Child-Parent Psychotherapy (CPP)

What is CPP?

Child Parent Psychotherapy (CPP) is an evidence-based modality for children 0-6 who have experienced a traumatic event and are experiencing attachment or behavioral problems. This is a great modality to help young children and their caregivers, as counseling sessions include both the child and the primary caregiver.  The goal of CPP is to support and strengthen the relationship between a child and their caregiver by helping the child make sense of what the family went through and cope with intense emotions. CPP perspective is that the caregiver/child relationship is the vehicle towards healing.  CPP is supported by the National Child Traumatic Stress Network, SAMHSA’s national Registery of Evidenced Based Programs and Practices, California Evidence-based Clearinghouse.  CPP draws from many different theories and modalities including psychodramatic, attachment, trauma, developmental, social learning and cognitive-behavioral theories. 

Helpful information:

  • Treatment looks like weekly sessions for 6-12 months.
  • Respects cultural values, helps families heal after stressful experiences, and supports family strengths. 
  • Provides concrete assistance in supporting caregivers and their children with daily living challenges. 
  • Key components include focusing on safety, affect regulation improving the child/caregiver relationship, normalization of trauma-related response, and a goal of returning the child to a normal developmental trajectory. 
  • CPP is not..
    • The therapist providing feedback from a different room through an earpiece. 
    • Providing a lot of interventions focused around the traumatic experience that might overwhelm the client or caregiver 
    • Curriculum driven 
    • Desensitization techniques that expose someone to their triggers
Our therapists want our families to know that it’s OK to trust others in the therapeutic process, that it’s hard, but we value their honesty in talking about the bad things that have happened and the tough feelings they have.  Families report an improvement in children’s stress response, behavioral challenges, mood, and decrease in trauma symptoms. Caregivers report improvement in their stress levels, their own trauma symptoms, and overall mood. CPP therapists help families construct a joint trauma narrative which allows the child and caregiver to make sense of the trauma events, but also the emotional responses by linking past experiences to present behaviors. 

Our process:

  • Schedule a caregiver intake 
  • 2-3 parent/caregiver sessions (child not present) so that we can gather information about your child & their developmental history, what traumas were experienced & understanding of caregiver’s history.
  • Sessions with child & caregiver together. 
    • Important the focus is on caregiver and child w/out other family members present.  
    • “Playtime” with child 
  • Caregiver follow up sessions 
    • The therapist will provide feedback, observations or concerns 
    • The therapist will help parents learn skills such as reflective listening, descriptive praise, and limit setting.
    • Discussion of the caregiver is a thermostat, not a thermometer, giving choices, and positive feedback.

 

Getting to know our family, gathering background & history This stage can seem somewhat daunting. Families may be asked to fill out multiple questionnaires. This is where we ask a lot of questions, and where we are gathering a lot of information and history about your child, you as the caregiver, and the family. For example topics include: 

  • History & experiences
  • Strengths 
  • Values
  • Needs 
  • Behaviors or challenges 

In this stage, we are also developing a plan for how CPP will help your family and if needed connecting your family to additional resources in our community. 

Meeting with the child & caregiver During this stage, our therapists historically meet with families once a week, which include child & caregiver.  The therapist and caregiver will help the children understand who we are and what our role is. We might answer questions as to why we are meeting and what we will do together.    This is playful, if virtually, we’ll have families put together play kits with specific toys, if in the office, we will use one of our child-friendly offices.  Toys are used because children often use toys to show thoughts & feelings through their play. 

During the special playtime, therapists will help parents and children understand each other, respond to their difficult feelings & behaviors as well as create a family story that can lead to healing. During parent sessions, therapists can help caregivers understand how the child’s experiences have affected their development and relationships, various ways to keep the family safe and ways to strengthen the caregiver relationship. 

Wrapping up and planning for the future Celebration of changes a family has made, talk about what needs might pop up in the future and how to address those. 

Helpful resources:

Research:

Therapists currently going through the 18-month Learning Collaborative

  • Miranda P.
  • Amanda K.
  • Amanda H.
  • Bo M.
  • Jennie W.