Psychotherapy with Infants and Young Children: Repairing the Effects of Stress and Trauma on Early Attachment

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Overview

"In situations of social and personal adversity, the everyday challenges of parenting can be overwhelming. How do stress and trauma disrupt early caregiving relationships, and what is the impact on children? What can practitioners do to help? This eloquent book describes child-parent psychotherapy (CPP), an empirically supported treatment that engages parents as the most powerful agents of their young children's healthy development. Grounded in extensive clinical experience and cutting-edge research, CPP provides vital tools for promoting children's well-being and parents' capacity to nurture and protect." Filled with detailed, evocative examples, the volume offers both a comprehensive theoretical framework and practical therapeutic guidelines. It takes the reader step by step through assessing clients and combining play, developmental guidance, trauma-focused interventions, and concrete assistance with problems of living. Clear-cut yet flexible strategies are presented for helping parents resolve their own painful past experiences, gain insight into their child's developmental stage and unique psychological makeup, respond more effectively to his or her emotional needs, and create a safer family environment.
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Editorial Reviews

Doody's Review Service
Reviewer: Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description: This book explains how child-parent psychotherapy (CPP), an evidence-based treatment for children from birth through five, can help in repairing primary attachment difficulties. This theoretical approach uses parents/guardians to be agents of change in order to enhance their child's healthy development.
Purpose: According to the authors, this book "describes child-parent psychotherapy (CPP), a relationship based approach to treatment for children ages birth through 5 when their parent's failure to protect them has derailed their mental health."
Audience: The target audience includes "clinicians with a wide range of experience, from seasoned practitioners to graduate students and interns in psychology and social work and residents in psychiatry." Dr. Lieberman and Dr. Van Horn both teach and practice at University of California San Francisco and the Child Trauma Research Project at San Francisco General Hospital.
Features: Covering the theoretical underpinnings and clinical application of CPP, the book presents an overview of CPP and the impact of stressors on brain development of young children. The authors then discuss assessment and treatment goals. Finally, the application in specific clinical cases is demonstrated and explained. This book does a very nice job of explaining the strategy. For example, in the chapter on the assessment process, the authors walk readers through diagnosis, case formulation, treatment goals, and providing feedback to parents. This chapter also includes brief case examples and a longer clinical example which illustrates the material in a step-by-step approach. The intervention chapters, which combine attachment and other psychodynamic approaches, describe early developmental issues and use brief case examples along with much more extensive clinical case material. I was impressed with the chapter on variations in child-parent psychotherapy because the authors admit that modifications to this approach are sometimes necessary based on conditions. The book ends with how the treatment is integrated with child protective services and the foster system.
Assessment: This book does a nice job of translating theory into practice. Reading these clinical vignettes and seeing the material illustrated is like taking a master's class. This treatment approach is appealing because parents are an integral part of it. Interventions that center on infants and young children are needed so that the most vulnerable members of society will be able to grow psychologically and live productive and satisfying lives.
From the Publisher
"This riveting book provides a comprehensive description of how attachment can be disrupted by stress and trauma—and how it can be mended through child-parent psychotherapy, an empirically supported treatment for infants, preschoolers, and their primary caretakers. Using the credo of 'starting with simplicity,' or developmental guidance, and moving on to behavioral and cognitive interventions and interpreting children's and parents' inner lives, this book is rich with diverse, illuminating clinical examples. Developmental psychologists, therapists, and anyone else working with traumatized infants and preschoolers should read this gem of a book. This is a wonderful text for training advanced graduate students in developmental psychology, infant psychology, and trauma psychology."—Judith A. Cohen, MD, Medical Director, Center for Traumatic Stress in Children and Adolescents, Allegheny General Hospital, Pittsburgh, Pennsylvania

"Lieberman and Van Horn present an extremely sensitive and comprehensive understanding of how their relationship-based approach to therapy can lead both child and parent toward positive mental health. Readers learn how to implement this important therapeutic intervention, with whom to use it, and variations in its use across different systems, such as child welfare and the judicial system. All mental health practitioners working with young children will benefit from the vivid clinical examples that bring to life the process of change. This superb book demonstrates the importance of working in the relationship in early development, and illustrates beautifully how to intervene to change maladaptive patterns."—Joy D. Osofsky, PhD, Departments of Pediatrics and Psychiatry, Louisiana State University Health Sciences Center

