Creating Unbreakable Bonds: ABC's Child-Parent Psychotherapy Program

What if parents and children in families most at risk for child abuse, neglect, and trauma formed healthy, unbreakable attachments?

Photo of Hannah Bernard
2 4

Written by

Founding Story: Share a story about a key experience or spark that helps the network understand why this project got started or a story about how you became inspired about the potential for this project to succeed.

For two decades, ABC’s All Children’s House has provided families at risk of losing children to foster care with the tools and support needed to break the cycles of abuse and neglect and promote long-term stability. The vast majority of families coming through ABC’s doors have experienced immense and compounded stressors and trauma in their lives – be it domestic violence, community violence, abuse, neglect, loss, abandonment, homelessness, transience, or the sort of abject poverty that results in constant struggle and an incessant level of insecurity suffered on a daily basis. Trauma is particularly harmful to very young children because of the long-term consequences that the sustained stress response to trauma can have on physical and brain development, impacting a child’s later ability to learn, to love, to trust, to take risks, and to maintain executive functioning even in times of elevated stress and distress. In an effort to mitigate the effects of abuse, trauma, and poverty on the youngest children, ABC launched a trauma-informed Child-Parent Psychotherapy model in 2013 within the context of its child abuse and neglect prevention program, All Children’s House, in the hope of significantly improving the outcomes for children ages 0-5, who are at the most serious risk of child maltreatment.

Which categories describe you? (the answer will not be public)

  • Asian (for example: Chinese, Filipino, Indian, Vietnamese, Korean, Japanese, Pakistani)
  • Black or African American (for example: African American, Jamaican, Haitian, Nigerian, Ethiopian, Somalian)
  • Hispanic, Latinx, or Spanish origin (for example: Mexican, Puerto Rican, Cuba, Salvadoran, Dominican, Colombian)
  • Middle Eastern or North African (for example: Lebanese, Iranian, Egyptian, Syrian, Moroccan, Algerian)
  • White (for example: German, Irish, English, Italian, Polish, French, Caucasian)

Website

www.a-b-c.org

Location: Where is your organization headquartered? [State]

  • New York

Location: Where is your organization headquartered? [City]

New York City

Location: Where is your project primarily creating impact? [State]

  • New York

Location: Where is your project primarily creating impact? [City]

ABC works with underprivileged children and families throughout New York City, with a particular focus on those living in East Harlem and the South Bronx, historically marginalized communities. East Harlem and the South Bronx have two of the highest poverty rates in New York City, with roughly half of all children under the age of 18 living in households with incomes below the Federal Poverty Level (48% in East Harlem; 52% in the South Bronx).

Problem: What problem is this project trying to address?

Children in East Harlem and the South Bronx suffer from disproportionately higher incidents of abuse, neglect, and violence in and outside the home, creating an immense need for comprehensive support. While the system of care for children who have been or are at risk of maltreatment is extensive in New York City, the rates of maltreatment recurrence (at 24% for infants and toddlers and 18% for preschoolers) indicate that there is much room for improvement. As a pioneering initiative, ABC’s Child Parent Psychotherapy (CPP) based child abuse prevention program serves as a blueprint for raising the standard of child welfare programming across the country by incorporating evidence-based treatments to address the often intractable and recurring phenomena of family violence, child maltreatment, and inter-generational abuse and neglect.

Child-Parent Psychotherapy (CPP) is one of the few empirically supported treatments for young children who are victims of trauma, be it in the form of domestic violence, community violence, abject poverty, sudden displacement, severe loss, or child abuse. In a number of rigorous empirical tests, CPP has been shown to lessen the risk factors of children in a diverse range of populations, including behavior and aggression problems  and developmental disabilities, therefore making those children less susceptible to abuse and neglect. Studies have also shown the success of CPP in abating child maltreatment, citing improvement in children’s relationship representations and attachment styles — which is important to maintaining a positive relationship with parents — as well as decreases in mothers' tendencies to abuse or neglect their children.

Association to Benefit Children (ABC) All Children's House CPP Preventive Services program focuses on developing and strengthening secure parent-child attachment by providing clinically intensive CPP to impoverished families with children under the age of six who have experienced trauma or abuse and are at the greatest risk of morbidity and mortality. CPP is delivered in the home by highly trained, licensed clinicians. CPP therapists utilize play therapy, psychotherapy, and relational therapy while providing psycho-education to the parent, expressing how vitally important emotional attachment and responsiveness is for very young children as their infant brains develop the architecture for lifelong learning and health. As a result of the primary attachments formed during CPP treatment, a child may have an easier time building other strong attachments in the future, contributing to that child's sense of belonging and self-worth. ABC's goal is to discharge families from the CPP program with the tools they need to forever remain stable, resilient, and united. 

ABC All Children's House is the only preventive services program in New York City to fully convert its entire preventive services program to this trauma-informed, therapeutic model that calls for a balance between a family’s therapeutic and concrete needs. As ABC has seen such a positive impact on families after participation in the program, it is opening a new CPP program center in the South Bronx, a community in dire need. It is ABC’s hope that other organizations in New York City and across the country will replicate this innovative model, incorporating evidence-based treatments to address the often intractable and recurring phenomena of family violence, child maltreatment, and inter-generational abuse and neglect. 

Is your model focused on any of the following traditionally underserved communities?

  • Communities of color
  • Low-income communities

Does your model work within any of the following sectors?

  • Child and Family Services
  • Mental Health

Year Founded

2013

Project Stage

  • Growth (the pilot has already launched and is starting to expand)

Example: Walk the network through a specific example of what happens when a person or group engages with your solution.

Through CPP, a struggling mom was able to learn that her children were very affected by her own behaviors and reactions. In the CPP program, she worked on controlling her own anger and frustration so that she could better tend to her children’s needs. Over the course of her treatment, her son became more comfortable sharing his experiences and concerns. With her son's ability to share his feelings, Mom felt more empowered to process family events with him and to reinforce that he could feel safe. Due to CPP, this mom has become more engaged with her children’s feelings and has sharpened her ability to recognize her own emotional needs. Both mom and son are now more resilient, which will protect the entire family from future harm and trauma.

Impact: What was the impact of your work last year? Please also describe the projected future impact for the coming years.

Families made significant gains in child health and well-being (69%), parent health and well-being (80%), family relationships (75%), and self-sufficiency and advocacy (54%). Improvements in these areas are encouraging, as they embody the goal of CPP. Overall, 95% of all families who have completed ABC's CPP program have improved their general risk profile in at least one area. As well, almost all of the families (91%) made progress toward their goals before discharge. As far as client satisfaction, all families rated the overall program as excellent (68%) or good (32%). In the future, at-risk families all over New York City will continue to build strong attachments and lower their risk of trauma, abuse, and neglect.

Organization Type

  • nonprofit/NGO/citizen sector

Annual Budget

  • over $5mil

Financial Sustainability Plan: What is your solution’s plan to ensure financial sustainability?

To ensure financial sustainability, ABC will continue to apply for private grants and cultivate private funders to supplement public funds distributed by the government. Also, through sharing the success of this innovative model, including hosting public forums, presenting at conferences, writing articles, and presenting to congressional staff, ABC hopes to inspire ongoing public investment and increased private support for its crucial services.

Unique Value Proposition: How else is this problem being addressed? Are there other organizations working in the same field, and how does your project differ from these other approaches?

ABC was the first organization selected by New York City Administration for Children's Services to provide CPP in a child welfare setting, and is currently the only program in New York City to fully convert its entire preventive services program to this trauma-informed, therapeutic model. As ABC has seen such a positive impact on families after participation in the program, it is opening a new CPP program center in the South Bronx, a community in dire need. It is ABC’s hope that other organizations in New York City and across the country will replicate this innovative model.

Reflect on the Field and its Future: Stepping outside of your project, what do you see as the most important or promising shifts that can advance children’s wellbeing?

The child welfare system in New York City is acknowledging that it has not successfully decreased the prevalence of child maltreatment with the current prevention strategies in place. Now, there is an intentional push to use treatment and intervention modalities that have been proven to have promise in reducing the risk of child abuse and neglect. CPP is the evidence-based modality that shows the most promise in reducing the risk among 0-5 year olds, the most fragile age group. The acceptance of and excitement about CPP is a promising step taken by the child welfare system.

Source: How did you hear about the Children’s Wellbeing Challenge? (the answer will not be public)

  • Email
  • Word of mouth

Program Design Clarity

Primary clients are families with children under 6 living in East Harlem and the South Bronx who have come to the attention of local child welfare authorities for concerns related to the risk of child abuse and neglect. Highly trained, licensed CPP therapists visit the parent and their child at least once weekly in their home or shelter over the course of at least one year and provide a combination of play therapy, psychotherapy, and relational therapy, psycho-education on emotional attachment and early brain development, and case management services as needed.

Community Leadership

ABC conducts a large-scale annual assessment where all ABC client families, past and present, are invited to provide input and feedback on all aspects of the program, informing planning for the subsequent year’s programming. Clients have opportunities to build their leadership through participating in community meetings, applying to become community advocates for other families, and participating in an annual meeting of ABC’s governing board.

