A considerable proportion of children exposed to adversities and trauma are under six years old, yet most trauma-focused treatment methods target older children and adolescents. Child–Parent Psychotherapy (CPP) is one of few interventions designed for traumatized children under six, focusing on the child–caregiver relationship as the foundation for recovery. This doctoral thesis aimed to evaluate CPP outcomes and experiences in a Swedish naturalistic clinical context. Study I examined caregiver experiences and how CPP meets the demands for dissemination in Sweden. Study II evaluated the impact of CPP on general psychological symptoms and post-traumatic stress in children, caregivers, and caregivers’ perceptions of their relationship with their child. Study III explored the long-term effects of CPP and potential predictors of outcomes. The overall findings were positive. The caregivers reported high satisfaction with CPP, and the intervention was practical to implement. Reductions in general psychological symptoms and post-traumatic stress were observed in both children and caregivers. Caregivers also reported improved abilities to manage their child’s behavior and a noticeable reduction in signs of disorganized caregiving. The results were sustained at follow-up. One potential predictor identified was that higher levels of child trauma symptoms were associated with a smaller reduction in caregiver trauma symptoms. The results align with international studies, demonstrating CPP’s effectiveness in reducing symptoms and improving child-caregiver relationships. Additionally, the findings highlight CPP’s sustainability in a naturalistic clinical setting in a new culture, indicating its promise for wider dissemination in Sweden. Considering a relatively small sample size and lack of control group, a Swedish RCT is needed to further investigate the effectiveness of CPP.

En betydande andel av de barn som drabbas av påfrestningar och trauma är under sex år, men de flesta traumafokuserade behandlingsmetoderna riktar sig till äldre barn och ungdomar. Child–Parent Psychotherapy (CPP) är en av få interventioner som är utformad för traumatiserade barn under sex år och som fokuserar på relationen mellan barn och omvårdnadsperson som grund för återhämtning. Denna avhandling syftade till att utvärdera effektiviteten hos och erfarenheterna av CPP i en svensk naturalistisk klinisk kontext. Studie I undersökte omvårdnadspersoners erfarenheter av CPP och hur metoden möter kraven för spridning i Sverige. Studie II utvärderade CPP:s inverkan på generella psykologiska symptom och posttraumatisk stress hos barn och omvårdnadspersoner, samt omvårdnadspersoners uppfattning om relationen till sitt barn. Studie III utforskade de långsiktiga effekterna av CPP och potentiella prediktorer för utfall. Resultaten var överlag positiva. Omvårdnadspersonerna rapporterade hög tillfredsställelse med CPP, och interventionen visade sig vara praktiskt genomförbar. Minskningar av generella psykologiska symptom och posttraumatisk stress observerades hos både barn och omvårdnadspersoner. Omvårdnadspersonerna rapporterade även förbättrade förmågor att hantera sitt barns beteende, och en minskning av tecken på desorganiserad omvårdnad noterades. Resultaten var stabila vid uppföljningen. En potentiell prediktor för utfall som identifierades var att högre traumasymptom hos barn var associerade med en lägre minskning av omvårdnadspersoners traumasymptom. Resultaten överensstämmer med internationella studier och visar på CPP:s effektivitet för att minska symptom och förbättra relationen mellan barn och omvårdnadspersoner. Fynden belyser CPP:s hållbarhet i en naturalistisk klinisk miljö i en ny kulturell kontext, vilket indikerar att metoden har potential för bredare spridning i Sverige. Med tanke på begränsningar som litet urval och avsaknad av kontrollgrupp behövs dock resultat från en svensk RCT för att ytterligare undersöka effektiviteten hos CPP. 

Many children exposed to adversities and trauma are under six years old, yet most trauma-focused treatments target older children. Child–Parent Psychotherapy (CPP) is one of few interventions designed for traumatized children under six, focusing on the child–caregiver relationship as the foundation for recovery. This doctoral thesis aimed to evaluate the outcomes and experiences of CPP when applied in a Swedish clinical context. Caregiver experiences when taking part in the treatment and how CPP meets the demands for dissemination were examined, as well as the impact of CPP on general psychological symptoms and post-traumatic stress in children, caregivers, and caregivers’ perceptions of their relationship with their child. Finally, the long-term effects of CPP were examined. Overall, the findings were positive. The caregivers were satisfied with CPP, and the intervention was practical to implement. Reductions in general psychological symptoms and post-traumatic stress were observed in children and caregivers. Caregivers also reported improvements in the relationship with their child. The results were stable at follow-up. The findings highlight CPP’s sustainability in a clinical setting in a new culture, indicating its promise for further dissemination and evaluation in Sweden.