Child-Parent Psychotherapy (CPP)

Placement on the Continuum of Evidence Effective-Quasi Download icon Download PDF
Target Population: 
Children, Parents
Sector: 
Community-Based
Topic: 
Behavioral Problems, Emotional Competency, Grief & Loss, PTSD, Relationships, Social Competency
Target Audience 

This program is for children 0 to 5 years old, who have been exposed to traumatic situations and are experiencing consequential trauma symptoms, and their primary caregiver.

Summary 

Child-Parent Psychotherapy (CPP), also known as Infant-Parent Psychotherapy or Toddler-Parent Psychotherapy depending on the developmental stage of the child, is a community-based program that is designed to help bolster and maintain or heal the child and caregiver relationship.  This program seeks to enhance the child’s sense of safety, promote healthy attachment to the caregiver, and increase social-emotional functioning for the child.

Evidence 

Multiple internal and external evaluations of CPP utilizing a quasi-experimental design have been performed.  Results consistently show positive program effects on attachment-related behaviors, especially attachment classification.  These results have been shown to last up to 1 year after program completion.  Additionally, one study found evidence suggesting that CPP helps to reduce behavior problems and traumatic symptoms in children exposed to marital violence.  Mothers also showed improvement in mental health symptoms, and these positive effects were found to last up to 6 months after program completion.

Components 

The CPP program seeks to support participants who exhibit signs of severe distress from maltreatment, family violence, physical or sexual abuse, serious accident, or sudden loss of someone close.  The formats of the CPP sessions are influenced by the following:

  • Type of trauma experienced by the child and
  • Age and developmental needs of the child.

If the child is an infant, the program is directed toward the caregiver.  The caregiver receives instruction on how he or she can help the infant heal.

When the child has acquired some language ability and has developed reciprocal play, the treatment actively involves the child through play between the child and parent to encourage bonding and communication.

In addition, therapists assist with caregivers who may struggle with past traumatic experiences and exhibit consequential symptoms and provide direction in the following areas:

  • Develop healthy communication skills and positive coping behaviors;
  • Facilitate safety in the home and the relationship;
  • Help the child recognize and cope with his or her feelings; and
  • Foster stability in daily living via household routines, pro-social behavior, and participation in useful activities.
Previous Use 

Since the Child Trauma Research Program began distributing the CPP program in 2002, CPP has been implemented in about 143 sites throughout the United States.

Training 

Training is required and facilitators must be therapists with at least a master's degree in a mental health related field.  Therapists must complete one of three training options.  Option 1 is a 1-year internship at an approved National Child Traumatic Stress Network (NCTSN) site.  This option involves didactic instruction, clinical experience, and weekly supervision; it is free.  Option 2 is a 1 1/2-year training that involves the Learning Collaborative Model of the NCTSN.  This option entails an initial 3-day training workshop followed by quarterly 2-day workshops and bi-monthly phone consultations.  This option is free excluding travel expenses.  Option 3 is a 1 1/2-year training for multiple agencies or a single agency.  This option includes the same training components as option 2 and costs $1,500 to $3,000 a day for up to 30 participants plus travel expenses.

For more information about these training options, please contact Chandra Ghosh Ippen by email using the email addresses in the Contact section.

Considerations 

Considerations for implementing CPP include securing facilitators with suitable backgrounds and ensuring they receive training, acquiring funds for training if option 3 is chosen, recruiting and retaining participants, and coordinating session times with caregivers as the sessions are often conducted in the home.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Implementation 

If you are interested in implementing CPP, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Time 

CPP is implemented weekly in 1- to 1 1/2-hour sessions for 1 year; however, the treatment may take longer depending on the complexity of the case.

Cost 

The standard treatment manual for CPP costs between $21.95 and $35.79 depending on the format (e.g., hardback, paperback, ebook).  An additional manual for family violence is also available for $24.95.  Technical assistance and support, beyond what was received in the training, costs between $150 and $350 per hour plus travel expenses.  Checklists for fidelity, training, and supervision are free.

Evaluation Plan 

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Contact 

Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu

You may also contact Chandra Ghosh Ippen, Ph.D., by phone 1-415-206-5312, email cpp.training@ucsf.edu, or Chandra.ghosh@ucsf.edu, or visit www.cebc4cw.org/program/child-parent-psychotherapy/detailed

References
References - Used For Placement 

Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2000). The efficacy of toddler-parent psychotherapy for fostering cognitive development in offspring of depressed mothers. Journal of Abnormal Child Psychology, 28, 135-148.

Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2006). Fostering secure attachment in infants in maltreating families through preventive interventions. Development and Psychotherapy, 18, 623-649.

Cicchetti, D., Toth, S. L., & Rogosch, F. A. (1999). The efficacy of toddler-parent psychotherapy to increase attachment security in off-spring of depressed mothers. Attachment & Human Development, 1, 34-66.

Lieberman, A. F., Ippen, C. G., & Van Horn, P. (2006). Child-Parent Psychotherapy: 6-month follow-up of a randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 913-918.

Lieberman, A. F., Van Horn, P., & Ippen, C. G. (2005). Toward evidence-based treatment: Child-Parent Psychotherapy with preschoolers exposed to marital violence. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 1241-1248.

Lieberman, A. F., Weston, D. R., & Pawl, J. H. (1991). Preventive intervention and outcome with anxiously attached dyads. Child Development, 62, 199-209.

Stronach, E. P., Toth, S. L., Rogosch, F., & Cicchetti, D. (2013). Preventive interventions and sustained attachment security in maltreated children. Development and Psychotherapy, 25, 919-930.

Toth, S. L., Maughan, A., Manly, J. T., Spagnola, M., & Cicchetti, D. (2002). The relative efficacy of two interventions in altering maltreated preschool children’s representational models: Implications for attachment theory. Development and Psychotherapy, 14, 877-908.

Toth, S. L., Rogosch, F. A., Manly, J. T., & Cicchetti, D. (2006). The efficacy of toddler-parent psychotherapy to reorganize attachment in the young offspring of mothers with major depressive disorder: A randomized preventive trial. Journal of Consulting and Clinical Psychology, 74, 1006-1016.

References - Not Used For Placement - Other 

Weiner, D. A., Schneider, A., & Lyons, J. S. (2009). Evidence-based treatments for trauma among culturally diverse foster care youth: Treatment retention and outcomes. Children and Youth Services Review, 31, 1199-1205.

*Resources and associated costs reflect those identified at the time of fact sheet publication.