Child-parent psychotherapy

Domain V · Systemic, relational, group & community · Alicia Lieberman, Patricia Van Horn, Chandra Ghosh Ippen · 1998 · UCSF Child Trauma Research Program, USA

What it is

What it is: a dyadic, relationship-based treatment for children aged 0–5 (the training documents say "under 6") who have experienced trauma (family violence, maltreatment, traumatic separation or loss, and similar) or who have mental-health, attachment or behaviour problems. The child and the…

Format

• Format and dose. Sessions are weekly. Published figures for length and number vary:
• NCTSN fact sheet (developer-reviewed): sessions are weekly. Foundational Phase: 4–8 sessions. Core Phase: generally at least 20 sessions, then a review of whether more treatment would help. The Core Phase can be shorter for a single-incident trauma that has resolved, and longer with severity or…

Who practises it, and how they are trained or regulated

• Feedback work: Review the results with the caregiver. Agree how the child will be told why they are coming to therapy. Prepare the caregiver for what the child may do in sessions, such as trauma play or dysregulation. Discuss the need for regulation breaks and regular weekly attendance. Explore cultural beliefs about talking to children about trauma. The NM manual warns that skipping or rushing this step "could be…
• Rostering benchmark: Training documents treat 16 or more Core sessions as a substantive case. This is a training criterion, not a clinical rule.
• Arousal is regulated.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Collateral sessions replacing the dyadic work.
• The caregiver feeling coached or judged. Frame it as an experiment.
• Crisis work crowding out treatment week after week. Agree a balance with the caregiver and your supervisor.
• Minimising, and an unclear custody or visitation situation. Mandatory reporting obligations apply (Section 5).
• The session turning into individual therapy for the caregiver at the child's expense. If so, schedule collateral sessions (D5).

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.