According to a new study from UC San Francisco, psychotherapy involving caregivers may help young children who have faced significant trauma avoid serious health issues as they grow older.
Previous studies have indicated that young children can experience psychological benefits for up to nine years following dyadic treatment with their parents for trauma. However, this research is the first to reveal a biological advantage stemming from such treatment.
Researchers at UCSF assessed the impact of dyadic therapy on a biomarker they identified as “age acceleration,” which indicates the speed at which an individual’s body is aging compared to their actual age.
This “epigenetic clock” tends to tick faster for individuals who have faced early childhood trauma, leading to heightened risks for various diseases, including heart disease, cancer, obesity, and asthma.
In this study, researchers compared two groups of children, aged 2 to 6, from the Bay Area, all of whom had undergone traumatic experiences. Initially, both groups exhibited similar levels of biological age acceleration.
One group participated in as many as 20 weekly sessions of Child-Parent Psychotherapy (CPP), a program crafted by Alicia Lieberman, PhD, the director of UCSF’s Child Trauma Research Program and a co-author of the study. The other group did not receive CPP.
The 45 children who undertook the therapy demonstrated less age acceleration than the 110 children who did not. While the difference was minor, it could still have important implications, as even slight biological alterations early in life can lead to significant health variations later on, explained Nicole Bush, PhD, a psychologist and head of UCSF’s Division of Developmental Medicine.
“These results emphasize the importance of ensuring that families experiencing trauma and stress have access to child-parent therapies to enhance both mental and physical health,” stated Bush, who holds the Lisa and John Pritzker Distinguished Professorship in Developmental and Behavioral Health.
This study was published on August 14 in Psychological Science.
Relationships are vital for health
Over 80% of the participants in the treatment group and two-thirds in the comparison group were Latinx. This is significant as families of color and those from low-income backgrounds often face higher rates of trauma than their white counterparts, yet they are frequently underrepresented in medical research.
The participants experienced levels of trauma that were more severe than what is usually studied in children, adding to the significance of the findings, according to Lieberman, who holds the Irving B. Harris Endowed Chair in Infant Mental Health.
“We are referring to very intense trauma in young children, such as the loss of a parent, abuse, and exposure to community violence,” Lieberman elaborated. “The children receiving intervention had an average of five traumatic events before the age of six, with research indicating that experiencing four or more such events before age 18 significantly increases the risk of developing one of the top ten causes of death in adulthood.”
Meanwhile, their parents reported an average of 13 traumatic experiences, which may impact their ability to manage their emotions and reactions to their children’s challenging behaviors, according to Lieberman.
In Child-Parent Psychotherapy, therapists use toys to help children express and process their emotions and thoughts related to trauma while assisting parents in understanding the connection between their child’s behaviors and experiences. The therapists also foster the parent-child relationship by guiding them through positive interactions.
“When both parent and child have experienced trauma, the effects can be compounded,” Lieberman noted. “Our method aims to heal both parties by addressing their trauma and strengthening their bond during joint sessions. Relationships are fundamental to health, starting from early childhood.”
According to psychologist Allie Sullivan, PhD, co-first author of the study and a postdoctoral scholar in the Department of Psychiatry and Behavioral Sciences at UCSF, “Parents can often feel powerless regarding their children’s trauma exposure. We hope these findings empower them by showing they have the capability and strength to safeguard their children from adverse experiences.”
An essential period for development
Interventions aimed at children younger than five are crucial, as this age marks the stage of the most significant brain development, which influences their mental and physical health in later life.
Recently, California’s Department of Health Care Services established benefits to promote family therapy and dyadic care for pediatric Medi-Cal patients beginning at birth. Zuckerberg San Francisco General Hospital offers this care and provides support to medical practices throughout California on how to implement and receive reimbursement for these services.
The researchers hope to highlight the social, ethical, and economic benefits of therapy-based solutions as alternatives to medication in addressing family trauma.
“Initiatives that unite families, acknowledge their trauma, and create a safe and healing environment can initiate biological recovery beneficial to mental and physical health throughout life,” Bush explained. “We aspire for policymakers and practitioners to take this into account.”