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Child-Parent Psychotherapy: A relationship-based treatment for traumatized young children

Child-Parent Psychotherapy: A relationship-based treatment for traumatized young children. Alicia F. Lieberman, Ph.D. alicia.lieberman@ucsf.edu Chandra Ghosh Ippen, Ph.D. chandra.ghosh@ucsf.edu. A Developmental Approach to Treatment. Young children develop in relationships

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Child-Parent Psychotherapy: A relationship-based treatment for traumatized young children

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  1. Child-Parent Psychotherapy: A relationship-based treatment for traumatized young children Alicia F. Lieberman, Ph.D. alicia.lieberman@ucsf.edu Chandra Ghosh Ippen, Ph.D. chandra.ghosh@ucsf.edu

  2. A Developmental Approach to Treatment • Young children develop in relationships • Young children use relationships with caregivers to • Regulate physiological response • Form internal working models of relationships • Provide secure base for exploration and learning • Model accepted behaviors

  3. Impact of Trauma on Caregiver-Child Relationship • Either partner may develop new negative attributions based on trauma experience • Changes in the way they perceive each other • Traumatic expectations • Caregiver and child may serve as traumatic reminders for one another (Pynoos, 1997)

  4. Young Children Need to Be Seen in the Context of Their Relationships

  5. Child-Parent Psychotherapy Goals • Encouraging normal development: engagement with present activities and future goals • Maintaining regular levels of affective arousal • Establishing trust in bodily sensations • Achieving reciprocity in intimate relationships

  6. Child-Parent Psychotherapy Trauma-related goals • Increased capacity to respond realistically to threat • Differentiation between reliving and remembering • Normalization of the traumatic response • Placing the traumatic experience in perspective

  7. Multi-Theoretical Approach to Treatment • Developmentally Informed • Attachment • Trauma • Psychoanalytic • Social Learning • Cognitive–Behavioral • Culturally informed

  8. Child-parent PsychotherapyIntervention Modalities 1. Promote developmental progress through play, physical contact, and language 2. Unstructured/reflective developmental guidance 3. Modeling protective behaviors 4. Interpretation: linking past and present 5. Emotional support 6. Concrete assistance, case management, crisis intervention

  9. Randomized Trial • Treatment children show greater improvements than comparison group children • Traumatic stress symptomatology • Diagnosis of Traumatic Stress Disorder • Behavior problems • Treatment mothers show greater improvement • Avoidant symptomatology • Total PTSD symptomatology • General symptomatology (Lieberman, Van Horn, & Ghosh Ippen, 2005; Lieberman, Ghosh Ippen, & Van Horn, in press)

  10. Maternal Symptomatology: PTSD (CAPS) P<.001

  11. Maternal Symptomatology:PTSD (CAPS Total Score) P<.05 P<.001

  12. Child Behavior Problems:Total Problems (CBCL) p<.01

  13. Child Traumatic Stress Disorder p<.001

  14. Child Diagnosis:Traumatic Stress Disorder

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