Rationale and Considerations for the Internet-Based Delivery of Parent–Child Interaction Therapy

• Internet-based delivery of PCIT (I-PCIT) may offer a transformative medium for overcoming traditional barriers to care.
• I-PCIT therapists provide remote, real-time coaching to parents during home-based parent–child interactions.
• PCIT may be particularly amenable to a web format given that by design the PCIT therapist is situated in another room.
• I-PCIT can offer a comparable quantity of therapist contact to that in standard PCIT.
• There is currently a randomized clinical trial evaluating the merits of I-PCIT relative to standard PCIT.

Given the enormous individual, familial, and societal costs associated with early disruptive behavior disorders, transformative efforts are needed to develop innovative options for overcoming traditional barriers to effective care and for broadening the availability of supported interventions. This paper presents the rationale and key considerations for a promising innovation in the treatment of early-onset disruptive behavior disorders—that is, the development of an Internet-based format for the delivery of Parent–Child Interaction Therapy (PCIT) directly to families in their own homes. Specifically, we consider traditional barriers to effective care, and discuss how technological innovations can overcome problems of treatment availability, accessibility, and acceptability. We then detail our current Internet-delivered PCIT treatment program (I-PCIT), which is currently being evaluated across multiple randomized clinical trials relative to waitlist comparison, and to traditional in-office PCIT. Embedded video clips of children treated with I-PCIT are used to illustrate novel aspects of the treatment.