This study examines how parent-child interaction therapy (PCIT) was adapted for Puerto Rican parents of children aged 4-6 with hyperactivity and other significant behavior problems. Four steps were followed: (1) translation and preliminary adaptation of the treatment manual, (2) application of the treatment to 9 families as part of an exploratory study using repeated measures, (3) treatment revision and refinement, and (4) in-depth interviews with parents (n=15) and clinical psychologists (n=5) from Puerto Rico who provided feedback on treatment process and components. Throughout this process, cultural elements and modifications were recommended to be incorporated into the treatment protocol. Both quantitative and qualitative results suggest that PCIT seems to be an acceptable intervention for this population, with some minor changes. Parents reported a high level of satisfaction, a significant reduction in children's externalizing behavior problems, and reduction of parenting stress and improvement in their parenting practices. Psychologists also evaluated positively the treatment protocol and recommended its use. Results from this study may inform clinicians and researchers who work with Latino families about relevant issues to be considered to promote their participation in behavioral family interventions and to enhance their acceptability and effectiveness.