Core Components

Child-Parent Relationship Therapy (CPRT) is a play therapy-based treatment programme for parents of young children aged 3 to 8 years presenting with behavioural, emotional, social, and attachment disorders. Parents are taught specific skills that focus on enhancing a secure attachment with their child, helping parents attune to and respond to their child's underlying needs to address symptoms. Parents also learn to effectively limit their child's misbehaviour while demonstrating empathy and respect for their children, practicing the implementation of Child Centred Play Therapy based skills in video recorded play sessions (30 mins) between parent and child, with feedback on their skills from a certified CPRT facilitator.

The programme which is suitable for implementation in hospital, out-patient, community and school-based settings, is delivered over 10 weekly, 2 hour group sessions with 5-8 parents and includes three key components: learning skills, receiving feedback on skill practice and connecting with other parents for support. During sessions 1-3, parents learn skills and prepare for their upcoming play sessions with their child and during weeks 4-10, parents practice their new skills with their child and receive therapist feedback for parents in the small group format. The sessions in order of delivery include

1) Reflective responding
2) Effective time in the Play
3) Do’s and don’ts in the play session
4) Delimitation principles
5) Physical interaction with the Child
6) The skill of offering a choice, training the responsibility and decision-making
7) Training the response that cause self-esteem in children
8) Creating a skill to encourage rather than praise
9) Sessions 9 & 10 - Review of the sessions.

Play therapists train parents to incorporate therapeutic skills into their relationships with their children to gain support, understanding and tools to address common parenting struggles.

This manualised programme includes a range of resources and support materials including (1) Child Parent Relationship Therapy Book (2) Child Parent Relationship Therapy Manual which includes handouts & notebook, homework, worksheets for each session and model adaptations (3) CD-ROM of training materials.

There is also a home-based component to this programme which includes weekly homework assignments (handouts/worksheets, relationship building activities, parenting skills, and self-reflective journals) to reinforce the teaching points made in each session.

Fidelity

In order to effectively replicate the programme and achieve good outcomes, all elements of the core programme are to be implemented in the order outlined in the treatment book. A CPRT Therapist Skills-Protocol Checklist (CPRT-TSPC) is also available to ensure fidelity of intervention protocol for training and research purposes.

Modifiable Components

All core elements of the programme are strongly recommended for implementation. Although CPRT was developed for children ages 3- 8, the programme has been adapted for use with toddlers and preadolescents. Model adaptation guidance is provided in the manual.

The CPRT manual is available in English, Chinese, Japanese, Korean, and Spanish.

Child-Parent Relationship Therapy (CPRT) was developed by the University of North Texas, Centre for Play Therapy in the United States.

Support for Organisation / Practice

Implementation Support

Support is provided from the Centre for Play Therapy in the form of one-to-one phone/email support and programme developments through newsletters and social media and remote support meetings.

Licence Requirements

A licence to deliver CPRT is not required.

Start-up Costs

Start-up costs include therapist training in two phases: Child-Parent Relationship Therapy 101 - $280 and Child-Parent Relationship Therapy 102 - $360. Additional resources are also required including the CPRT Therapy Model book at $55 per individual purchase and the CPRT Treatment Manual at $45 per individual purchase or $80 if purchased as a set.

Building Staff Competency

Qualifications Required

To become a CPRT level 1 & level 2 certified practitioner, participants are required to be a mental health practitioner who has received extensive training in Child Centred Play Therapy (CCPT) principles along with completion of the CCPT101 training which is a pre-requisite.

For participants who are not trained mental health practitioners, associate/parent educator certification is available and for mental health professionals working outside the US, the Centre for Play Therapy offers an international certificate.

Training Requirements

Training to become a CPRT therapist is a requirement. Professionals must complete CPRT 101: Foundations in CPRT (12 hours) and CPRT 102: Advanced CPRT Practice and Application (12 hours). The total training time is 4 days, 6-hour training per day (24 hours). Upon completion of training, practitioners must complete 3 CPRT groups under supervision with an approved CPRT supervisor.

Mental health professionals working outside the US, who complete the international CPRT certificate, are eligible to apply to become a certified therapist.

In order to maintain certification status, CPRT certification must be renewed every 5 years. Requirements for renewal include 18 continuing education hours specific to CPRT and a renewal fee of $95.

The Centre for Play Therapy also provides ongoing training in CPRT through annual workshops and conferences.

Supervision Requirements

Supervision for this programme includes completion of 3 groups under supervision with an approved CPRT supervisor required upon completion of training (minimum of 8 hours of supervision per group or two groups can be conducted simultaneously with a minimum of 12 hours of supervision).

