Glossary

Self-assessment

Child Parent Relationship Therapy (CPRT)

Child-Parent Relationship Therapy (CPRT) is a play-based treatment programme for young children 3-8 year old presenting with behavioural, emotional, social, and attachment concerns. CPRT is delivered over 10 weekly, 2 hour group sessions with 5-8 parents.

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Usability Rating

4

Supports Rating

3

Evidence Rating

4

Fit Rating

NYR

Capacity Rating

NYR

Need Rating

NYR

The Hexagon: An Exploration Tool

The Hexagon can be used as a planning tool to guide selection and evaluate potential programs and practice for use.

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Evidence

4

Fit

NYR

Capacity

NYR

Supports

3

Usability

4

Need

NYR

Usability - Rating: 4

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.

Supports - Rating: 3

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).

Evidence - Rating: 4

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.

Preschool: 3 to 5 years - Rating: 4

Research Design & Number of Studies

The best evidence identified for children in the 3–5 age range comes from 5 RCTs, undertaken by the programme developer. The study populations included children from adoptive families aged 2-10 years (n=61, Carnes-Holt & Bratton, 2014) (n=49, Opiola & Bratton, 2018); single parents with children aged 3-7 years (n=43, Bratton & Landreth, 2015); incarcerated fathers with children 4-9 years (n=32, Landreth & Lobaugh, 1998); and nonoffending parents of children who have been sexually abused aged 4-10 years (n=26, Costas & Landreth, 1999). Separate data are not available for the age range 3–5 years.

Outcomes Achieved

Child Outcomes

• Statistically significant findings and large treatment effects in treatment groups compared to waitlist control groups in the reduction of children's behaviour problems (Bratton & Landreth, 2015; Carnes-Holt & Bratton, 2014; Opiola & Bratton, 2018).

• Statistically significant reduction in parent-child relationship stress (Carnes-Holt & Bratton, 2014; Opiola & Bratton, 2018; Costas & Landreth, 1999; Landreth & Lobaugh, 1998; Bratton & Landreth, 2015).

Parent Outcomes

• Statistically significant improvements (between group differences) in increasing empathic interactions between parents and their children (Bratton & Landreth, 2015; Carnes-Holt & Bratton, 2014; Costas & Landreth, 1999; Landreth & Lobaugh, 1998; Opiola & Bratton, 2018)

• Compared to the control group, incarcerated fathers receiving CPRT reported a statistically significant increase in their self-concept from pre- to post-testing (Landreth & Lobaugh, 1998).

Key References

Bratton, S., & Landreth, G. (1995). Filial therapy with single parents: Effects on parental acceptance, empathy, and parent stress. International Journal of Play Therapy, 4(1), 61-80.

Carnes-Holt, K., & Bratton, S. C. (2014). The efficacy of child parent relationship therapy for adopted children with attachment disruptions. Journal of Counseling and Development, 92(3), 328-337.

Costas, M., & Landreth, G. (1999). Filial therapy with nonoffending parents of children who have been sexually abused. International Journal of Play Therapy, 8(1), 43–66.

Landreth, G. L., & Lobaugh, A. F. (1998). Filial therapy with incarcerated fathers: Effects on parental acceptance of child, parental stress, and child adjustment. Journal of Counseling & Development, 76, 157–165.

Opiola, K. K., & Bratton, S. C. (2018). The efficacy of child-parent relationship therapy for adoptive families: A replication study. Journal of Counseling & Development, 96(2), 155–166.

Primary school: 6 to 12 years - Rating: 4

Research Design & Number of Studies

The best evidence identified for children in the 6-12 age range is the same for the 3-5 age range above with the addition of one further externally conducted Randomised Controlled Trial (Abassi et al, 2016) which includes 31 children aged 6-7 years.

Outcomes Achieved

Child Outcomes

• Significant difference between experimental and control groups in reducing symptoms and improved separation anxiety in children. (Abassi, et al).

Parent Outcomes

• N/A

Key References

Abassi, Z., Amiri, S., & Talebi, H. (2016). Efficacy of Child-Parent Relationship Training (CPRT) on reduction of separation anxiety symptoms in children aged 6-7 years. International Journal of Philosophy and Social-Psychological Sciences, 2(2), pp. 21-33.

Capacity

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?

Capacity Score

Self-assessment

Child Parent Relationship Therapy (CPRT)

Compare

Usability Rating

4

Supports Rating

3

Evidence Rating

4

Fit Rating

NYR

Capacity Rating

NYR

Need Rating

NYR

The Hexagon: An Exploration Tool

The Hexagon can be used as a planning tool to guide selection and evaluate potential programs and practice for use.

Evidence

4

Fit

NYR

Capacity

NYR

Supports

3

Usability

4

Need

NYR

Preschool: 3 to 5 years - Rating: 4

Primary school: 6 to 12 years - Rating: 4

Need

Fit

Capacity

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