Facilitators of Child-Parent Relationship Therapy (CPRT) for adoptive families are recommended to have training and supervision in the traditional CPRT approach before utilizing and adapting the model for adoptive parents. Children who have experienced frequent changes in caregivers, recurring neglect, and abuse can experience difficulty feeling safe in relationships with others. A report issued by the Donaldson Adoption Institute evaluated the empirical support for adoption-related interventions and recognized the Carnes-Holt and Bratton study in its conclusion that among parent-child interventions, CPRT demonstrated the strongest empirical support for helping adopted children and their parents. CPRT therapists must have understanding of the interrelationship between trauma and attachment in order to help parents identify and understand their adopted children’s underlying needs and behaviors. In the majority of sessions, it is suggested in the treatment manual that the therapist present the option to end the group with a motivational poem, story, or Rule of Thumb.