PCIT Therapy Techniques: Strategies for Reducing Oppositional and Defiant Behaviors

Parenting can be challenging, but it is also one of the most fulfilling roles we undertake. Have you ever asked yourself, “Is there a better way I could discipline my child?” or “Am I doing the right thing?” Does your child struggle with temper tantrums, aggression, defiance, difficulty sharing, anxiety, picky eating, sleep issues, impulsivity, or sibling rivalry?

Some of the most frustrating and challenging behaviors that parents face are oppositional and defiant behaviors, but PCIT therapy techniques can help.

Oppositional and defiant behaviors in children typically refer to a range of actions characterized by negativity, hostility, and defiance, often directed toward authority figures such as parents, teachers, and other adults. These behaviors go beyond typical childhood misbehavior, sometimes forming a persistent pattern. When these behaviors are severe and persistent, they may be diagnosed as Oppositional Defiant Disorder (ODD).

Fortunately, there are positive approaches to help reduce the time and energy you spend managing these types of problematic behaviors. Parent-Child Interaction Therapy (PCIT) has been developed through years of comprehensive research and practical application. PCIT therapy techniques offer accessible and straightforward tools for parents, teachers, and medical providers to manage problematic child behaviors better.

What is PCIT?

Parent-child Interaction Therapy (PCIT) is an evidence-based, gold-standard therapy intervention that treats children with significant behavioral concerns. PCIT consists of two phases: Child-Directed interaction (CDI) and Parent-Directed Interaction (PDI). The CDI phase is not just about learning skills. It’s about empowering parents with positive parenting skills to build trust, secure attachment, and warmth with their children. The PDI phase then equips parents with effective discipline skills to reduce their child’s problematic behaviors.

With PCIT, you are not just a parent. You are a capable and empowered guide for your child. To learn more about PCIT and positive parenting, check out our article on strengthening family relationships through PCIT and positive parenting.

What is Oppositional Defiant Disorder (ODD)?

The Diagnostic Statistical Manual (DSM-5) defines ODD as “A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months” and evidenced by the presentation of at least four of the following symptoms:

1. Often loses temper

2. Is often touchy or easily annoyed

3. Is often angry and resentful

4. Often argues with authority figures or, for children and adolescents, with adults

5. Often actively defies or refuses to comply with requests from authority figures or with rules

6. Often deliberately annoys others

7. Often blames others for their mistakes or misbehavior

8. Has been spiteful or vindictive at least twice within the past six months.

Although ODD is rarely discussed, it is not a rare condition. Recent studies estimate that the global prevalence rate of ODD is about 3.3% (Seppä et al., 2023), highlighting the extensive nature of this behavioral concern.

Children with ODD also often have dual diagnoses of Attention-Deficit Hyperactivity Disorder (ADHD), which may lead to more behavioral problems, such as acting without thinking.

PCIT Therapy Techniques for Managing Opposition and Defiance

Therapeutic interventions such as PCIT can be effective in managing ODD. PCIT can also be highly effective in managing oppositional and defiant behaviors, even if those behaviors do not meet the diagnostic criteria for ODD.

PCIT can be considered for any child exhibiting oppositional and defiant behaviors, particularly if:

• The behaviors are causing significant stress within the family.
• The child is having difficulty in school or social settings due to these behaviors.
• Previous attempts at managing the behaviors have been unsuccessful.
• The parents seek structured support and guidance in improving their child’s behavior.

Effective Discipline Means Giving Effective Commands

A common misconception that adults and parents may hold is that children with ODD do not want to listen. However, children often feel very proud when they listen immediately and receive praise for their compliance. Often, a child with lower self-esteem has difficulty listening because he believes he cannot or does not have the ability.

By implementing these 8 Rules of Effective Commands, children may be more likely to comply, and this can positively impact their self-esteem:

Rule #1: Give direct commands instead of indirect

For example, it is more effective to tell your child, “Please pick up your socks,” instead of “Pick up your socks, okay?” or “Let’s pick up your socks.”

Direct commands make it absolutely clear to your child that she is being directed and not asked to do something. It is also clear to her that she is expected to complete the task, not both of you.

Rule #2: State your commands positively instead of negatively

When you tell your child not to do something, that is a criticism of her behavior, which can reduce her self-esteem. It is often possible to correct a negative behavior by telling your child to do a positive opposite.

For example, you might say, “Please keep your gum in your mouth” instead of “Don’t play with your gum.”

Rule #3: Give a command for one thing at a time

Too many commands at one time will overwhelm your child, and she will be less likely to complete every part of your command.

Inclusive commands, such as “Clean up your room,” are not as effective because your child may not know what to clean up first. Furthermore, multipart commands, such as “Pick your socks up, put them in the hamper, and bring the hamper to the laundry room,” can make it difficult for your child to remember all the tasks.

Instead, give a command for each individual task, wait until your child complies, and then follow up with another individual task.

Rule #4: Make your command as specific as possible

Your child is less likely to comply with a vague command, such as “settle down” or “watch out,” because those commands do not let her know precisely what you expect.

To make that command more specific, you might say, “Please use your quiet voice.”

Rule #5: Make your commands developmentally appropriate

Your child should be able to understand your command and do it easily for it to be an effective command.

You wouldn’t tell your 4-year-old to bring in all the groceries, right? But you may tell her, “Please open the fridge for the groceries.”

Rule #6: Give your command in a neutral tone of voice

When you give commands tentatively, you may unexpectedly tell your child that compliance is optional. On the other hand, if you raise your voice with a command, you are inadvertently telling your child to ignore your polite commands and wait for your angry tone.

Calmly stated commands will prepare your child to listen to other adults and will model appropriate talk.

Rule #7: Give a reason for your command before you give it or after your child complies

Giving a reason before you give a command may increase compliance because your child will know why you want them to do something. For example, “We need to go to the store. Please put on your shoes” is more effective than suddenly saying, “Put your shoes on.”

Furthermore, giving your reason after your child complies can be a great learning moment. For example, “Thank you for putting on your rain boots. Now the puddles won’t make our feet wet.”

However, it’s important to remember that providing a reason for your command after you have already stated it will likely only lead to more dawdling and negotiation from your child. For example, if you were to say, “Please put on your rain boots,” and your child says, “Why?” to which you reply, “Because it’s raining outside;” your child with ODD may challenge that and say, “No it’s not!” or “It’s going to stop raining soon.”

This pattern then leads to a coercive cycle of power struggles.

Rule #8: Only give commands when absolutely necessary

You can often give your child an option to increase buy-in and general compliance rather than a command. For example, you might say, “Do you want to brush your teeth or put on your pajamas first?”

Giving too many commands a day can frustrate your child, making it difficult for you to follow through.

Note: While these rules for giving effective commands can lead to more compliance, parents must partake in the first part of PCIT treatment (the CDI phase of positive parenting) to make this compliance phase more effective. A child with ODD needs to build their self-esteem and attachment with their parents to feel confident in complying with commands.

Closing Thoughts

PCIT is a highly effective intervention for managing oppositional and defiant behaviors, regardless of whether those behaviors rise to the level of ODD. It provides parents with the tools and skills needed to foster a positive relationship with their child and to manage challenging behaviors in a structured and supportive manner.

Jessi Gholami, LMSW-C, LCSW-C

Senior Contributor
Jessi Gholami is a dedicated clinical social worker (LMSW-C and LCSW-C) and licensed PCIT therapist with extensive experience working with children, families, adolescents, and adults. Jessi specializes in treating anxiety, depression, ADHD, Autism, and behavioral disorders. 

Sharing is caring!