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The Guild et al. ([9]) study makes a significant addition to the literature documenting the long-term beneficial impact of Child-Parent Psychotherapy (CPP) on child and maternal outcomes in dyads at risk for or manifesting mental health problems. Together, these findings indicate that treatment effects for CPP are sustained years after the completion of treatment. In this study, the CPP intervention group showed significant decreases in maternal posttraumatic stress symptoms (specifically avoidance symptoms) and global psychiatric distress (Lieberman et al, [11]) that were sustained at 6-month follow-up (Lieberman et al., [12]). Lack of CPP-specific treatment effects might have been due to the outside treatment received by both groups, as well as to the relatively restricted range of depression scores. [Extracted from the article]

This article describes the impact on young children of sudden and extended separation from a primary attachment figure. It recommends clinical intervention when the child's development and family functioning are negatively affected by the severity of the child's symptoms, and it highlights key treatment modalities derived from Child--Parent Psychotherapy, including the importance of "speaking the unspeakable," defined as affirming reality by giving words to the separation and its sequelae and the importance of offering a safe space for the child's expression of sadness, anger, and fear in the supportive presence of the caregiver. Two clinical examples illustrate treatment while the separation is ongoing and after reunion takes place. [ABSTRACT FROM AUTHOR]

This paper outlines the theoretical antecedents that contextualize parental insightfulness and examines this concept’s value in assessing parental functioning and in monitoring treatment progress with parents and young children who experience mental health and relationship problems. As a concept, parental insightfulness provides a much-needed bridge linking important aspects of attachment theory with their psychoanalytic origins, including early contributions that conceptualize parenting as a developmental process that furthers the unfolding capacities of the adult self. The paper examines the compatibility between the dimensions of parental insightfulness and the criteria for a healthy adult sense of self. The empirical body of knowledge generated by the concept of parental insightfulness is briefly reviewed as the basis for using the concept as a valuable tool for the empirical exploration of intrapsychic, interpersonal, and clinical processes in parents and their children. [ABSTRACT FROM AUTHOR]

This article describes the Attachment Vitamins program, a trauma-informed parent group intervention for families with young children. Attachment Vitamins is a relational psychoeducational intervention based on the principles of Child- Parent Psychotherapy (CPP). Its goal is to repair the impact of chronic stress and trauma through strengthening the child-parent relationship. The authors discuss the history, development, and implementation of the intervention, made possible through a collaborative research and development platform. Two vignettes are presented to highlight unique aspects of the program. Attachment Vitamins is a promising new intervention with the potential to improve outcomes for vulnerable young children and their families on a large scale. [ABSTRACT FROM AUTHOR]

Childhood experiences of interpersonal trauma often leave a legacy of painful emotions and memories that can be especially destructive when adults transition to parenthood. In this article, the authors present a promising treatment approach, Perinatal Child-Parental Psychotherapy (P-CPP), adapted from evidence-based Child-Parent Psychotherapy (CPP) for trauma-exposed parents and young children. Like CPP, P-CPP addresses traumatic experiences and improves mother-child emotional attunement, but it brings this work to the prenatal period. A clinical case illustrates the core modalities of P-CPP and emphasizes how uncovering, making meaning of, and healing from childhood trauma has enduring benefits on prenatal and postnatal maternal and child well-being. [ABSTRACT FROM AUTHOR]

This discussion elaborates on Dr. Slade’s paper about the centrality of fear in the etiology of emotional problems and discusses the transmission from parent to child of unaddressed sources of parental fear. [ABSTRACT FROM AUTHOR]

The impacts of violence for young children and their caregivers are multidimensional. The story of 2-year-old Tyronne, his mother, Josephine, and his father, James, illustrates the use of a relationship-focused treatment, child-parent psychotherapy (CPP), in addressing the traumatic consequences of exposure to violence. This family's story exemplifies the complexity of domestic violence by unraveling the source of intergenerational transmission of attachment patterns and unresolved psychological conflict that become internalized, impacting sense of self, safety, and emotional well-being. [ABSTRACT FROM AUTHOR]

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Child-Parent Psychotherapy (CPP), an evidence-based dyadic therapeutic intervention for very young children exposed to trauma, is becoming the go-to therapeutic intervention for infant mental health practitioners. Although CPP has been shown to be effective for rebuilding the parent-child relationship, reducing trauma symptoms, and reducing depression in mothers, there are some challenges to training and disseminating the model. The authors present two training methods that have been anecdotally effective in training clinicians in the model. [ABSTRACT FROM AUTHOR]

Each year, exposure to violent trauma takes its toll on the development of millions of children. When their trauma goes unaddressed, children are at greater risk for school failure; anxiety and depression and other post-traumatic disorders; alcohol and drug abuse, and, later in life, engaging in violence similar to that to which they were originally exposed. In spite of the serious psychiatric/developmental sequelae of violence exposure, the majority of severely and chronically traumatized children and youth are not found in mental health clinics. Instead, they typically are seen as the ‘trouble-children’ in schools or emerge in the child protective, law enforcement, substance abuse treatment, and criminal justice systems, where the root of their problems in exposure to violence and abuse is typically not identified or addressed. Usually, providers in all of these diverse service systems have not been sufficiently trained to know and identify the traumatic origins of the children's presenting difficulties and are not sufficiently equipped to assist with their remediation. This multiplicity of traumatic manifestations outside the mental health setting leads to the inescapable conclusion that we are dealing with a supra-clinical problem that can only be resolved by going beyond the child's individual clinical needs to enlist a range of coordinated services for the child and the family. This paper will focus on domestic violence as a paradigmatic source of violent traumatization and will (a) describe the impact and consequences of exposure to violence on children's immediate and long-term development; (b) examine the opportunities for, as well as the barriers to, bridging the clinical phenomena of children's violent trauma and the existing systems of care that might best meet their needs; and (c) critique current national policies that militate against a more rational and coherent approach to addressing these needs. [ABSTRACT FROM AUTHOR]

