How does parent‑child interaction therapy work? And who can use it?

Shawna Mastro Campbell, Bond University; Melanie J. Zimmer-Gembeck, Griffith University, and Tanya Hawes, Griffith University

Children thrive when parents are warm and responsive to their needs, while also providing clear guidance and setting limits. This is known as authoritative parenting.

But most parents will tell you authoritative parenting is easier said than done, especially when children have frequent intense emotions, big behaviours, meltdowns and outright defiance.

These challenges can lead parents to wish they had a parenting coach helping them know what to do and say.

Parent-child interaction therapy aims to do just that. It has been used in parts of Australia for around 20 years and is now available in some western Sydney schools.

So how does it actually work?

It focuses on the relationship

Parent-child interaction therapy is based on attachment theory, which posits that quality relationships in childhood predict wellbeing.

The parent and child play together in one room while the therapist observes in an adjacent room through a one-way mirror.

Using an ear-piece and microphone (or other communication device), the therapist acts as a coach to guide a parent’s responses to their child during play.

Coaching guides parents as they use positive attention skills to respond to their children’s behaviours and emotions as they occur. Within such a supportive environment, this reduces the child’s problematic behaviour and increases appropriate behaviours.

This guided, real-life practice gives parents the ability to use the techniques on their own, wherever they are, and enriches the parent-child connection.

Here’s what it can look like in practice.

How do kids experience it?

Parent-child interaction therapy was was first used in the 1970s to treat problem behaviours of children aged three to seven years. It’s now used from 15 months of age.

Although the child can’t see the therapist through the mirror window, they are aware their parent can hear the therapist through the earpiece.

From the child’s perspective, the play environment is often enjoyable and they get to spend high quality one-on-one time with their parent, enhancing the relationship.

Parents learn the importance of their attention

Throughout the therapy, the parent directly experiences the importance of their own attention.

When children get their parent’s attention for disruptive or other challenging behaviour, such as yelling, this can escalate children’s disruptive behaviour over time because parental attention makes any behaviour more likely to occur.

Children will even seek this attention if it comes in the form of a parent yelling, correcting, or negotiating, especially if they get little connection or attention when behaving appropriately.

In parent-child interaction therapy, parents use attention to reinforce their child’s positive behaviour. They practise giving positive attention for appropriate behaviour, such as praising and showing enthusiasm for children’s patience, kindness, good listening, or sharing.

The therapy also encourages parents to limit attention to unwanted behaviour when it’s safe to do so. A parent may be coached to avoid acknowledging when a child uses inappropriate language or “toilet talk”, for example.

Practising these attention strategies can increase children’s positive behaviours and interrupt the cycle of worsening behaviour and negativity.

Parents practise authoritative parenting

During parent-child interaction therapy, parents practise real-time strategies for authoritative parenting that:

• demonstrate warmth and responsiveness to their child’s needs
• fairly and clearly state expectations for behaviour
• are consistent in developmentally appropriate consequences, especially for aggressive behaviour.
  

Coaching focuses on responding kindly, while still setting clear boundaries and expectations for behaviour.

For example, by saying:

Thank you for following the rule of being gentle today. I really like when you do that at home with your brother, too.

Who is – and isn’t – it suitable for?

Research from Australia and abroad shows this type of therapy can be effective for behavioural and related emotion regulation problems.

It has also been shown to be effective among culturally diverse families and those who have faced adversity or have complex health and mental health challenges.

Research shows additional benefits for parents. These include reduced stress, improved parenting skills and confidence and improvements in the ability to manage difficult emotions such as anger.

Parent-child interaction therapy is most often used for children with conduct disorder, oppositional defiance disorder, and trauma-related conditions, as well as conditions where behaviour concerns can be a symptom, such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder.

However, it can be used for children without any mental health diagnosis

It’s not recommended when there are safety issues or unstable relationships in the family or home environment. In these instances, other interventions should be prioritised over treating children’s behaviour concerns.

The downsides

Parent-child interaction therapy is time consuming and resource intensive. Therapy typically lasts 14 to 16 weeks, with most sessions involving both parents and children. Research shows repeated practice can lead to more sustained improvements in children’s behaviour. So it can involve a big commitment from parents.

Parent-child interaction therapy is delivered by qualified mental health service providers such as registered psychologists and social workers. They require extensive training, ongoing professional development and program training from an approved provider, as well has months of supervised practice. They also require specialised rooms and equipment. This can limit access.

Currently in Australia, the program is offered at a few universities and in some school settings, with costs often offset by public funding. There are few private providers.

Behaviour problems are the most common reason parents seek support for children. Supporting them with evidence-based programs or therapies – whether that’s parent-child interaction therapy or others – can deliver wide-reaching benefits across their lifespan.

Shawna Mastro Campbell, Associate Professor in Clinical Psychology, Bond University; Melanie J. Zimmer-Gembeck, Professor of Psychology, Griffith University, and Tanya Hawes, Program Co-ordinator/ Psychologist, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read More........→July 01, 2026

Spending on child protection has almost doubled in a decade, so why isn’t it improving?

Bethany Beck/Unsplash

Claudia Bull, Deakin University and Daryl Higgins, Australian Catholic University

The central aim of any child protection system is in the name: protect children. But over the years, inquiries and media reports have shown fulfilling this goal has too often proved tragically elusive.

