Child-Parent Relationship Therapy

Mental Health Promising

Child-Parent Relationship Therapy (CPRT), an adaptation of Child-Centered Play Therapy (CCPT), is designed for parents of children ages 2–10 who are experiencing social, emotional, and relational disorders. CPRT aims to strengthen the parent-child relationship. CPRT helps parents learn to respond more effectively to their children’s emotional and behavioral needs and to understand and accept their child. CPRT teaches parents CCPT skills to help them connect with their children through play and child-centered principles, including unconditional acceptance, recognizing and reflecting the child’s feelings, respect for the child’s ability to solve problems, and establishing a feeling of permissiveness in the relationship.

 

A therapist delivers CPRT to parents in a series of 10 weekly structured group sessions. Session structure follows the 3 Ds: Describe, Demonstrate, Do. In each session, the therapist describes a skill and then demonstrates it through video and live modeling. Next, parents practice with each other through role play. Between sessions, parents complete a homework assignment practicing the skills from the previous session. 

 

During CPRT sessions 1–3, the therapist introduces parents to CCPT concepts. Skills taught in these three sessions prepare parents for weekly at-home play sessions with their child. Parents implement the 30-minute play session in weeks 4–10, just before the CPRT group session. The play sessions take place at home with the child. If both parents are participating in CPRT, they each can conduct play sessions with a different child or hold separate weekly 30-minute play sessions with the same child.  

 

During CPRT sessions 4–9, parents share their play session experiences and have the chance to role play to address questions that arise. One or two parents share a video of their recent play session and receive feedback from the therapist and other group members. Following the discussion about play sessions, therapists continue to teach parents new skills and parents practice through role play. 

 

During session 10, parents discuss how child behaviors have changed, how they themselves have changed, and evaluate their experience as they prepare to transition out of the program. 


CPRT is rated as a promising practice because at least one study achieved a rating of moderate or high on study design and execution and demonstrated a favorable effect on a target outcome.

 

A re-review of a study of CPRT was conducted in July 2023 due to an error wherein a particular study was incorrectly included in the list of studies reviewed. To correct this error, Study 12915 (Su, 2016) has been removed from CPRT. Study 12851 (Bratton, 1995) has been added to the list of studies for CPRT. The re-review did not affect the program or service rating.


Date Research Evidence Last Reviewed: Jul 2023


Sources

The program or service description, target population, and program or service delivery and implementation information were informed by the following sources: the program or service manuals, the program or service developer’s website, and the studies reviewed.


This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.

Target Population

CPRT is designed for parents of children ages 2–10 who are experiencing social, emotional, behavioral, and relational disorders. 

Dosage

Therapists deliver CPRT to groups of 6–8 parents in 10 weekly, 2-hour sessions. CPRT includes 30-minute at-home parent-child play sessions before group sessions 4–10. CPRT can also be delivered in an individual family format or in an intensive format where session content is delivered more frequently.

Location/Delivery Setting
Recommended Locations/Delivery Settings

CPRT is delivered in a clinical setting. 

Location/Delivery Settings Observed in the Research

  • Mental Health Center, Treatment Center, Therapist Office

Education, Certifications and Training

Certified CPRT practitioners must be licensed mental health professionals and must also be certified in CCPT. CPRT therapists must have at least a master’s degree in a mental health field. 

CPRT practitioners must (1) complete a minimum of 24 hours of coursework in the CPRT model, (2) complete the CPRT Certification Exam, (3) complete three supervised CPRT groups with at least 8 hours of supervision per group, and (4) complete a cumulative self-evaluation paper. Therapists must renew CPRT certification every 5 years.  

Certified CPRT Practitioners may complete additional steps to become a Certified Advanced CPRT Practitioner/Supervisor. Supervisors must (1) complete a workshop on CPRT supervision, (2) complete two additional CPRT groups under supervision, (3) supervise eight 1-hour sessions for a beginning CPRT practitioner, (4) complete a self-evaluation paper, and (5) complete educational and exam components. 

Individuals without a mental health license may become certified as a CPRT Associate/Parent Educator. With this certification, they can use the content of the CPRT manual but cannot conduct the full protocol. This certification requires prior training in CCPT and completion of a CPRT workshop series. 

Program or Service Documentation
Book/Manual/Available documentation used for review

The Child-Parent Relationship Therapy: An evidence-based 10-session filial therapy model manual is implemented in conjunction with the Child-Parent Relationship Therapy Treatment Manual.

Landreth, G. L., & Bratton, S. C. (2020). Child-Parent Relationship Therapy: An evidence-based 10-session filial therapy model (2nd ed.). Routledge. 

