Mitigating the impact of intimate partner violence in pregnancy and early childhood: A dyadic approach to psychotherapy

Intimate partner violence (IPV) is often considered an adult problem despite profound consequences for the children who are exposed toviolent relational patterns. About a third of children and adolescents report past exposure to parental IPV, and a majority were first exposed as infants. Exposure to IPV during pregnancy through the first 5 years of a child's life has consequences ranging from adverse birth outcomes to diagnosable emotional problems and lasting physiological dysregulation. This article reviews risks and consequences of IPV in pregnancy and early childhood and discusses a relational psychotherapeutic treatment approach (Child-Parent Psychotherapy) applied to both developmental stages to mitigate the adverse consequences of family violence on parents and their children. Research evidence for the effectiveness of Child-Parent Psychotherapy (CPP) among IPV-exposed families is reviewed as are specific treatment components which seek to restore relational safety following familial violence. Additionally, clinical considerations unique to families with histories of or ongoing exposure to IPV are discussed. Finally, recommendations are presented to improve the integration between medical and early childhood behavioral health systems for families at highest risk for chronic IPV. Infants and children exposed to IPV are at elevated risk for later socioemotional difficulties, physiological dysregulation and child welfare involvement.IPV threatens relational safety; dyadic, relationship-based psychotherapies are well suited to repair ruptures in family relationships caused by violence restore psychological health.Child Parent Psychotherapy and its perinatal application are interventions that can improve to child and parental psychopathology, parenting beliefs and attachment security.