Table 3 Key psychological theories and therapies that guided the development of the CGI

Attachment-based therapy

Attachment theory [88, 89] posits that the connection and interactions between infant and primary caregiver are key to the healthy psychosocial development of the child.

A caregiver’s ability to provide attuned reassurance and assist the child make meaning of distressing experiences can be more influential on psychological outcomes than the nature of the adverse experience itself [7, 90].

Psychoeducation; Realistic expectations; Perspective taking; Building empathy; Play; Communication of validation, love and affection; Showing interest in the child.

Cognitive behaviour therapy (CBT)

CBT aims to reduce distress and improve functioning by addressing: (i) maladaptive patterns of thinking and beliefs, and (ii) maladaptive behavioural patterns that serve to cause, exacerbate, or maintain poor mental health.

CBT approaches have a strong evidence-base and have been used extensively and effectively in parenting interventions.

Psychoeducation; Relaxation exercises; Goal setting; Cognitive reappraisal (self-awareness; realistic expectations; helping children make sense of their experiences); Discipline (safe, consistent parenting; positive reinforcement).

Mind-body therapy (MBT)

MBT, based on polyvagal theory (PVT) [91,92,93], explains how humans react to environments of safety, danger and life-threat. MBT integrates ‘top-down’ and ‘bottom-up’ approaches to strengthen bidirectional connection and communication between body, brain, and mind [94, 95].

Ongoing threat lowers a person’s threshold for defensive reaction and disrupts the ability to co-regulate [96] resulting in dysregulation of emotion and behaviour, hyper- or hypo-arousal, and maladaptive social behaviours. Co-regulation within the parent-child dyad is critical to optimal neurobiological and psychosocial development of the child [97, 98].

Psychoeducation; Relaxation exercises; Building awareness of one’s own physiological and psychological state; Using play, communication, and comfort to facilitate co-regulation. The concepts of survival brain and learning brain [99] reflect neural states described in PVT.

Strengths-based therapy

Strengths-based therapy [100] is guided by core principles and practices that emphasise client involvement and a client-therapist alliance [100]. It can be incorporated into all therapeutic approaches.

This evidence-based approach [100] encourages agency and empowering perspectives, recognises strengths and avoids language or frameworks (e.g. diagnosis) that can reinforce hopelessness, helplessness, or self-blame.

Goal-setting; Use of language and formulations that highlight strengths and hope; Collaborative approach. Facilitators elicit, notice, and highlight the strengths of participants. Facilitators respect and promote parents’ knowledge about their own child, family, and experiences.