test form PCIT

PCIT Application Form

  • Contact Information

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  • Description of Agency, Team, Implementation Plans, and Experience. For the following questions, estimates are fine.

  • Individual Child Therapy:Family Therapy with the child present:Family Therapy without the child present: 
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  • PCIT is a fast‐paced model requiring the therapist to respond to parent and child behaviors in the moment. Review the following two video segments:

  • Link to Video 1
  • Link to Video 2
  • After viewing the video segments, please answer the following questions:

  • 16. Does your agency have in place appropriate space and equipment for providing PCIT?

  • 17. Clinicians participating in the training are expected to begin providing PCIT approximately 3 months into the Initial Training period.

  • Expectations (Please initial each item to signify understanding and agreement.)

  • All Clinicians will: