CPP Newsletter
Summer 2024
Welcome!
For other editions of the CPP Newsletter, click here.
Members of the CPP Community at from the ZERO TO THREE conference. We hope to connect with more of you in the upcoming year!!
Dear Community,
The results of an important CPP study have just been published! The findings provide evidence that a psychosocial treatment can affect neurobiological trajectories. Important takeaways include:
- Participation in CPP is associated with lower levels of Epigenetic Age Acceleration post-treatment than a no-treatment comparison group.
- CPP may support slower biological aging by enhancing safe, protective, and emotionally responsive caregiving practices.
- Early interventions like CPP may have significant long-term implications for child health and disease trajectories.
Please spread this wonderful news by sharing the infographic, the article, and your thoughts about this exciting research.
Citation:
Alexandra D. W. Sullivan, Sarah M. Merrill, Chaini Konwar, Michael Coccia, Luisa Rivera, Julia L. MacIsaac, Alicia F. Lieberman, Michael S. Kobor, & Nicole R. Bush. (2024) Intervening After Trauma: Child-Parent Psychotherapy Treatment Is Associate With Lower Pediatric Epigenetic Age Acceleration. Psychological Science. https://doi.org/10.1177/09567976241260247.
Voices from the Field
Breea Wainwright—the recipient of the 2023 Alicia Lieberman Award—has a story that reflects a profound commitment to the practice and principles of Child-Parent Psychotherapy (CPP). Breea first encountered CPP during her tenure at a therapeutic nursery in Los Angeles. She quickly embraced the model for its approach to healing and attachment, training first as a clinician and then as a supervisor. For her, CPP’s appeal lies in its holistic framework, which elevates the therapeutic bond between caregiver and child. This approach not only fosters resilience and emotional healing in children but also supports caregivers in understanding and responding to their children’s needs effectively. “It’s probably my favorite modality to use with families.”
Breea also completed specialized training in perinatal mental health and sees CPP as a powerful way to emphasize the critical role of maternal well-being in child development.
Breea Wainwright,
LMFT
“I’ve been in awe such of CPP and how beautifully it closes the loop with perinatal [care].”
After moving to the Bay Area, Breea began consulting on how to support infant and early childhood care providers, particularly those known as family, friend, and neighbor (FFN) care providers. In this work, Breea facilitates community-of-support groups on Caregiver Well-being, Supporting Connection and Relationships, and Reflective Healing: Empowering BIPOC Voices. She also co-founded the Black Girls Mental Health Collective, where she and others work to create safe spaces for Black mothers and provide specialized support for maternal well-being. “It’s nice to get to focus on mom while also helping with attachment,” she noted. Breea’s work within these initiatives underscores her holistic approach to mental health care, combining clinical expertise with community empowerment.In recognition of her leadership and advocacy, Breea received the 2023 Alicia Lieberman Award at the California Association for Infant and Early Childhood Mental Health Conference. Looking ahead, she is enthusiastic about advancing CPP practices in perinatal care for BIPOC communities and expanding community-based supports for FFN childcare providers. She is determined to continue advancing equity in mental health services and empowering care providers, “so that they can be the amazing people that they are for their littles.”
Leader Spotlight
Catherine Wright, Minnesota’s CPP Champion, spearheads statewide initiatives to promote evidence-based practices for young children and families. As the Early Childhood Mental Health System Coordinator at the Department of Human Services (DHS), she leads workforce development, shapes policy, and collaborates with CPP leaders to ensure widespread and sustainable implementation.
“Catherine is committed to covering the state in CPP.”
-Minnesota CPP Leader
Before joining DHS, she worked as a clinician and program manager in several organizations serving young children and families in Minnesota. During this time,
Catherine Wright,
PsyD, LP, LCCC
Minnesota, which gave her first-hand knowledge of the benefits of both the model and the implementation-level training process.
“[CPP training] teaches clinicians on how to do this intervention but also teaches them grounding in development, dyadic work, trauma-informed care…We’ve used it as a way of training our workforce in how you better serve young children and families.”
To secure resources for CPP training and implementation, Catherine leverages program effectiveness data collected from participants to emphasize the benefits of the model. She also works to educate adult-serving systems about the impact of trauma, so they integrate an understanding of their clients’ experiences as young children.Under her coordination, Minnesota state funds have been matched with federal Title V Block Development Grants to pay for statewide CPP training. She lobbied successfully for a bundled Medicaid benefit for highly distressed children under six years of age in foster care that consists of at least six hours per week of CPP per client (with a sustainable client caseload between four and six). She continues to champion the cost savings of EBPs to legislators and agency directors, emphasizing that early interventions are cheaper and less likely to result in long-term treatment. Minnesota now has over 200 rostered providers in large part due to her efforts.Looking ahead, Catherine is advocating for increased Medicaid reimbursements for evidence-based services. Through her work, she is paving the way to better support for Minnesota’s youth as well as their families.
