304 | Facilitating CPRT With Challenging Parent Dynamics

In this episode, I respond to a question from Tess in Illinois about coaching parents with personality disorders—specifically borderline and narcissism—within the CPRT (Child-Parent Relationship Therapy) framework. This is a tough but important topic because it forces us to examine fit, expectations, and how to approach CPRT when cognitive or relational barriers are present.

I walk through how to vet parents for CPRT, what makes someone a good candidate, and how personality disorders can complicate the process. I also talk about the critical need for patience: some parents are essentially rewiring their entire parenting approach, and ten weeks isn’t always enough. Finally, I encourage clinicians to hold clear and kind conversations, maintain realistic expectations, and remember that transformation is possible—even when it’s slow.

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Common References:
Cochran, N., Nordling, W., & Cochran, J. (2010). Child-Centered Play Therapy (1st ed.). Wiley.
VanFleet, R., Sywulak, A. E., & Sniscak, C. C. (2010). Child-centered play therapy. Guilford Press.
Landreth, G.L. (2023). Play Therapy: The Art of the Relationship (4th ed.). Routledge.
Bratton, S. C., Landreth, G. L., Kellam, T., & Blackard, S. R. (2006). Child parent relationship therapy (CPRT) treatment manual: A 10-session filial therapy model for training parents. Routledge/Taylor & Francis Group.
Benedict, Helen. Themes in Play Therapy. Used with permission to Heartland Play Therapy Institute.

Episode Transcript

(00:00):
You're listening to the Play Therapy Podcast with Dr. Brenna Hicks,
your source for centered and focused play therapy coaching.
Hi,
I'm Dr. Brenna Hicks,
The Kid Counselor.
This is the Play Therapy Podcast where you get
a master class in child-centered play therapy
and practical support and application for your
work with children and their families.
In today's episode,
I am answering a question from Tess in Illinois.

(00:23):
And this is specifically about coaching parents.
We have been talking a lot about CPRT.
I know I mentioned a couple episodes ago that we
are launching the certification program with Corwell for CPRT training.
Very excited about that.
And for those of you that are already using CPRT.
Thank you for working with parents.

(00:43):
We know
that parents statistically
have
more impact
as far as change in their families than we do,
and that's meaningful to be able to take advantage
of relationships and history and connections that are already there
amongst parent and child versus trying to start
from scratch with the therapist and child.

(01:06):
So Tess's question is about working with parents who
have disorders and therefore it makes it a little
bit difficult to teach CCPT skills to them.
So I'll read parts of her email and then we'll dive in together.
I've noticed that several parents I'm working with have personality disorders,
either borderline or narcissistic.
I'm finding it difficult to effectively teach these parents CCP

(01:29):
CCPT parenting skills,
gosh,
say that fast,
when they struggle with insight or providing
unconditional positive regard to their children.
I would appreciate any thoughts.
All right,
Tess,
thank you for this.
One of the things that we need to
start off with from the very beginning.
I
vetting
our CPRT parents.

(01:50):
And really what that means practically speaking is
not every parent is the right fit.
Just like not every family and or child is the right fit for CCPT.
And
I mean,
almost always kids are the right fit for CPR CCPT,
but often the circumstances or the parent's

(02:11):
dynamic or the parent's personalities or whatever,
you know,
if a parent says,
I want you to
take care of this in 4 weeks.
That's
not congruent with CCPT.
If a parent says,
you need to fix my child,
this is 100% my child's problem and you need to fix them.
That is not adherent to CCPT.
So

(02:31):
we recognize that sometimes we have to either say,
I'm not sure that this is the right fit or
we have discussions to where we can get to a
point where we're all on the same page at least
that we think that this is a viable option.
Even if it's not necessarily an easy fit,
but we can all get on the same page with it.

(02:52):
So specifically with
the vetting of parents,
one of the things that is important to keep in mind,
there has to be a cognitive capacity
for
the parent to actually learn and integrate skills.
I worked with a stroke victim
in CPRT once,
and she,
because of her stroke,
she could not remember things.

(03:14):
And about halfway through CPRT I realized
even though she really is trying hard and she's taking all
these notes and she really wants to learn this stuff,
her brain will not allow her to remember it post stroke.
I had another parent I worked with
that had had a traumatic brain injury.
And she had working memory and cognitive delays because of it,

(03:38):
and she struggled mightily
with CPRT,
not because
she didn't want to learn it,
not because it didn't matter,
not because she took it flippantly,
her brain just really was not able to make
sense of the information that she was learning.
So
this would apply in a grand scale to personality disorders as well.

(04:00):
Certain types of parents
because of
language barriers,
because of cognitive delays,
because of disorders,
because of
whatever you name it,
fill in the blank,
they're going to have a more difficult time than others
integrating CPRT knowledge.
It's not to say that it's impossible.

(04:20):
It's just it's going to be a different process,
sometimes a harder process.
We need to think through that before we start working with parents.
Typically
there are certain personalities of parents that are very well suited for CPRT,
and then there are certain personalities of parents that
don't seem to be the most ideal fit.

