Vol.:(0123456789) 1 3 Journal of Clinical Psychology in Medical Settings https://doi.org/10.1007/s10880-019-09614-6 Child–Parent Psychotherapy with Infants Hospitalized in the Neonatal Intensive Care Unit Patricia P. Lakatos 1  · Tamara Matic 1  · Melissa Carson 1  · Marian E. Williams 1 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Hospitalization in the Neonatal Intensive Care Unit (NICU) is a stressful and potentially traumatic experience for infants as well as their parents. The highly specialized medical environment can threaten the development of a nurturing and secure caregiving relationship and potentially derail an infant’s development. Well-timed, dose-specifc interventions that include an infant mental health approach can bufer the impact of medical traumatic stress and separations and support the attach- ment relationship. Many psychological interventions in the NICU setting focus on either the parent’s mental health or the infant’s neurodevelopmental functioning. An alternative approach is to implement a relationship-based, dyadic intervention model that focuses on the developing parent–infant relationship. Child–parent psychotherapy (CPP) is an evidence-based trauma-informed dyadic intervention model for infants and young children who have experienced a traumatic event. This article describes the adaptation of CPP for the NICU environment. Keywords Infant mental health · Neonatal intensive care unit · Trauma-informed care · Child–parent psychotherapy · Pediatric psychology · Pediatric medical traumatic stress Hospitalization in the Neonatal Intensive Care Unit (NICU) is a stressful and potentially traumatic experience for infants as well as their parents (Aftyka, Rybojad, Rosa, Wróbel, & Karakuła-Juchnowicz, 2017; Lefkowitz, Baxt, & Evans, 2010), impacting developmental and attachment outcomes. Interventions have been developed to address parental men- tal health during NICU stays and to enhance neurodevel- opmental care for hospitalized newborns. However, these interventions may not be sufcient to optimally support the developing relationship between the infant and parents when this critical developmental period is spent in a medical setting. Utilizing an infant mental health perspective pro- vides a dyadic, relationship-based orientation that shows promise in addressing the parent–infant relationship dur- ing this stressful time. This article provides a rationale for the need for this type of service, the role of infant mental health in the NICU setting, and an overview of Child–Parent Psychotherapy (CPP), an evidence-based intervention for trauma that addresses the parent–child dyad in treatment. Detailed information is provided to describe how the authors adapted CPP to provide trauma-informed, dose-specifc, dyadic intervention in the NICU setting. Psychosocial Needs in the Neonatal Intensive Care Unit The sights, sounds, separations, and daily experience for families within the NICU setting are stressful, and can interfere with the parents’ opportunity and ability to read the infant’s cues, and exacerbate familial confict. Parents often have to juggle work responsibilities, the care for other children, and other psychosocial stressors that can interfere with the ability to be at the bedside, alter family communi- cation, and place an additional burden on the development of parent–infant attachment. Events surrounding the child’s birth and the knowledge that the infant is medically frag- ile requiring intensive medical care are additional stress- ors. Pediatric medical traumatic stress (PMTS) has been defned as “psychological and physiological responses of children and their families to pain, injury, serious illness, * Patricia P. Lakatos plakatos@chla.usc.edu 1 University Center for Excellence in Developmental Disabilities, Children’s Hospital Los Angeles, University of Southern California, 4650 Sunset Blvd, MS#53, Los Angeles, CA 90027, USA