In response, governments across the country have poured more and more money into their child protection systems in the hope of getting better outcomes.

Our newly-published research shows total national spending has almost doubled over the decade, climbing from $5.4 billion in 2014–15 to $10.2 billion in 2023–24 (adjusted for inflation).

But we found this hasn’t been matched by changes in activity across systems, like increases in the rate of investigations for alleged maltreatment, or the number of children entering out-of-home care. Nor has it improved outcomes for children.

So if money alone isn’t the answer, what is? Here’s what the evidence shows would help.

A maze of moving parts

Protecting Australia’s children is not the job of a single system. It involves many overlapping systems – health, childcare, education, justice and policing, disability services, and other parts of the social welfare system – working together to prevent and respond to child abuse, neglect and exploitation.

In Australia, there is no national child protection system to bring these parts together. Each state and territory runs its own. They share the same guiding principles, such as acting in the best interests of the child. But how they operate in practice differs across the country.

The result is several systems made up of many moving parts that do not always work as a coordinated whole. And too often, prevention is left to the side, in favour of reacting to harm once it has already happened.

Recent inquiries in Queensland and Victoria show this fragmentation is not just inefficient, but may be causing more harm than good.

The concerns raised in the recent Queensland and Victorian inquiries about how we protect children are not new. They have been raised many times in recent history.

Queensland alone has had four inquiries in the past 30 years (1999, 2004, 2012–13 and 2025–26), while Victoria has had three (2012, 2024, and 2026).

But as the presiding commissioner for the 2025–26 Queensland inquiry, Paul Anastassiou put it:

[…] the child protection system continues to fail children and the community in serious respects.

So, what are the problems?

1. Child protection systems don’t work as a whole

Statutory child protection services hold decision-making authority over when and how to intervene in a child’s life, and ultimately, whether a child needs to be removed from their parent(s) to keep them safe.

But it doesn’t control the conditions that create harm in the first place. Those sit across other systems.

For example, poverty and housing instability are linked to harm, yet responsibility for addressing these conditions lies within housing and income support systems, not child protection.

Similarly, other causes of harm such as family violence, mental illness, and substance use are addressed through justice, health, and alcohol and other drug systems.

This means responsibility for child safety is distributed across many systems. Accountability, however, is not.

Each system remains accountable for its own functions, rather than for whether children are kept safe, stable and supported. No single system is accountable for whether the child’s best interests are upheld across their life course.

This has real consequences for statutory child protection decision-making. Information about children and families sits across multiple systems, and those systems do not always communicate. So, child safety decisions are often made with incomplete, fragmented or selectively available information.

At the same time, decisions are made under pressure and often rely on adult’s views without meaningful consultation of children and young people about their own safety, or what would help.

Together, this creates child protection systems where high-stakes decisions are made on shaky foundations.

2. Child protection systems act too late and can cause harm

Systems remain overwhelmingly reactive, responding only after harm has happened, rather than preventing it in the first place.

In more than 50% of cases, children and families in contact with systems have already been subject to a child protection investigation.

The Victorian inquiry revealed that once in contact with statutory child protection, children aged 15–17 years old can expect to be re-reported almost seven times.

While this is not a new problem, it is one that must be solved.

Worse still, child protection systems themselves can cause harm. Children might experience multiple placements, uprooting relational and environmental stability, as well as significant delays in receiving health and medical care.

The most recent Queensland inquiry also highlighted children placed in residential care in particular experience higher rates of trauma, unmet mental health needs, self-harm and suicide attempts.

The commission rightly recognised the state’s heavy reliance on residential care as one of its biggest failures.

3. Over-prioritising crisis responses

Both the Queensland and Victorian inquiries found most resources are spent on responding to crises rather than on early intervention.

Our research found while overall spending was increasing, out-of-home care saw most of the funding boost. Between 2014–15 and 2023–24, the proportion of all spending that was on activities associated with out-of-home care increased from 58.4% to 63.6%.

Meanwhile, investment in intensive family support reduced from 8.2% to 6.2% of the overall spend.

What needs to be done?

Together, findings from recent inquiries and our own research show child protection systems across Australia are not consistently delivering on their core aim: acting in the best interests of the child.

While state-level statutory child protection reform is welcome, addressing this will require federal leadership.

Australia needs a national child maltreatment prevention agenda with sustained investment in prevention and early support. It could be overseen by the Department of Social Services, whose role is to improve the economic and social wellbeing of individuals, families and vulnerable members of Australian communities.

Alternatively, because child maltreatment is a significant public health issue, it could also be assigned to the Australian Centre for Disease Control: a national agency established to strengthen Australia’s prevention, preparedness and response to public health threats.

There also needs to be shared accountability across all systems that should be involved in supporting children’s safety.

Finally, genuine partnership with First Nations organisations is needed to help Indigenous children, who are over-represented in child protection systems.

Until these systems are designed to work together, they will continue to fail to deliver what children need most: safety, stability and support.

Claudia Bull, Postdoctoral research fellow, Deakin University and Daryl Higgins, Professor & Director, Institute of Child Protection Studies, Australian Catholic University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read More........→June 24, 2026