Therapy on the Cutting Edge

Speaking the Unspeakable: Healing Trauma with Young Children and Infants in Collaboration with Their Attachment Figure

Episode Summary

In this episode, I speak with Chandra about her path into trauma-informed work with young children and their caregivers. Raised in San Francisco by parents who worked in child welfare, Chandra was exposed early to stories of trauma and healing. Before age 7, several of her friends lost their parents to cancer, which inspired her to become a doctor. In high school, during an internship on a pediatric oncology ward she noticed that while physical health was prioritized, children’s emotional needs were often overlooked. This realization led her to study psychology. After college, Chandra worked at a residential program with children aged 6–12. She found the children often opened up about trauma during informal moments—car rides, bedtime, or watching TV—highlighting the need to involve caregivers in the healing process. In 1998, Chandra interned with Dr. Alicia Lieberman at UCSF’s Child Trauma Research Program, where she trained in Child-Parent Psychotherapy (CPP), an evidence-based treatment for young children under age 6 who have experienced trauma. She later developed the CPP fidelity framework and co-authored the second edition of the manual. Chandra noted a key challenge: although many parents recognize their child’s trauma, few clinicians are trained to work effectively with young children. Many therapists also avoid discussing trauma directly with young children, which can leave them alone with their experiences. CPP begins with the therapist meeting alone with the caregiver to supportively explore the child’s symptoms, experiences of trauma, the caregiver’s own history, including how past experiences may shape the parent's responses. Then the therapist and caregiver gently acknowledge past traumatic experiences to the child—“speaking the unspeakable”—and help the child process their experiences using developmentally attuned pacing and modalities, including play and art. As children process their experiences they sometimes shift topics or activities or seek physical comfort when they begin to move outside their window of tolerance. Therapists help parents understand this process, attune to their child’s needs, and support their child. CPP has a strong evidence base, including five randomized controlled trials. It has shown positive outcomes for preschoolers exposed to violence and infants and toddlers who experienced maltreatment. Notably, a recent study found CPP is associated with lower epigenetic age acceleration in trauma-exposed children aged 2–6—suggesting a measurable impact at the biological level. Chandra Ghosh Ippen, Ph.D. is a child trauma psychologist specializing in working with families with children under age 6. She is co-developer of Child-Parent Psychotherapy, the associate director of the Child Trauma Research Program at the University of California, San Francisco, and a member of the Board of Directors of Zero to Three. She has spent over 30 years conducting clinical work, research, and training in the area of childhood trauma and diversity-informed practice. She is also an award-winning children’s book author and has written 5 children’s books as well as the free Trinka and Sam disaster series, which has been translated and distributed to over 400,000 families around the world.