"This long-awaited book definitively describes child/n-/parent psychotherapy, one of the most important and effective interventions in infant mental health. The authors are master clinicians who repeatedly place the reader in the trenches of clinical dilemmas and never disappoint with their thoughtful considerations of what transpires there. With clear and illuminating prose and richly evocative vignettes, this book is 'must' reading for child clinicians."—Charles H. Zeanah, MD, Sellars Polchow Professor and Vice Chair of Child and Adolescent Psychiatry, Tulane University Health Sciences Center

The National Psychologist
"Lieberman and Van Horn present a well-reasoned, well-integrated, admirably stated scholarly review of the various literatures on attachment research, child psychoanalysis, and developmental neurobiology....This is a well-narrated, sumptuous textbook which provides chicken soup for the clinicians'' soul. It reconnects seasoned clinicians with their idealistic roots. It reinforces the fretful novice with its infectious aroma of optimism. Thus, it is a must read for clinicians, foster care workers, protective service workers, teachers, and all pediatric professionals who believe that the internal, unarticulated enactments emitted from the very young must have a meaning that through patient, thoughtful work can be understood, formulated into a captivating narrative and worked into a meaningful, transformative treatment plan."--The National Psychologist
— Sharon R. Kahn
From The Critics
Reviewer: Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description: This book explains how child-parent psychotherapy (CPP), an evidence-based treatment for children from birth through five, can help in repairing primary attachment difficulties. This theoretical approach uses parents/guardians to be agents of change in order to enhance their child's healthy development.
Purpose: According to the authors, this book "describes child-parent psychotherapy (CPP), a relationship based approach to treatment for children ages birth through 5 when their parent's failure to protect them has derailed their mental health.
Audience: The target audience includes "clinicians with a wide range of experience, from seasoned practitioners to graduate students and interns in psychology and social work and residents in psychiatry." Dr. Lieberman and Dr. Van Horn both teach and practice at University of California San Francisco and the Child Trauma Research Project at San Francisco General Hospital.
Features: Covering the theoretical underpinnings and clinical application of CPP, the book presents an overview of CPP and the impact of stressors on brain development of young children. The authors then discuss assessment and treatment goals. Finally, the application in specific clinical cases is demonstrated and explained. This book does a very nice job of explaining the strategy. For example, in the chapter on the assessment process, the authors walk readers through diagnosis, case formulation, treatment goals, and providing feedback to parents. This chapter also includes brief case examples and a longer clinical example which illustrates the material in a step-by-step approach. The intervention chapters, which combine attachment and other psychodynamic approaches, describe early developmental issues and use brief case examples along with much more extensive clinical case material. I was impressed with the chapter on variations in child-parent psychotherapy because the authors admit that modifications to this approach are sometimes necessary based on conditions. The book ends with how the treatment is integrated with child protective services and the foster system.
Assessment: This book does a nice job of translating theory into practice. Reading these clinical vignettes and seeing the material illustrated is like taking a master's class. This treatment approach is appealing because parents are an integral part of it. Interventions that center on infants and young children are needed so that the most vulnerable members of society will be able to grow psychologically and live productive and satisfying lives.
From the Publisher

"This riveting book provides a comprehensive description of how attachment can be disrupted by stress and trauma--and how it can be mended through child-parent psychotherapy, an empirically supported treatment for infants, preschoolers, and their primary caretakers. Using the credo of 'starting with simplicity,' or developmental guidance, and moving on to behavioral and cognitive interventions and interpreting children's and parents' inner lives, this book is rich with diverse, illuminating clinical examples. Developmental psychologists, therapists, and anyone else working with traumatized infants and preschoolers should read this gem of a book. This is a wonderful text for training advanced graduate students in developmental psychology, infant psychology, and trauma psychology."--Judith A. Cohen, MD, Medical Director, Center for Traumatic Stress in Children and Adolescents, Allegheny General Hospital, Pittsburgh, Pennsylvania

"Lieberman and Van Horn present an extremely sensitive and comprehensive understanding of how their relationship-based approach to therapy can lead both child and parent toward positive mental health. Readers learn how to implement this important therapeutic intervention, with whom to use it, and variations in its use across different systems, such as child welfare and the judicial system. All mental health practitioners working with young children will benefit from the vivid clinical examples that bring to life the process of change. This superb book demonstrates the importance of working in the relationship in early development, and illustrates beautifully how to intervene to change maladaptive patterns."--Joy D. Osofsky, PhD, Departments of Pediatrics and Psychiatry, Louisiana State University Health Sciences Center