Bratton, S., & Landreth, G. L. (2020). Child-Parent Relationship Therapy treatment manual: An evidence-based 10-session filial therapy model (2nd ed.). Routledge.

Available languages

CPRT materials are available in English, Chinese, Japanese, Korean, and Spanish. 

Other supporting materials

CPRT Overview

CPRT Certification

CCPT Certification

Landreth, G. L. (2012). Play therapy: The art of the relationship (3rd ed.). Routledge.

For More Information

Website: https://cpt.unt.edu/child-parent-relationship-therapy

Phone: (940) 565-3864

Email: cpt@unt.edu


Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.

Results of Search and Review Number of Studies Identified and Reviewed for Child-Parent Relationship Therapy
Identified in Search 32
Eligible for Review 18
Rated High 4
Rated Moderate 1
Rated Low 13
Reviewed Only for Risk of Harm 0

Outcome Effect Size Effect Size more info
and Implied Percentile Effect Implied Percentile Effect more info 		N of Studies (Findings) N of Participants Summary of Findings
Child well-being: Behavioral and emotional functioning 1.11
36 		4 (8) 138 Favorable: 4
No Effect: 4
Unfavorable: 0
Adult well-being: Positive parenting practices 1.85
46 		2 (2) 72 Favorable: 1
No Effect: 1
Unfavorable: 0
Adult well-being: Parent/caregiver mental or emotional health 4.45
49 		1 (3) 32 Favorable: 3
No Effect: 0
Unfavorable: 0
Adult well-being: Family functioning 0.82
29 		2 (2) 81 Favorable: 2
No Effect: 0
Unfavorable: 0

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group.

Outcome Effect Size Effect Size more info
and Implied Percentile Effect Implied Percentile Effect more info 		N of Studies (Findings) N of Participants Summary of Findings Months after treatment
when outcome measured Months after treatment when outcome measured more info
Child well-being: Behavioral and emotional functioning 1.11
36 		4 (8) 138 Favorable: 4
No Effect: 4
Unfavorable: 0
 -
Study 12867 - Filial Child-Parent Relation Therapy (CPRT) vs. No Training Control (Ebrahimi, 2019)
Children's Depression Inventory 5.63 *
49 		- 32 - 0
Study 12890 - Filial Therapy (CPRT) vs. No Treatment Control Group (Mirzaie, 2019)
Test of Everyday Attention for Children 1.90 *
47 		- 34 - 0
Test of Everyday Attention for Children 1.71 *
45 		- 34 - 3
Child Symptom Inventory – 4, Teacher: Hyperactivity 0.36
14 		- 34 - 0
Child Symptom Inventory – 4, Teacher: Hyperactivity 0.32
12 		- 34 - 3
Study 12893 - CPRT vs. Treatment As Usual Control (Opiola, 2018)
Child Behavior Checklist: Total Problems 0.66 *
24 		- 49 - 0
Study 12921 - Filial Therapy (CPRT) vs. Waitlist Control Group (Tew, 2002)
Child Behavior Checklist: Total Problems 0.81
29 		- 23 - 0
Child Behavior Checklist: Anxious/Depressed 0.73
26 		- 23 - 0
Adult well-being: Positive parenting practices 1.85
46 		2 (2) 72 Favorable: 1
No Effect: 1
Unfavorable: 0
 -
Study 12893 - CPRT vs. Treatment As Usual Control (Opiola, 2018)
Measurement of Empathy in Adult-Child Interaction 2.91 *
49 		- 49 - 0
Study 12921 - Filial Therapy (CPRT) vs. Waitlist Control Group (Tew, 2002)
Porter Parental Acceptance Scale 0.70
25 		- 23 - 0
Adult well-being: Parent/caregiver mental or emotional health 4.45
49 		1 (3) 32 Favorable: 3
No Effect: 0
Unfavorable: 0
 -
Study 12867 - Filial Child-Parent Relation Therapy (CPRT) vs. No Training Control (Ebrahimi, 2019)
Depression Anxiety Stress Scales – 21, Persian: Depression 4.80 *
49 		- 32 - 0
Depression Anxiety Stress Scales – 21, Persian: Anxiety 3.39 *
49 		- 32 - 0
Depression Anxiety Stress Scales – 21, Persian: Stress 5.17 *
49 		- 32 - 0
Adult well-being: Family functioning 0.82
29 		2 (2) 81 Favorable: 2
No Effect: 0
Unfavorable: 0
 -
Study 12885 - Filial Therapy (CPRT) vs. Routine Treatment Control (Kiyani, 2020)
Parenting Stress Index – Short Form 0.85 *
30 		- 32 - 0
Study 12893 - CPRT vs. Treatment As Usual Control (Opiola, 2018)
Parenting Stress Index – Fourth Edition 0.80 *
28 		- 49 - 0

*p <.05

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications.

Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.

Full citations for the studies shown in the table are available in the "Studies Reviewed" section.

Sometimes study results are reported in more than one document, or a single document reports results from multiple studies. Studies are identified below by their Prevention Services Clearinghouse study identification numbers. To receive a rating of supported or well-supported, the favorable evidence for a program or service must have been obtained from research conducted in a usual care or practice setting.

Studies Rated High

Study 12893

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. https://doi.org/10.1002/jcad.12189

Study 12890

Mirzaie, H., Mehraban, A. H., Hosseini, S. A., Fard, F. G., & Oori, M. J. (2019). Comparison of the effect of filial and Adlerian play therapy on attention and hyperactivity of children with attention deficit hyperactivity disorder: A randomized clinical trial. Iranian Rehabilitation Journal, 17(4), 341-350. https://doi.org/10.32598/irj.17.4.341

Study 12885

Kiyani, Z., Mirzai, H., Hosseini, S. A., Sourtiji, H., Hosseinzadeh, S., & Ebrahimi, E. (2020). The effect of filial therapy on the parenting stress of mothers of children with autism spectrum disorder. Archives of Rehabilitation, 21(2), 206-219. https://doi.org/10.32598/RJ.21.2.2726.1

Study 12867

Ebrahimi, E., Mirzaie, H., Saeidi Borujeni, M., Zahed, G., Akbarzadeh Baghban, A., & Mirzakhani, N. (2019). The effect of filial therapy on depressive symptoms of children with cancer and their mother's depression, anxiety, and stress: A randomized control trial. Asian Pacific Journal of Cancer Prevention, 20(10), 2935-2941. https://doi.org/10.31557/apjcp.2019.20.10.2935


Studies Rated Moderate

Study 12921

Tew, K., Landreth, G. L., Joiner, K. D., & Solt, M. D. (2002). Filial therapy with parents of chronically ill children. International Journal of Play Therapy, 11(1), 79-100. https://doi.org/10.1037/h0088858


Studies Rated Low

Study 12851

Bratton, S., & Landreth, G. (1995). Filial therapy with single parents: Effects on parental acceptance, empathy, and stress. International Journal of Play Therapy, 4(1), 61-80. https://doi.org/10.1037/h0089142

This study received a low rating because it did not meet design confound standards.
Study 12884

Kidron, M., & Landreth, G. (2010). Intensive Child Parent Relationship Therapy with Israeli parents in Israel. International Journal of Play Therapy, 19(2), 64-78. https://doi.org/10.1037/a0017516

This study received a low rating because it did not meet design confound standards.
Study 12855

Ceballos, P. L., & Bratton, S. C. (2010). Empowering Latino families: Effects of a culturally responsive intervention for low-income immigrant Latino parents on children's behaviors and parental stress. Psychology in the Schools, 47(8), 761-775. https://doi.org/10.1002/pits.20502

This study received a low rating because it did not meet design confound standards.
Study 12863

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. https://doi.org/10.1037/h0089427

This study received a low rating because it did not meet design confound standards.
Study 12883

Kale, A. L., & Landreth, G. L. (1999). Filial therapy with parents of children experiencing learning difficulties. International Journal of Play Therapy, 8(2), 35-56. https://doi.org/10.1037/h0089430

This study received a low rating because it did not meet design confound standards.
Study 12887

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(2), 157-165. https://doi.org/10.1002/j.1556-6676.19

This study received a low rating because it did not meet design confound standards.
Study 12876

Harris, Z. L., & Landreth, G. L. (1997). Filial therapy with incarcerated mothers: A five week model. International Journal of Play Therapy, 6(2), 53-73. https://doi.org/10.1037/h0089408

This study received a low rating because it did not meet design confound standards.
Study 12928

Yuen, T., Landreth, G., & Baggerly, J. (2002). Filial therapy with immigrant Chinese families. International Journal of Play Therapy, 11(2), 63-90. https://doi.org/10.1037/h0088865

This study received a low rating because it did not meet design confound standards.
Study 12854

Carnes-Holt, K., & Bratton, S. C. (2014). The efficacy of Child Parent Relationship Therapy for adopted children with attachment disruptions. Journal of Counseling & Development, 92(3), 328-337. https://doi.org/10.1002/j.1556-6676.2014.00160.x

This study received a low rating because it did not meet design confound standards.
Study 12888

Lee, M. K., & Landreth, G. L. (2003). Filial therapy with immigrant Korean parents in the United States. International Journal of Play Therapy, 12(2), 67-85. https://doi.org/10.1037/h0088879