Age of Children Impacted

  • Pregnancy - 0
  • 0-1.5
  • 1.5 -3
  • 3 - 5

Spread Strategies

As a pioneering initiative, ABC’s CPP-based child abuse prevention program serves as a blueprint for raising the standard of child welfare programming across the country. ABC has made it a priority to share this innovative model with other stakeholders, including through hosting public forums, presenting at child welfare conferences, writing articles in scientific journals and publications, and presenting to congressional staff.

Reflect on how your work helps children to thrive. How are you cultivating children’s sense of self, belonging, and purpose through your model?

The goal is to help create a secure, emotionally grounded attachment between parent and child early in life which will help a child feel secure for the rest of his or her life. With this crucial sense of safety, children can develop emotional well-being, positive self-esteem, and increased cognitive functioning, laying the groundwork for improved school performance and the formation of lasting positive relationships with family members and peers.

Leadership Story

ABC’s Founder and Executive Director, Gretchen Buchenholz, founded ABC in 1986 with the mission of defending the right of every child to a safe, permanent home, ample food, and a nurturing family. In response to the ever-changing complications of children’s poverty, ABC has urgently updated, expanded, and added to its programs, intervening as early as possible and realizing a “whole family” approach. In response to the urgent need of families facing severe and repeated trauma, ABC embarked on this innovative initiative in 2012 to raise the standard of child welfare programming.

Organization’s Facebook Page (URL)

https://www.facebook.com/assoctobenefit/

Evaluation results

4 evaluations so far

1. Relevance: Does this project seem to help children (ages 0 to 12 years) develop a strong sense of self, belonging, and purpose?

5 - Yes, this is great! The project lays out a strong, compelling case for how its model nurtures children’s wellbeing. - 50%

4 - It seems like a good fit, and the model talks explicitly about children’s wellbeing. - 50%

3 - I think so. The project seems related to children’s wellbeing, but the logic is vague. - 0%

2 - Not sure. The project doesn’t have much to do with wellbeing, or it doesn’t give enough information. - 0%

1 - Nope, this project definitely doesn’t fit the challenge brief (e.g., It doesn’t help kids younger than 12, isn’t in the U.S., etc.) - 0%

2. Innovation: Does this project tackle children’s wellbeing from a new angle?

5 - I loved this! The project describes a novel model that addresses important cultural or systemic barriers. - 25%

4 - This is pretty cool. The project is addressing an important problem in a new or compelling way. - 75%

3 - I feel like there’s something there, but I want more details about what makes it distinctive. - 0%

2 - It’s a good project, but I’ve seen others like it before. - 0%

1 - It was confusing or hard to tell what it made it different. - 0%

3. Social Impact: What is this project’s potential for creating positive social impact?

5 - Lots of potential. This project is achieving impressive results, and it’s growing quickly. It could absolutely inspire changes in the ways we approach caring for kids nationally, across sectors (e.g. childcare, healthcare, education). - 25%

4 - Pretty good potential. This project demonstrates significant positive impact so far, and it could scale regionally or nationally one day and fundamentally change how a system operates (e.g. childcare, healthcare, education). - 50%

3 - Budding potential. This project is creating local impact, but it would take a few adjustments before it could scale. - 25%

2 - Some potential. This project demonstrates some initial positive impact, but it would require major changes before it could scale. - 0%

1 - Limited potential. This project has great intentions, but it looks like it does not include key drivers of a shift towards children’s wellbeing. - 0%

4. Overall, how do you feel about this idea?

5 - This idea rocked my world. It’s awesome! - 25%

4 - This idea seems really exciting. With a little more polishing, it’d be among my favorites. - 75%

3 - I think the idea is great, but it needs some work before it moves onto the next round. - 0%

2 - I liked it fine but preferred others. - 0%

1 - It didn’t make my heart beat faster. Needs significant revisions. - 0%

5. Offer some feedback. Where should this participant spend some time revising?

DEFINING THE PROBLEM. Make sure to articulate the root causes or main barriers of the social issue your project addresses. (Founding Story, Problem, Solution). - 0%

CLARITY OF MODEL. Make sure to mention (a.) the beneficiary, b) the main activities, and c) how those activities drive social impact. Keep it streamlined! - 50%

MARKETPLACE. Make sure to research other players in this space and articulate how this project is different. I didn’t get a complete sense of how this project compares to others. - 0%

IMPACT POTENTIAL. Make sure to use specific numbers to describe what your project has achieved so far! And consider how you might scale the model or its insights, through partnerships, trainings, or franchising. - 50%

WRITING STYLE. Try to stay concise and make it vivid. Avoid jargon. - 50%

Nothing stands out! I thought it was great. - 100%

2 comments

Join the conversation:

Comment
Photo of Charlotte Stites
Team

Sounds like great work. So important. So time consuming. I'm glad that you have found funding and supporters to continue and expand upon your work.

Photo of Hannah Bernard
Team

Thank you, Charlotte Stites! We appreciate it.