ECMH Teacher-Child Interaction Therapy Model

You can’t correct a child

if you don’t connect first.

Children like to be understood. But it’s sometimes not easy to understand a child. Especially one that is throwing a tantrum or being aggressive. What is there to understand when they won’t stop? You don’t even know where to start or how to deal with this situation that keeps occurring. You are already out of ideas and it’s not like you haven’t tried before. You are starting to dread coming to teach because of these recurring situations… Meanwhile, you have 12 other kids waiting for your direction on the next activity.

This is where the Teacher-Child Interaction Training (TCIT)* comes in. This is a program that works one on one with early childhood teachers (who work with kids between the ages of 2.5 and 7 years) on how to better connect with these children who are having difficulty with aggressive behavior in the classroom setting. The issue is more common than you would think.

Ten to twenty-two percent of kids are struggling with these types of behavior (behavioral challenges and psychological disorders) and many teachers were not feeling confident that they had the necessary skills to work with the issues at hand. Also, research tells us that adverse outcomes of emotional and behavior problems in early childhood, which are not treated appropriately lead to expulsion, decreased likelihood of receiving positive feedback and instruction from teachers, more likely to be held back early in their educational career and drop out once into adolescence, less likely to succeed in academic tasks and more likely to engage in delinquent behavior, and in general, are at risk for poor social, emotional, and cognitive outcomes.

This is why the Office of Child Development’s Early Childhood Mental Health Consultation (ECMHC) team has partnered with The Mathilda Theiss Child Development Center of WPIC to implement the TCIT model. Teachers interact with the children in their class for many hours of the day each day. It is a golden opportunity to try to improve these children’s outcomes within that setting, as it will reap them many positive benefits later in life. TCIT is about building relationships with those children; the ones that teachers can – despite their best intentions – find the most difficult and frustrating. The program offers teachers the perspective that they are being "Paid to play"! This makes a huge difference, and already the ECMHC team has seen positive cases and are excited to grow their reach.

The program is really hands-on. This means that teachers receive professional development from an ECMH consultant and then receive intensive follow-up coaching from the consultant. Just like with anything in life, one can be told how to do something, but they can also be shown. Any person can be told how to play basketball, but if it remains conceptual it will be really difficult to actually play. If a person is instead taken on the court to play, then it is memorable and makes it easier to apply because they know what it’s like. That’s why the TCIT model is an intense direct coaching style within the classroom. Doing so ensures that the theory is brought to practice and brings it to reality with real life children and practical situations.

The program is structured in two phases. The first asks teachers to just focus on how they interact with the child. They work with a child for 5 minutes every day as homework. The Early Childhood Mental Health consultant is there to provide live feedback and coaching. The first TCIT skill set that is measured is the use of the "PRIDE" skills. PRIDE stands for these interaction items below:

  • Praise
  • Reflect
  • Imitate
  • Describe
  • Enjoy

Once the teacher has mastered this phase, which is the Child Directed Interaction model (CDI), the teachers then move toward second phase, the Teacher Directed Interaction model (TDI). Here, teachers learn how to give clearer and more positive and consistent instruction, according to best practice. In this phase, the teachers give more direction and implement the “Sit and Watch” strategies among others. “Sit and Watch” strategies differ from the standard “time out” by engaging the child in learning as they watch other kids behave well, therefore understanding that they are not playing with the other kids because they were behaving improperly. Teachers love the positive intent of the Sit and Watch technique and feel that it is a better fit for an early care and education setting than time out. The positive outlook and reinforcement impacts both the child and the teacher!

The core features of this program are that intense children are given positive praise which is something they are not used to hearing. Improved behavior is immediately noticeable. Just from this one simple step! After just a few weeks of TCIT implementation, teachers become like magnets to the children who love the new strategy and respond positively to the reinforcement. By the end of the program, the cases show that the children had a better temperament, and the teachers also felt more confident in handling the classroom, and felt that they were being more effective and less stressed at their job.

The TCIT model is a collaborative effort on multiple levels. It builds on a significant body of research, with its key focus is on developing, testing and adapting a model for use in an arena that has not been used in previously. It helps bring research to practice.

What are some of the positive outcomes of this model?

  • Increase teacher’s use of positive communication and attention skills.
  • Increase child compliance to teacher commands.
  • Increase in positive teacher-child relationship.
  • Decrease in disruptive, aggressive, and inappropriate behaviors!

For more information, contact Sharon Geibel at

*The TCIT model is based on its, also very successful, counterpart, Parent-Child Interaction Therapy (PCIT).