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Members of CTRP at the opening reception for the Nancy Pritzker Building.
(from left to right: Ben Spevack, Joyce Dorado Ph.D., Chandra Ghosh Ippen Ph.D., Alicia Lieberman Ph.D., Lisa S. Pritzker, and Miriam Hernandez Dimmler Ph.D.)
CPP helps us to find hope in hard places. This is part of our practice.
Unfortunately, as we continue to experience repeated community-level violence: community and school shootings, war, ongoing political turmoil . . . coupled with inadequate societal-level protection and ongoing COVID-related fears, we may feel drained of the fount of hope that is required for the work that we do. You are not alone if you have found yourself trying to hold on to hope and do this work while also feeling overwhelmed by alternating waves of anger, sadness, and numbness. We have been surrounded by despair for too long.
And yet, our actions, as individuals and as a community matter, which means that in addition to strengthening our team supports, we need to enhance our capacity to find and hold on to waves of hope.
How do we find and hold onto waves of hope?
Recently, I have been reflecting on Dowling’s article “Compassion does not fatigue” and in her distinction between empathic distress and compassion. Dowling notes that compassion fatigue “is a misnomer.” Empathy fatigues but compassion does not. Empathy, while a powerful therapeutic skill, causes distress when the boundary between self and other becomes blurred, when caring leads us to take in another person’s pain, and when we feel helpless to change things. Compassion, in contrast, involves caring deeply, sending our care outward, and taking action for others, even when the action feels small.
This distinction reminds me that events are experienced as traumatic when they overwhelm us and rob us of our sense of competence and capacity. In CPP, in the face of ongoing trauma and difficult ports of entry, I have learned to become aware of what I am able to do or say and to grow my capacity to respond in difficult moments. I recognize that bearing witness to other people’s pain so that they are not alone with it (being with) has value. Following the principles of Tikkun Olam, I try to honor the actions that I take, even when the larger problems remain. Moreover, in keeping with the wisdom of many cultural groups, I have learned that it is not just my actions that matter but those of our entire community, our collective actions and stories matter.
Sharing stories of hope
The other day, a provider (Kelli Wright) shared a CPP story where she described working with a 4-year-old girl who had experienced severe neglect. The child had been kept at times in small, locked spaces, and she was present when her mother used substances, including being removed when her mother overdosed. The therapist noted that following the presentation of the CPP triangle, the child started re-enacting her trauma story immediately through play. She repeated the same play week after week involving death, hiding from danger, and being unsafe. Foster mom and provider joined the child in her trauma play as she worked through those themes. In her most recent session, after 7-8 weeks of this repeated play, the provider started setting up the same play space. To her surprise, the child instead said to her, "No, I don't need the blanket for my fort today because I'm safe now." I heard the story from the consultant who stated “All of us on the call felt the CPP magic in our bodies at the end of the story and shared a moment of celebration for this young child who had already been through so much.”
Another provider (Amy Shohet) posted a CPP success story in our CPP Provider Facebook group. To paraphrase, she described a treatment with a child with complex trauma and noted that in the beginning “his play was so disorganized and aggressive. He threw toys and drew on the table and ripped things.” She did the CPP triangle and noted that he just watched and did not say anything. But the next week, he went to the dollhouse, threw out the dolls and then represented his history with the furniture and a character. She ended her story by saying “Each session since his play is organized and intentional and he plays the trauma and now is starting to play with me. CPP is magical!” Others in the provider group noted that this is “such a beautiful, inspiring, and hope-filled story.”
These stories came when I was in need of hope. In a world with so much despair, it was beautiful to be a part of this community where we have moments like this, moments where the child, family, and provider create something magical together. These waves add up and carry us forward. We know that the “body keeps the score,” and the body remembers not only trauma but also healing and beauty. And so, with this newsletter, we ask the question, “what helps you to hold on to hope?” We invite you to share your stories of hope and beauty in our closed CPP Provider Facebook group or via this survey. In future newsletters we will share some of your responses, so that together we jointly create ripples of hope and joy.
Farewell to Building 20
The Zuckerberg San Francisco General Hospital, affectionately known as “The General”, is the beloved San Francisco County hospital that sits on the border of the Mission and Potrero Hill neighborhoods. It has been home to the Child Trauma Research Program (CTRP) for the past 25 years serving young children and their families exposed to trauma.