Trainer Spotlight
Jane Ellison
LMFT, IMH-E®
Jane Ellison has been instrumental in bringing CPP to children and families in Minnesota. As a program manager at the Greater St. Cloud Area Thrive, she championed programs promoting healthy socio-emotional development for young children. While in this role, her conviction in the value of CPP prompted her to organize an introductory training with Dr. Chandra Ghosh Ippen for clinicians in her area:
“Considering that all development occurs within the context of relationships, it doesn’t make sense to work with young children without their caregivers.”
In 2011, Jane joined the first CPP implementation-level training held in Minnesota. This cohort–which involved faculty in the University of Minnesota Infant and Early Childhood Mental Health Certificate Program–served as a pilot for CPP in Minnesota and helped shape the state’s CPP dissemination plan.
“It’s really refreshing to have a model that’s really looking at [children aged] birth through five and understanding how trauma and relationships impact them.”
In 2014, Jane was selected by the CPP Dissemination Team and the Minnesota Department of Human Services to become the Minnesota State CPP trainer. Since that time, she has trained 15 cohorts of clinicians in Minnesota and partnered with state IECMH leaders to pilot a CPP sustainability model. The model now involves 12 agency teams across Minnesota that are able to sustain CPP practice. According to Jane, clinicians value CPP for its procedural flexibility and multigenerational lens.To support sustainability and deepen CPP practice across Minnesota, Jane organizes an annual CPP booster session, supports the development of CPP leaders and champions, and holds advanced calls with agency trainers, supervisors, and clinicians. She also works closely with Catherine Wright, the state’s Early Childhood Mental Health Coordinator, to advocate for policies that deepen CPP implementation and sustainability and partners with other systems, including the child welfare system, to develop partnerships that create improved services for families. Thank you, Jane, for your dedication, benevolence, and leadership, and for sharing your wisdom with so many in Minnesota and beyond.
“There is a lot that you learn in the process [of CPP training] that will impact the work you do with young children no matter what model you’re using, because it is so grounded in development, trauma, and working in relationships.”
Honoring Our Angels
Robie Harris inspired the concept of “Angels in the Nursery.” She was a wife, mother, social worker, teacher, children’s book author, and a cherished friend within our CPP community. She passed away on January 6th, 2024, but she remains in our hearts, and many in our field of infant mental health, even without personally knowing her, have benefited from her wisdom.
Robie often credited her beloved mother’s nurturing care with shaping her own love of children. One day as Bill Harris, her husband, observed their son playing with their grandson, he was reminded of how Robie used to play with their son. This reflection on the generational transmission of love – from Robie’s mother to Robie, from Robie to their son, and from their son to their grandson – led Bill to call and ask Alicia a thought-provoking question. “Everybody talks about ghosts in the nursery. Are there also angels in the nursery?” This question sparked the development of “Angels in the Nursery” as a clinical companion to Selma Fraiberg’s “ghosts” – a reminder that love and hope are key ingredients of healing across generations. We are grateful to Robie and Bill for the value of this concept in our work, our field, and for the families we serve.
Robie had a profound appreciation for the magic and wisdom of young children, and she helped others to see the world through their eyes. In her 1967 documentary film, Child’s Eye View, she gave cameras to young children and allowed them to capture their neighborhoods. Throughout the film, we hear her gentle voice asking simple questions, opening doors to the children’s experiences, and helping them to speak the unspeakable. The children filmed pigeons, horses on the streets, buses, traffic, people fighting. They talked about the dangers and inequities in their New York neighborhoods, and Robie listened. Robie helped others recognize what children see and know, highlighting the importance of not leaving them to face these experiences alone.
Child: “The bums.”
Robie: “What do they do?”
Child: “Oh they do plenty. One killed a child once.”
Child: “People get killed a lot on this street.”
Robie: “How do you know that?”
Child: “My brother reads it in the newspaper.’
Child: “I don’t like when people go in our hallway and get drunk… It gets me scared.”
“She had a gift for speaking the language of children — she understood their fears, angers, and longings, and she knew how to translate these huge feelings into child-sized words that spoke both to children and to adults. She really was one of a kind.”
-Alicia Lieberman
Robie’s wisdom and lessons learned live on in the pages of the over 30 children’s books she has written. Her books open the door to important conversations, helping adults support children in feeling their feelings. Here are some examples:
- Anger and Ruptures in Relationships:I’m So Mad; When Lions Roar; The Day Leo Said I Hate You
- New Siblings: Mail Harry to the Moon; Hi New Baby
- Separations: Don’t Forget to Come Back; I Am Not Going to School Today
- Loss: Goodbye Mousie
- Sex, Bodies, Conception, & Birth: It’s Perfectly Normal; It’s not the Stork; Who Has What?; It’s so Amazing
Some of her books address topics that society often considers “unspeakable,” and because of this, there were efforts to “ban” them. However, Robie understood that, to quote Bowlby, children already know what they are not supposed to know. As she put it, “Our kids already know about 99.9 percent of this stuff. What concerned me is that they have a lot of misinformation, no matter how much they tell us, and I wanted them to get accurate information.” Many people agreed with her, as evidenced by the millions of copies sold worldwide. Her books not only give children accurate information but also an opportunity for open dialogue with the adults in their lives about topics that most matter to them. Her books are on our shelves and in our hearts, guiding us and supporting the work we do.So let’s honor Robie, and in true CPP fashion, raise a glass of Scotch to celebrate her enduring legacy and contributions. She is a true angel in our nursery.
