The Effectiveness of Child-Parent Psychotherapy on Traumatized Preschoolers and Their Caregivers: A Swedish Multi-Site Study

Introduction: Trauma affects a child's mental health and appears to be associated with challenges in caregiver-child dynamics. Nearly half of child trauma victims are under the age of six, yet few interventions are designed for this age group. Child-Parent Psychotherapy (CPP) is an attachment-based trauma treatment for preschool-aged victims of adversities and their caregivers. This study examines the effectiveness of CPP when implemented in a Swedish naturalistic multi-site clinical setting. Method: 57 children (age 2–6 years) with potentially traumatic experiences and their caregivers participated. They were recruited from 12 mental health services providing child treatment. The study has a one-group, pretest-posttest design. Outcome measures covered posttraumatic stress and general psychological symptoms in children and caregivers and caregivers' perceptions of their relationship with their child. Paired t-tests were used to calculate within-group differences. Effect sizes were computed as Cohen's d and associations between child and caregiver outcomes as Pearson's correlation coefficient (r). A hierarchical regression analysis was tested to explore the correlation analysis. Results: Reductions in posttraumatic stress and general psychological symptoms with small-to-medium effect sizes were found in children and caregivers. Caregivers reported perceived improvements in their relationship with their child, with associations to findings in child posttraumatic stress reduction. Discussion: Findings support earlier results that CPP may be a suitable choice of treatment for preschoolers exposed to potentially traumatic events, such as violence. The dyadic treatment model seems to address the association between child traumatic stress and caregivers' perceptions of the caregiving relationship. Further dissemination testing is suggested.