Child-Parent Psychotherapy (CPP) was birthed within these brick walls. As our team developed, researched, and disseminated CPP, we also trained many mentees through our internship and postdoc programs. All of our trainees have taken what they learned about young children and trauma to make changes in their own ways as clinicians, caregivers, program leaders, researchers, funders, and policy makers. We treasure the memories of deep conversations where we bore witness to beautiful work with families. We remember our time together, often with pie and lemon bars, celebrating the arrival of CTRP babies and grandbabies, welcoming new staff, and bidding farewell to colleagues. We continue to grieve the loss of our beloved Patricia Van Horn and hold her memory as an inspiration. We developed a fellowship of those who truly understand the consequences of early childhood trauma and benevolently partner with families to support multi-generational healing. The families also remain with us - their stories reminding us that we must create better systems and services, because early childhood healing is possible.
Members of CTRP say good-bye to Building 20 and honor the roots of CPP, with scotch for Patricia Van Horn and sheep for Selma Fraiberg.
(Back row from left to right: Markita Mays, Brooke Kimbro, Ann Chu, Miriam Hernandez Dimmler. Front row from left to right: Chandra Ghosh Ippen, Alicia Lieberman, Barclay Stone, Gloria Castro, Belen Rogowski, and Vilma Reyes.)
Building 20 was the home of our NIMH randomized controlled trial that contributed to the evidence base for CPP with families who had experienced domestic violence. It held the think tank that created the Early Trauma Treatment Network, a collaboration of infant/early childhood mental health sites that is a center of the National Child Traumatic Stress Network and leads national CPP dissemination. It was also the birthplace of CPP-informed service programs:
It was where multiple books were written, among them
As we continue to navigate our way back to office-based work in the midst of the COVID pandemic, our new home base will be the UCSF Nancy Friend Pritzker Psychiatry Building at the UCSF Mission Bay campus. We will keep a foothold at the General to continue serving the population that is so deeply embedded in our hearts, so we are not saying goodbye. And yet, this is a transition, a closing phase. As we move, we are thinking back on our formative years in this iconic institution with fondness and gratitude. We look forward to forging innovative cross- campus initiatives and to creating many Angel memories with our new neighbors and partners.
Note: This album offers just a glimpse of the hundreds of students and staff who have graced CTRP with their rich laughter, assiduous caring, and warm memories. Each of these wonderful individuals--pictured or not--holds a special place in our hearts.
Lisa Spinas, LCSW
Humboldt Bridges to Success
Stories from the Field
I wanted to express how grateful I am for the Child Parent Psychotherapy Learning Collaborative you have provided for myself and other therapists in my county. Part of my job is to help link families with children 5 and under to therapeutic supports. Prior to our participation in the CPP Learning Collaborative, it was challenging to find therapists who could work with young children who have experienced trauma.
We are so much better able to meet that need now after having therapists trained and supported in learning Child Parent Psychotherapy. As a therapist myself, it has also increased my engagement and satisfaction in the work that I do. It feels good to feel effective. Many thanks for such an impactful learning collaborative!
Honoring Our Angels
Bill Harris has a special gift for crafting language that propels transformational action. He wrote that trauma is a supraclinical problem that requires the coordinated engagement of multiple service systems to address its many manifestations in physical and mental illness, school failure, substance use, family violence, and criminal behavior. He encourages us to become noticers – keen observers who detect unexpected connections that lead to new insights. We owe to him the term “Angels in the Nursery”, which transformed the practice of Child-Parent Psychotherapy by highlighting the intergenerational transmission of feeling loved, nurtured, delighted in, and protected.
Bill Harris with Alicia Lieberman
These indelible experiences are passed on from grandparent to parent and from parent to child, creating hope as a roadmap to transcend sorrow and despair. He teaches and demonstrates that political engagement is essential in the pursuit of social justice. Bill embodies generativity, working quietly and unassumingly over many decades to create initiatives and advance public policies that improve the lives of many millions of children and their families.
Thank you, Bill, for everything you do and everything you represent.
The Road Ahead
This fall we are excited to share our plan to pilot test our CPP Agency Mentorship Program (CAMP).
We will begin with an open application. Agencies who meet criteria of having at least 3 rostered supervisors with deep CPP experience are encouraged to apply to be a part of an 18-month training experience that will allow you to sustain the practice and roster clinicians trained using the CAMP model. We hope to develop at least 6 CAMP sites over the course of our grant.