Theory of Change

Child-Parent Relationship Therapy (CPRT) is a systemic intervention grounded in Child-Centred Play Therapy (CCPT) theory, attachment principles, and interpersonal neurobiology. CPRT is based on the premise that a secure parent-child relationship is the essential factor for a child’s well-being. In a supportive group environment, parents learn skills to respond more effectively to their children’s emotional and behavioural needs. In turn, children learn that they can count on their parents to reliably and consistently meet their needs for love, acceptance, safety, and security. The goal of CPRT is to strengthen the quality of the parent-child attachment bond as a means of reducing child behaviour problems and stress in the parent-child relationship.

Values

Child-Parent Relationship Therapy (CPRT) exemplifies the Centre for Play Therapy’s mission which is to encourage the unique development and emotional growth of children through the process of play therapy, a dynamic interpersonal relationship between a child and a therapist/parent trained in play therapy procedure.

• Does encouraging the unique development and emotional growth of children through the process of play therapy align with the key values of your organisation?

Priorities

CPRT promotes the parent-child bond which holds much more emotional significance than the relationship between a therapist and a child. A parent acting as an agent for change in place of a therapist can result in significant therapeutic gains. Child-Parent Relationship Therapy will help therapists train parents to work with their children by providing them with the basic child-centred play therapy principles and skills needed to conduct parent-child play sessions to strengthen their bond.

• Is a play therapy prevention approach aimed at helping develop the parent-child bond a priority for your organisation?
• Is helping parents develop a secure attachment to reduce child behaviour problems and stress in the relationship a priority for your organisation?

Existing Initiatives

• Does your service already provide play therapy programmes aiming to improve the parent-child bond, children’s development and emotional growth?
• Does your area have practitioners trained in delivering CPRT?
• Do you have links with CAMHS, Adult Mental Health Services and Child Protection Services to refer onto if required?

Workforce

To deliver Child-Parent Relationship Therapy (CPRT) requires a mental health practitioner (or co-leaders) who has received extensive training in Child-Centred Play Therapy (CCPT) principles and who has participated in the CPRT training which takes in total 24 hours.

• Do you have enough mental health practitioners who have received the necessary training in CCPT available to commit to undertake training?

The delivery of CPRT takes place over 10 weeks and is made up of 2-hour weekly group sessions

• Do you have enough licensed mental health practitioners or co-leaders available to commit to delivering the full extent of this programme?

Technology Support

To implement CPRT requires minimal technological resources. Some of the teaching sessions may require online access to technology that enables web access to teaching, resources, and streaming.

• Do you have access to adequate technology to support practitioners to effectively undertake training online and to access the optional teaching elements of the programme?

Administrative Support

Practitioner preparation for each session is minimal requiring only printing, photocopying and cutting up of resources in advance of each session and one home activity prepared and sent home per module.

• Do you have enough administrative capacity to meet these needs?

Financial Support

To deliver CPRT requires a total training fee of $880 and 5 yearly renewal of license at $95. Additional resources are also required including the CPRT Therapy Model book at $55 and the CPRT Treatment Manual at $45 per individual purchase.

• Do you have the finances to purchase the training and supervision, programme resources and manuals/books?

Comparable Population

Child-Parent Relationship Therapy (CPRT) is designed as a play therapy-based treatment programme for parents of young children aged 3 to 8 years presenting with behavioural, emotional, social, and attachment disorders.

Evidence of its effectiveness includes children aged 2 to 10 years including adoptive families with attachment disruptions, single parents, non-offending parents of children who have been sexually abused and incarcerated fathers.

• Is this comparable to the population you serve?
• Does your organisation have existing contacts with this population?
• Are you likely to receive enough referrals/demand for eligible parents of children with behaviour problems to populate a recurring programme of CPRT?

Desired Outcome

The goal of CPRT is to strengthen the quality of the parent-child attachment bond as a means of reducing child behaviour problems and stress in the parent-child relationship. CPRT specifically aims to enhance the caregiver-child relationship to increase trust, security, and closeness between the dyad and ultimately between other family members; Improve communication within the parent-child relationship; Increase problem-solving strategies within the parent-child relationship; Increase expressions of affection and familial enjoyment within the parent-child relationship; Increase parental acceptance and empathy; Improve parent’s ability to attune and respond sensitively to their children’s emotional needs; Help parents develop more realistic developmental expectations and limits on their children’s behaviour; Increase overall confidence and self-acceptance as parents; Increase the child’s expression of their needs and feelings and; Increase more appropriate and satisfying ways for the child to express, regulate, and meet their needs.

Research has identified that Child-Parent Relationship Therapy reduces children’s behaviour problems and increases parental acceptance, empathic behaviour and reduction in levels of stress related to the parent-child relationship.

• Do these programme outcomes align with your service’s desired outcomes?
• Does your organisation have other initiatives in place that effectively and efficiently address the above outcomes?