Fraiberg and her colleagues (1975) introduced the metaphor “ghosts in the nursery” to describe the ways in which parents, by reenacting with their small children scenes from the parents' own unremembered early relational experiences of helplessness and fear, transmit child maltreatment from one generation to the next. In this article we propose that angels in the nursery—care-receiving experiences characterized by intense shared affect between parent and child in which the child feels nearly perfectly understood, accepted, and loved—provide the child with a core sense of security and self-worth that can be drawn upon when the child becomes a parent to interrupt the cycle of maltreatment. We argue that uncovering angels as growth-promoting forces in the lives of traumatized parents is as vital to the work of psychotherapy as is the interpretation and exorcizing of ghosts. Using clinical case material, we demonstrate the ways in which early benevolent experiences with caregivers can protect against even overwhelming trauma, and examine the reemergence of these benevolent figures in consciousness as an instrument of therapeutic change. Finally, we examine implications of the concept of “angels in the nursery” for research and clinical intervention. [ABSTRACT FROM AUTHOR]

This article describes the mental health assessment in preparation for treatment conducted in two University-based clinical programs that offer dyadic child-parent psychotherapy as the treatment modality. The Infant-Parent Program is a mental health program serving children between birth and 3 years of age and their families when the parent-child relationship is jeopardized by risk factors in the parent, child, or family circumstances. The Child Trauma Research Project is an intervention outcome research program serving preschool- aged children and their mothers when the child witnessed domestic violence. The programs share a similar assessment approach emphasizing the importance of a working alliance, spontaneous parental reports, and observation of child-parent interaction in a variety of settings. However, their different functions in terms of clinical service and research dictate appropriate modifications in their respective assessment procedures. The two assessment protocols and their rationale will be described in the context of the clinical and research goals of the programs. © 1997 Michigan Association for Infant Mental Health [ABSTRACT FROM AUTHOR]

Sexuality and aggression emerge in the second year of life as important motivational systems that organize substantial aspects of the toddler's behavior, affecting the operation of the attachment system and transforming the parents' perceptions and behaviors toward the child. The interconnection between different motivational systems in the parent and child is discussed as an important dimension in broadening our understanding of attachment and caregiving behaviors and representations in toddlerhood. [ABSTRACT FROM AUTHOR]

In recent years, research and practice on adverse childhood experiences (ACEs) have shifted from delineating effects of ACEs on adulthood health problems to preventing ACEs in children. Nonetheless, little attention has focused on how parents' own childhood experiences, adverse or positive, may influence the transmission of ACEs across generations. Children's risk for ACEs and potential for resilience may be linked to the early child-rearing experiences of their parents carried forward into parenting practices. Additionally, parents with multiple ACEs may have PTSD symptoms, an under-recognized mediator of risk in the intergenerational transmission of ACEs. Guided by developmental psychopathology and attachment theory with an emphasis on risk and resilience, we argue that a more comprehensive understanding of parents' childhood experiences is needed to inform prevention of ACEs in their children. Part I of this review applies risk and resilience concepts to pathways of intergenerational ACEs, highlighting parental PTSD symptoms as a key mediator, and promotive or protective processes that buffer children against intergenerational risk. Part II examines empirical findings indicating that parents' positive childhood experiences counteract intergenerational ACEs. Part III recommends clinically-sensitive screening of ACEs and positive childhood experiences in parents and children. Part IV addresses tertiary prevention strategies that mitigate intergenerational ACEs and promote positive parent-child relationships. • Risk for intergenerational ACEs often stems from parents' childhood experiences. • Primary prevention of ACEs in children must consider parents' history of ACEs. • Parents' PTSD symptoms may mediate their ACEs and ACEs in their children. • Parents' positive childhood experiences are also transmitted across generations. • Parent and child ACEs screening should also include positive childhood experiences. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study involves a reanalysis of data from a randomized controlled trial to examine whether child–parent psychotherapy (CPP), an empirically based treatment focusing on the parent–child relationship as the vehicle for child improvement, is efficacious for children who experienced multiple traumatic and stressful life events (TSEs). Methods: Participants comprised 75 preschool-aged children and their mothers referred to treatment following the child''s exposure to domestic violence. Dyads were randomly assigned to CPP or to a comparison group that received monthly case management plus referrals to community services and were assessed at intake, posttest, and 6-month follow-up. Treatment effectiveness was examined by level of child TSE risk exposure (<4 risks versus 4+ TSEs). Results: For children in the 4+ risk group, those who received CPP showed significantly greater improvements in PTSD and depression symptoms, PTSD diagnosis, number of co-occurring diagnoses, and behavior problems compared to those in the comparison group. CPP children with <4 risks showed greater improvements in symptoms of PTSD than those in the comparison group. Mothers of children with 4+ TSEs in the CPP group showed greater reductions in symptoms of PTSD and depression than those randomized to the comparison condition. Analyses of 6-month follow-up data suggest improvements were maintained for the high risk group. Conclusions: The data provide evidence that CPP is effective in improving outcomes for children who experienced four or more TSEs and had positive effects for their mothers as well. Practice implications: Numerous studies show that exposure to childhood trauma and adversity has negative consequences for later physical and mental health, but few interventions have been specifically evaluated to determine their effectiveness for children who experienced multiple TSEs. The findings suggest that including the parent as an integral participant in the child''s treatment may be particularly effective in the treatment of young children exposed to multiple risks. [Copyright &y& Elsevier]