Oh, the Places We’ve Gone
A photo of CPP attendees at the Minnesota Association for Infant Mental Health conference in 2023.
As we write this feature, we are thinking of the communities in southern Minnesota enduring loss and hardship from flooding. May they find safety and strength moving forward.
The dissemination of CPP in Minnesota is a testament to the state’s reputation as a trailblazer in infant and early childhood mental health (IECMH) and trauma-informed care. Today, over 200 providers across 78 Minnesotan agencies are rostered in CPP. The state’s regional CPP training model has been built by assiduous champions, established IECMH infrastructure and funding streams, and an incredible community of practice.Jane Ellison and Catherine Wright—the lead CPP state trainer and DHS coordinator for IECMH, respectively—are a dynamic duo for dyadic care. Jane was involved in the state’s first official CPP training organized at the University of Minnesota in 2011. Today, she oversees implementation-level training, mentors regional leaders, and engages with cross-sector partners. Catherine is the conduit between Minnesota’s CPP community and state government. She advocates to policymakers, identifies funding opportunities, and manages statewide data collection. Together, they address challenges to sustainability to improve CPP services for children and families across the state.
“Minnesota is exceptional in its support of CPP.”
-State CPP leader
The growth of CPP in Minnesota benefitted not only from steadfast champions but also from the state’s robust IECMH infrastructure. University of Minnesota—which has run a longitudinal study of parents and children since 1975 and currently offers a graduate certificate in IECMH—partnered with the Harris Fund to sponsor the first CPP cohort in 2011. Later, DHS sponsored 50 system and agency leaders to attend a CPP Learning Collaborative. The state continues to fund training for certain experienced providers who plan to be rostered and see clients on Medicaid. Catherine Wright noted that “Thinking from a state perspective, we want to make sure that we have a workforce that can meet the needs of our families.”
This funding for this workforce development comes from the state budget and a federal behavioral health block grant. These funding streams—$1 million and $1.5 million, respectively—sustain IECMH training, consultation, and select clinical services, including CPP. Additionally, a one-time federal allocation from the COVID Relief Act was used to sponsor 20 BIPOC, Spanish-speaking, or American Sign Language clinicians to train in CPP.Looking ahead, Minnesota remains committed to CPP dissemination and sustainability. The successes of its CPP implementation highlight the North Star State’s collaborative and forward-thinking strategy in trauma-informed care.
The Road Ahead
Expansion Learning Collaborative
The Child Trauma Research Program is thrilled to announce an upcoming Expansion CPP Learning Collaborative (LC), starting in January 2025. Led by CPP Trainer Phillip Stepka, PsyD, and Adriana Bowen, LMHC, IMR-E, this training aims to expand the reach of CPP in rural states with limited capacity, specifically targeting Montana, Idaho, Wyoming, North Dakota, and South Dakota. By joining the Expansion CPP LC, agencies will have the opportunity to increase their capacity to provide trauma treatment services to children and families and contribute to the long-term sustainability of CPP in their respective regions. Thanks to the generous support of the Substance Abuse and Mental Health Administration as part of the National Child Traumatic Stress Network, this training is provided free of charge for qualified agency teams. Over fifty agency teams from 25 states have expressed interest, and we look forward to continuing to expand CPP in other states in the future.
CPP State Policy Features
The Dissemination Team is excited to announce the launch of our CPP State Policy Features. Our first round includes Arkansas, Minnesota, and New Hampshire. Each feature explores a state with a robust CPP dissemination system and offers a top-level summary into the history, infrastructure, and lessons learned for advancing CPP through policy. The goal of the series is to celebrate the efforts of state CPP leaders and offer guidance for advocacy in other states.Check out this webpage to explore the series–next up are Oklahoma, New Mexico, and Washington.
Gratitude
New Hampshire State Senator Rebecca Whitley is a true champion of children and families in the Granite State. She has partnered with CPP leaders in New Hampshire to recast data on health outcomes and implementation into an intentional, effective policy strategy. Together with local foundations, and advocacy organizations, Senator Whitley was instrumental in the passage of Senate Bill 444, which allocated approximately $700,000 for the dissemination of CPP across the state. She also testified before state congress on the potential for CPP to advance New Hampshire’s system of care for children who have experienced trauma. Thank you, Senator Whitley, for your conviction and acuity in bringing CPP to those who need it most.
Senator Whitley and her family