An evaluation of Neuro-Physiological Psychotherapy: An integrative therapeutic approach to working with adopted children who have experienced early life trauma

Family-based psychological interventions for domestically adoptive families: a systematic review

Adopted children are often at a risk of experiencing several neurobiological and psychosocial difficulties. Adoptive parents must support these difficulties whilst managing their own idiosyncratic challenges. Family-based psychotherapeutic interventions which promote adoptive family functioning, environments and relationships can mediate these difficulties for adopted families. This review synthesises evidence exploring family-based psychological interventions for adoptive families, appraises the literature's strengths and weaknesses, and reports characteristics of promising interventions. Included studies recruited domestically adoptive families receiving psychotherapeutic interventions delivered to at least one adoptive parent and child. The authors searched seven electronic information databases, four grey literature databases, two journals and five relevant websites up to 12.12.2022. The quantitative Risk of Bias in Non-Randomised Studies of Interventions tool and the qualitative Critical Skills Appraisal Programme checklist assessed risk of bias. The narrative synthesis presents 20 papers detailing 18 studies involving at least 729 adopted children and 829 adoptive parents. Findings provide preliminary support for integrative interventions which include aspects of sensory activities, attachment-based play, Dyadic Developmental Psychotherapy and Eye Movement Desensitisation and Reprocessing with Therapeutic Input provided to adopted children and adoptive parents separately, alongside the adoptive family. However, risk of bias was high, limiting the conclusions. Future research should examine the feasibility, acceptability and efficacy of integrative therapeutic approaches for adoptive families to further direct clinical practice.

A comparison between a Neuro-Physiological Psychotherapy (NPP) treatment group and a control group for children adopted from care: Support for a neurodevelopmentally informed approach to therapeutic intervention with maltreated children

BACKGROUND

Little evidence exists regarding outcomes of therapeutic interventions for maltreated children who are removed from their birth families and then adopted. This study follows on from a previous evaluation of the Neuro-Physiological Psychotherapy (NPP) model, which found significant, positive and sustained post-treatment change.

OBJECTIVE

To compare the outcomes for the NPP intervention group to those of a control group.

PARTICIPANTS AND SETTING

Participants were families who received the NPP intervention and families who, following assessment, did not receive the NPP intervention as recommended.

METHODS

Groups were matched in terms of demographics and presentation at assessment. A comparison of outcomes took place using ANCOVA.

RESULTS

Significant differences were found between group measures of Behavioral Regulation Index (moderate effect size, Cohen's d = .435; F(1, 1505) = 14.476, p = .000) and Global Executive Functioning (BRIEF) (small effect size, Cohen's d = .147; F(1, 3506) = 7.771, p = .008); mental health difficulties common in maltreated children (ACC/ACA) (small effect size, Cohen's D = .212; F(1, 1100) = 6.197, p = .020) and externalizing behavior (CBCL) (small effect size, Cohen's D = .025; F(1, 686) = 5.420, p = .025). A comparison of parent responses on quantitative aspects of a structured interview using chi-square analysis revealed significant differences between the groups on relationship quality (x2 (2, N = 53) = 10.453, p = .005 with a medium effect size, Cramer's V = .444), disruption (x2 (1, N = 54) = 4.998, p = .025. The effect size was medium with Cramer's V = .304), parental separation rates (x2 (1, N = 45) = 9.474, p = .002. The effect size was moderate with Cramer's V = .459) and several indicators for longer-term social inclusion. The results are discussed in the light of the model's neurodevelopmental and sequential approach, which focuses on sensory integration, affect regulation and therapeutic life story work alongside parent and school support.

CONCLUSIONS

Implications regarding current treatment guidelines for this population are discussed; and a call is made for interventions which actively consider and address the neurodevelopmental impact of maltreatment.