GLORIA CASTRO, PsyD
Gloria Castro, PsyD, spent years providing mental health services in The Children’s Hospital at the Centro Médico Nacional in Mexico City, before moving to the Bay Area. She received the Selma Fraiberg Fellowship to complete her postdoctoral work at the Infant Parent Program at UCSF. At Zuckerberg San Francisco General Hospital, she worked as part of an interdisciplinary team, providing continuity of care for pregnant women and their infants. In 2017, Gloria joined the CTRP team to collaborate in the development and implementation of Perinatal Child-Parent Psychotherapy. There, she also contributed to the publication of Make Room for Baby. Perinatal Child-Parent Psychotherapy to Repair Trauma and Promote Attachment.
For Gloria, CPP offers the opportunity to directly address trauma in hospital settings, where perinatal mental health services are not widely available. She has navigated the medical system as part of an interdisciplinary team and draws on her experience from the Centro Médico Nacional and the Infant-Parent Program: “If you are working with pre-verbal babies, you are working in a family system…you need to understand the history and experience of the parents, the internal world of the baby, and how these affect their growth and development.”
The impact of Gloria’s work at CTRP reaches well past San Francisco. She routinely provides training in perinatal mental health in different hospitals in the Bay Area, and in other states. She has worked with acute programs for women with mental health issues, pregnant women, and newborns to support them in providing a trauma-informed care and addressing perinatal mental health challenges. As a result of her training, the program adapted its intervention to relationship-focused services that included babies alongside the mothers. In addition, Gloria has imparted her knowledge to numerous pre- and post-doctoral students, who now work in various care systems across the country.
SHONDRA DAVIS, PsyD
Shondra rejoined the CPP Team in March of 2022. She previously completed a pre-doctoral internship at CTRP in 2012. After completing her doctoral degree, she went on to spearhead the CPP Agency Mentorship Program (CAMP) at Instituto Familiar de la Raza in San Francisco. She then continued her apprenticeship as a CPP Agency Trainer at The Jewish Board in New York City where she supported the agency's CAMP implementation process while being to become a CPP Learning Collaborative Trainer. Shondra is pleased to have rejoined the CTRP mothership. As a bilingual clinician, she has worked extensively with Spanish-speaking children and families. She is passionate about decreasing mental health stigma and increasing access to services in communities overly impacted by trauma. She weaves together her training as a psychologist with specialized training in integrative somatic approaches to trauma therapy, meditation and yoga. She looks forward to supporting partner agencies in the CAMP application and implementation process. In her spare time, she can be found trying her hand at a new DIY project. She lives by the motto: "Will travel for delicious food!"
Oh, The Places We've Gone...
Join us in our new CPP webinar series!
We kicked off our inaugural webinar with Charley Zeanah, MD, and Anna Kelley, PsyD, who discussed the Countertransference in the Treatment of Maltreated Children.
In May, Ruth Paris, PhD, LICSW, and Susan O’Donnell, LMHC, continued the series with Lessons Learned from Project BRIGHT: A Trauma-Informed Attachment Intervention for Parents with Substance Use Disorders and Their Children. Look for Part 2 of Lessons Learned from Project BRIGHT in June!
Over the next 4 years, we hope many of you will join us as we host quarterly webinars open to all rostered CPP providers. Together we will gain a better understanding of how we can partner with the child welfare system, how we can support those with substance use challenges, and how we can deepen our core CPP competencies, supervision, and much much more. Webinar details will be emailed to the CPP roster and posted in the CPP Provider Facebook group.
Mental Health Professionals
In recent months, our lives have once again been rocked by violence and loss. The shockwaves have radiated through our schools, homes, and workplaces. Even as mental health professionals process their own emotions, they have borne witness and offered counsel to others. In the midst of fear and grief, they have stretched their arms wider to hold affected communities. They have rolled up their sleeves and begun anew the work of healing. Our world is brighter for having them.
The Battery Foundation
The Battery SF has empowered both widespread education on Child-Parent Psychotherapy and community-activities. The foundation’s generous support has funded the production of high-quality videos that capture the spirit and process of CPP for families and clinicians (a special thank you to our talented video producer—Meco Raivan Hall—who captured and curated the actual footage!). The Battery is also funding an upcoming conference for CPP providers in the Bay Area. This support has helped us to carry CPP to the world, and we are profoundly grateful.