"This long-awaited book definitively describes child/n-/parent psychotherapy, one of the most important and effective interventions in infant mental health. The authors are master clinicians who repeatedly place the reader in the trenches of clinical dilemmas and never disappoint with their thoughtful considerations of what transpires there. With clear and illuminating prose and richly evocative vignettes, this book is 'must' reading for child clinicians."--Charles H. Zeanah, MD, Sellars Polchow Professor and Vice Chair of Child and Adolescent Psychiatry, Tulane University Health Sciences Center

The National Psychologist
"Lieberman and Van Horn present a well-reasoned, well-integrated, admirably stated scholarly review of the various literatures on attachment research, child psychoanalysis, and developmental neurobiology....This is a well-narrated, sumptuous book which provides chicken soup for the clinicians' soul. It reconnects seasoned clinicians with their idealistic roots. It reinforces the fretful novice with its infectious aroma of optimism. Thus, it is a must read for clinicians, foster care workers, protective service workers, teachers, and all pediatric professionals who believe that the internal, unarticulated enactments emitted from the very young must have a meaning that through patient, thoughtful work can be understood, formulated into a captivating narrative and worked into a meaningful, transformative treatment plan."—The National Psychologist
PsycCRITIQUES
"An essential book for those who work with traumatized young children and their families."—PsycCRITIQUES
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Product Details

  • ISBN-13: 9781593856755
  • Publisher: Guilford Publications, Inc.
  • Publication date: 4/30/2008
  • Edition description: New Edition
  • Pages: 366
  • Sales rank: 1,210,525
  • Product dimensions: 6.20 (w) x 9.30 (h) x 1.00 (d)

Meet the Author

Alicia F. Lieberman, PhD, is Irving B. Harris Professor of Infant Mental Health and Vice Chair for Academic Affairs in the Department of Psychiatry, University of California, San Francisco, and is Director of the Child Trauma Research Project at San Francisco General Hospital. She directs the Early Trauma Treatment Network, a collaborative of four university-based programs that is a center of the Substance Abuse and Mental Health Services Administration (SAMHSA) National Child Traumatic Stress Network. She is president of the board of directors of Zero to Three: The National Center for Infants, Toddlers and Families. Dr. Lieberman is the author of The Emotional Life of the Toddler and senior author of Losing a Parent to Death in the Early Years: Guidelines for the Treatment of Traumatic Bereavement in Infancy and Early Childhood and Don’t Hit My Mommy!: A Manual for Child-Parent Psychotherapy with Young Witnesses of Family Violence, among numerous other publications. Her major interests include infant mental health, early trauma, and closing the service gap for minority and underserved young children and their families.

Patricia Van Horn, JD, PhD, is Associate Clinical Professor in the Department of Psychiatry at the University of California, San Francisco, and Associate Director of the Child Trauma Research Project. She serves as technical assistance provider and clinical consultant to the San Francisco Safe Start Initiative and has trained clinicians nationally and abroad in child-parent psychotherapy through the SAMHSA National Child Traumatic Stress Network and the Safe Start Promising Practices Initiative. She is the author of a child trauma training curriculum for advocates serving women and children affected by domestic violence and a coauthor of Don’t Hit My Mommy! and Losing a Parent to Death in the Early Years.

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Table of Contents

Ch. 1 When Development Falters: Putting Relationships First 1

Ch. 2 Coping with Danger: The Stress - Trauma Continuum 35

Ch. 3 Practicing Child-Parent Psychotherapy: Treatment Targets and Strategies 64

Ch. 4 The Assessment Process 100

Ch. 5 "Not Quite Good Enough": Perturbations in Early Relationships 138

Ch. 6 Ghosts and Angels in the Nursery: Treating Disturbances and Disorders 174

Ch. 7 Variations in Child-Parent Psychotherapy 210

Ch. 8 Lapses in Attunement: Failures in the Therapeutic Relationship 246

Ch. 9 Integrating Child-Parent Psychotherapy with Other Service Systems 277

Ch. 10 Closing Thoughts: Taking Perspective 317

References 331

Index 351

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