This study received a low rating because it did not meet design confound standards.
Study 12910

Sheely, A. I., & Bratton, S. C. (2010). A strengths-based parenting intervention with low-income African American families. Professional School Counseling, 13(3), 175-183. https://doi.org/10.1177/2156759X1001300305

This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.
Study 12857

Chau, I. Y. F., & Landreth, G. L. (1997). Filial therapy with Chinese parents: Effects on parental empathic interactons, parental acceptance of child and parental stress. International Journal of Play Therapy, 6(2), 75-92. https://doi.org/10.1037/h0089409

This study received a low rating because it did not meet design confound standards.
Study 13043

Glover, G., & Landreth, G. L. (2000). Filial therapy with Native Americans on the Flathead Reservation. International Journal of Play Therapy, 9(2), 57-80. https://psycnet.apa.org/doi/10.1037/h0089436

This study received a low rating because it did not meet design confound standards.


Studies Not Eligible for Review

Study 12840

Ashori, M., & Karimnejad, R. (2021). The effect of filial therapy on the interaction of deaf mothers with their hearing children. International Journal of Play Therapy, 30(3), 195-205. https://doi.org/10.1037/pla0000161

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 12841

Baggerly, J., & Landreth, G. L. (2001). Training children to help children: A new dimension in play therapy. Peer Facilitator Quarterly, 18(1), 6-14.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 12853

Carnes-Holt, K. (2012). Child-Parent Relationship Therapy for adoptive families. Family Journal, 20(4), 419-426. https://doi.org/10.1177/1066480712451242

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 12856

Ceballos, P. L., Lin, Y.-W., Bratton, S. C., & Lindo, N. (2019). Effects of parenting programs on Latina mothers' parental stress and their children's internalizing behavioral problems. Journal of Child & Adolescent Counseling, 5(1), 73-88. https://doi.org/10.1080/23727810.2018.1556983

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 12862

Cornett, N., & Bratton, S. C. (2014). Examining the impact of Child Parent Relationship Therapy (CPRT) on family functioning. Journal of Marital and Family Therapy, 40(3), 302-318. https://doi.org/10.1111/jmft.12014

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 12865

Dillman Taylor, D., Purswell, K., Lindo, N., Jayne, K., & Fernando, D. (2011). The impact of Child Parent Relationship Therapy on child behavior and parent-child relationships: An examination of parental divorce. International Journal of Play Therapy, 20(3), 124-137. https://doi.org/10.1037/a0024469

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 12866

Draper, K., Siegel, C., White, J., Solis, C. M., & Mishna, F. (2009). Preschoolers, Parents, and Teachers (PPT): A preventive intervention with an at risk population. International Journal of Group Psychotherapy, 59(2), 221-242. https://doi.org/10.1521/ijgp.2009.59.2.221

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 12873

Goetze, H., & Grskovic, J. A. (2009). The effects of peer-facilitated filial therapy: A play tutor approach. Person-Centered and Experiential Psychotherapies, 8(4), 282-298. https://doi.org/10.1080/14779757.2009.9688494

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 12875

Grskovic, J. A., & Goetze, H. (2008). Short-term filial therapy with German mothers: Findings from a controlled study. International Journal of Play Therapy, 17(1), 39-51. https://doi.org/10.1037/1555-6824.17.1.39

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 12878

Hosseini, N., Akhoundzadeh, G., & Hojjati, H. (2022). The effect of Child-Parent Relationship Therapy on social skills of preschool children: A semi-experimental study. International Journal of Adolescent Medicine and Health, 34(3). https://doi.org/10.1515/ijamh-2019-0151

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 12879

Jang, M. (2000). Effectiveness of filial therapy for Korean parents. International Journal of Play Therapy, 9(2), 39-56. https://doi.org/10.1037/h0089435

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 12881

Jones, L., Rhine, T., & Bratton, S. (2002). High school students as therapeutic agents with young children experiencing school adjustment difficulties: The effectiveness of a filial therapy training model. International Journal of Play Therapy, 11(2), 43-62. https://psycnet.apa.org/doi/10.1037/h0088864

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 12904

Robinson, J., Landreth, G., & Packman, J. (2007). Fifth-grade students as emotional helpers with kindergartners: Using play therapy procedures and skills. International Journal of Play Therapy, 16(1), 20-35. https://doi.org/10.1037/1555-6824.16.1.20

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 12922

Topham, G. L., Wampler, K. S., Titus, G., & Rolling, E. (2011). Predicting parent and child outcomes of a filial therapy program. International Journal of Play Therapy, 20(2), 79-93. https://doi.org/10.1037/a0023261

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).