Outcomes of Therapy in High Risk Mother-Child Dyads in Which There is Active Maltreatment and Severely Disturbed Child Behaviors

Parallel Parent and Child Therapy (PPACT) is an attachment-based therapy for mother-child dyads in which there is significant relationship breakdown and histories of relational trauma. Research on PPACT has focused on its application with high risk mother-child dyads where the child presents with disturbed behaviors and where there are multiple risk factors for maltreatment, including unresolved parental history of childhood maltreatment and parental mental illness (Chambers, Amos, Allison, & Roeger, 2006; Amos, Furber, & Segal, 2011; Amos, Beal, & Furber, 2007). This paper presents outcomes for six consecutive cases treated over a five-year period where multiple types of assessment, including standardized instruments and interviews, were employed. Four of the six cases showed lasting improvements for the child, the mother, or both, evidenced by remission of psychiatric symptoms and parental reports of improved social and family outcomes. This early evidence suggests the PPACT model has promise in the treatment of high risk mother-child dyads and that the processing of relational trauma may be central to its impact.