When a child struggles with defiance, aggression or other behavior problems, the whole family feels it. Parents argue about discipline, siblings get less attention and every day can turn into a power struggle. Family therapy and parent training programs work on these patterns directly. Instead of treating the child alone, they teach parents specific skills and change how family members respond to each other. For young children with disruptive behavior, parent training is the treatment with the strongest evidence, and for teens with serious problems, family-based programs can keep them at home and in school. This guide compares the best-known programs and explains what parents practice at home.
Key points
- Behavior problems are often kept going by a “coercive cycle” of escalating demands and giving in, which parent training is designed to break.
- Parent-Child Interaction Therapy (PCIT) for ages 2 to 7 uses live coaching through an earpiece.
- Incredible Years, Triple P and Parent Management Training teach consistent praise, rewards and calm consequences.
- Functional Family Therapy and Multisystemic Therapy are intensive programs for teens with serious behavior problems.
- Family-Based Treatment (the Maudsley approach) puts parents in charge of their teen’s recovery from anorexia.
Why the family is part of treatment
Psychologist Gerald Patterson at the Oregon Social Learning Center described a pattern he called the coercive cycle. A parent gives an instruction, the child protests or throws a tantrum, the parent repeats it louder, the child escalates, and eventually the parent gives up. The child learns that escalating works. Next time, the parent may start harsher, and both sides get stuck. Nobody plans this; it happens in loving families under stress. Parent training breaks the cycle by making positive behavior pay off and by giving parents calm, predictable responses to misbehavior.
Parent-Child Interaction Therapy (PCIT)
PCIT was developed by psychologist Sheila Eyberg for children aged about 2 to 7 with disruptive behavior. Its unusual feature is live coaching: the parent plays with the child while the therapist watches from behind a one-way mirror or on video and coaches the parent through a small earpiece.
Phase 1: Child-Directed Interaction
The child leads play, and the parent practices the PRIDE skills:
- Praise specific behavior: “Great job putting the blocks away gently.”
- Reflect what the child says.
- Imitate the child’s play.
- Describe what the child is doing, like a sportscaster.
- Enjoy the time together.
Parents avoid commands, questions and criticism during this play time. They practice 5 minutes of “special time” at home every day.
Phase 2: Parent-Directed Interaction
Parents learn to give clear, direct commands, praise compliance and follow through with a consistent time-out sequence when the child does not comply. PCIT is mastery-based: families move on when they reach set skill levels, often after about 12 to 20 weekly sessions.
Other parent training programs
- Parent Management Training – Oregon Model (PMTO): based on Patterson’s research; teaches encouragement, limit setting, monitoring, problem solving and positive involvement.
- Incredible Years: developed by Carolyn Webster-Stratton at the University of Washington; group programs for parents (and versions for children and teachers) using video examples, typically over 12 to 20 weekly sessions.
- Triple P – Positive Parenting Program: developed by Matthew Sanders at the University of Queensland; offered at several levels, from brief seminars to intensive individual support.
The CDC recommends parent training in behavior management as the first treatment for children under 6 with ADHD, and these programs are also first-line for oppositional behavior. See children with ADHD and conduct disorder and ODD.
Family programs for teenagers
Functional Family Therapy (FFT)
FFT, developed by James Alexander, serves young people aged about 11 to 18 with behavior problems, delinquency or substance use. Sessions usually take place over 3 to 5 months, often 12 to 14 sessions, in the office or at home. The therapist first lowers blame and negativity in the family, then builds communication, problem solving and parenting skills, and finally connects the family with community resources.
Multisystemic Therapy (MST)
MST, developed by Scott Henggeler, is designed for teens aged about 12 to 17 with serious antisocial behavior who are at risk of out-of-home placement. Therapists carry small caseloads, work in the family’s home, school and neighborhood and are available around the clock. Treatment typically lasts 3 to 5 months and targets every system around the teen: family, peers, school and community.
Family-Based Treatment for eating disorders
Family-Based Treatment (FBT), also called the Maudsley approach, is a leading outpatient treatment for adolescents with anorexia nervosa. In the first phase, parents take charge of meals and weight restoration. Control is gradually handed back to the teen in the second phase, and the third phase addresses normal adolescent development.
Comparing the programs
| Program | Ages | Format | Typical length | Main focus |
|---|---|---|---|---|
| PCIT | 2–7 | Parent and child, live coaching | About 12–20 sessions | Disruptive behavior, parent-child bond |
| PMTO | About 3–16 | Parents, individual or group | Several months | Defiance, aggression |
| Incredible Years | Toddlers to about 12 | Parent groups with video | 12–20 weeks | Behavior problems, school readiness |
| Triple P | Birth to 16 | Seminars to individual sessions | Varies by level | Everyday parenting challenges to serious problems |
| FFT | 11–18 | Whole family, office or home | 3–5 months | Delinquency, substance use |
| MST | 12–17 | Home and community | 3–5 months | Serious antisocial behavior |
| FBT (Maudsley) | Teens | Whole family | Often 6–12 months | Anorexia nervosa |
What parents practice at home
- Daily special time: 5 to 10 minutes of child-led play without instructions or criticism.
- Specific praise: name exactly what the child did well, several times a day.
- Clear commands: one at a time, stated positively (“Please put your shoes by the door”), not as a question.
- Planned ignoring: do not react to minor attention-seeking behavior such as whining.
- Consistent consequences: calm time-out or loss of a privilege, applied the same way every time.
- Reward charts: stickers or points for target behaviors, traded for small privileges.
- Agreement between caregivers: parents, grandparents and babysitters use the same rules.
Many children with autism or ADHD also benefit from these methods, adapted to their needs. Learn more in children with autism and behavioral therapy for children.
Finding a program
Ask your pediatrician, school psychologist or local community mental health center which programs are available. Many states fund PCIT, Incredible Years, FFT or MST through Medicaid or the juvenile justice system. When contacting a provider, ask whether the therapist is certified in the specific model, because these programs work best when delivered as designed.
Frequently Asked Questions
Does family therapy mean the parents are to blame?
No. Behavior problems have many causes. Family therapy treats parents as the most important partners in change, not as the cause of the problem.
Will my child attend sessions?
It depends on the program. PCIT includes the child in every session; some parent training programs are for parents only; FFT and MST involve the whole family.
How quickly will behavior improve?
Many families notice changes within a few weeks, but behavior can get worse briefly when new limits are introduced. Consistency over months brings lasting results.
Can family therapy help with depression or anxiety too?
Yes. Approaches such as family-based interpersonal therapy and parent-focused anxiety programs involve families in treating emotional problems. See interpersonal therapy.
This article is general information and does not replace an evaluation by a licensed mental health professional.
