) under the guidance of Daniel Beck, faculty member at the Beck Institute for CBT. Following graduate school, Kristen pursued her interest in working with children ages 0-7. Kristen's clinical expertise earned her national certifications in Child-Parent Psychotherapy and Parent-Child Interaction Therapy, two premier evidence-based practices that address difficulties between children and parents. She is also nationally certified in Trauma-Focused Cognitive Behavioral Therapy. Kristen's specialization in infant and early childhood mental health led her to become the Child-Parent Psychotherapy supervisor across three children's programs in outpatient mental health.



Konstantin Lukin, Ph.D., is a licensed clinical psychologist in Ridgewood, Hoboken, NYC, Jersey City and Englewood. He has extensive clinical and research experience spanning individuals of all ages, in both inpatient and outpatient settings. He specializes in men’s issues, couple’s counseling, and relationship problems. His therapeutic approach focuses on providing support and practical feedback to help patients effectively address personal challenges. He integrates complementary modalities and techniques to offer a personalized approach tailored to each patient. He has been trained in cognitive-behavioral, dialectical behavior, schema-focused, and emotionally focused therapy, and has also been involved with research projects throughout his career, including two National Institute of Mental Health-funded studies. He is a member of the Association for Behavioral and Cognitive Therapies, New Jersey Psychological Association, Northeast Counties Association of Psychologists, New York State Psychological Association, The International Centre for Excellence in Emotionally Focused Therapy, The New York Center for Emotionally Focused Therapy, the International OCD Foundation, the Association for Contextual Behavioral Science (ACSB) and a regular contributor to Psychology Today.

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