(04:42):
It doesn't mean that it can't work with anyone.
It just means that we have to be considerate
of where the difficulties might be,
what obstacles we might be up against,
and therefore how to address those.
So Tess,
when you're mentioning borderline and narcissism,
those are
issues that are going to

(05:03):
get in the way
of them being able to focus on relationship with their children.
That's the whole premise of CPRT.
That's why it's called child parent relationship.
The whole notion is that you're working to create a different relationship
with your children
and with borderline and narcissism,
they're going to struggle relationally.

(05:26):
It's not to say it doesn't have any influence,
it's not to say it can't work,
it may just not move the needle as far.
And another consideration is
we have to be really patient.
We are sometimes expecting parents to rewire their entire brains.
In other words,
they have to think differently,

(05:46):
speak differently,
respond differently,
understand differently,
communicate differently,
basically undo everything they've ever done.
And this is not a quick process.
This is not an easy fix,
and 10 weeks is actually very short.
So sometimes we don't even see a whole lot of evidence
in that 10 week curriculum

(06:07):
that
parents are really getting it,
that they're actually able to integrate these.
We usually see small changes,
sometimes we see monumental changes,
but often
it's slow and think about it,
we
know that the average for children is 30 to 40 weeks.
If we're only meeting with a parent 10 times,
we wouldn't expect a child

(06:27):
to monumentally change in 10 weeks in the playroom.
So therefore we have to have realistic expectations of timeline for them.
Sometimes they're going to have to have longer
before this sinks in and before they're able to actually
really consistently integrate this new knowledge that they're learning.
They have to basically start over from scratch a lot of the times.

(06:48):
So even with something like borderline or narcissism,
that can certainly be a hindrance,
but it's also sometimes just being patient
because
if they really truly want
a relationship with their children,
they really truly want
to change,
they want the outcome to be different,
it might be really slow,
but it doesn't mean that it won't happen.

(07:10):
We typically encourage parents to continue doing play
sessions long after that 10 week curriculum.
Why?
Because the child's only had 7 play sessions
at the end of that 10 week window.
7 play sessions,
that's a fraction of what kids need.
And as long as parents remain consistent and they
continue to do that 30 minute special playtime,

(07:33):
parents continue to change,
child continues to change,
relationship continues to change.
That's the goal.
As far as those specific disorders tests,
so borderline and narcissism,
I would certainly advocate that they are in therapy themselves,
so you might want to have that discussion
and see,
you know,
what their receptivity is to

(07:54):
whether or not they are in therapy or whether they would consider therapy.
You also sometimes have to help parents understand
that.
This is not a unilateral change process.
In other words,
the child is not the only one changing,
the parent is not the only one changing.
It is from all ends.
So as the parent changes,
it forces the child to change.

(08:15):
As the child changes,
it forces the parent to change.
As each one of those members change,
it
causes the relationship to change.
As the relationship changes,
the family dynamic changes,
and so on and so on.
So often it's helping parents see
the bigger picture.
This isn't just you have to do all kinds of parenting work.

(08:35):
This isn't just your child needs to develop all
kinds of self regulation and self-control and emotional vocabulary.
It's collaborative effort
where everyone is working toward the common goal
of
increase in relationship
that is healthy
because everything flows out of a healthy relationship.

(08:56):
Borderline and narcissism are a hindrance to healthy relationships
and therefore
they are sometimes going to have a harder road,
but it's not impossible,
and I think it's about being very clear.
You know,
clear is kind,
honest is kind.
We have to have clear and honest conversations sometimes,
and sometimes those conversations are not easy,

(09:18):
but we're always advocating on behalf of the child
and the child's family.
If they know,
like and trust you,
they will understand why you're bringing up
difficult topics and having difficult conversations.
So often you might have to say.
I understand that this is probably a little bit challenging for you.

(09:40):
And let's let's process that together.
CPRT is a lot of
parent
discussion.
Yes,
there's curriculum,
but sometimes it's just the parent and you
talking about life
and you providing support and encouragement and feedback
because yes,
they need to know skills,

(10:00):
but they also need someone to walk alongside them and help
and guide,
and that's our role as a CPRT facilitator.
So,
Tess,
thank you so much for the question.
I hope that that is helpful.
For those of you who have never
used CPRT as a parent coaching curriculum,
if you are
fully adherent to child-centered play therapy,

(10:21):
and it is all you provide,
CPRT is an incredible
avenue for providing parent coaching in addition to your work with children.
So I would highly recommend
looking into that if you have no background in that.
And for those of you that are familiar,
you know the outcomes and you've seen what it does for families,
and that's one of my favorite things.

(10:42):
CPRT is not easy to facilitate,
but the outcomes speak for themselves,
and when you watch transformation in families
and in relationships between a parent and child,
and you see how different their play sessions are over the course of the training.
It's so encouraging and rewarding.
So really a special
additional suite of service that you can offer.

(11:04):
All right,
love y'all.
If you want to reach out,
please do brenna@heid counselor dot com.
We'll talk again soon.
Bye.
Thank you for listening to the Play Therapy Podcast with Dr.
Brenna Hicks.
For more episodes and resources,
please go to www.playtherapypodcast.com.