Piloting the Common Elements Treatment Approach with Mothers in Lima, Peru
In the busy district of San Juan de Lurigancho (SJL)—Lima’s most densely populated and economically strained area—mothers often navigate an invisible web of challenges. Many have endured violence, instability, and chronic stress while caring for young children. The effects ripple outward: anxiety, depression, and disrupted family bonds can become the unseen inheritance passed from one generation to the next.
With support from the Mental Research Institute (MRI), Dr. Laura Miller-Graff and her team at the University of Notre Dame and Instituto de Pastoral de la Familia (INFAM) set out to explore a new path for healing—one rooted in evidence-based care and relational strength. Their pilot study, Piloting the Common Elements Treatment Approach (CETA) with Mothers in Lima, Peru, sought to understand how a global mental health model could be meaningfully adapted to the lived realities of Peruvian women and their families.
Recent research in Lima shows that nearly half of women of reproductive age have experienced intimate partner violence (IPV). In SJL, a district of more than one million residents served by only three community mental health centers, access to care remains profoundly limited.
CETA—a flexible, evidence-based approach drawn from core elements of cognitive-behavioral therapy—offered a promising avenue. The program emphasizes engagement, psychoeducation, and coping strategies, but in this study, it also included specific attention to parenting .
Twenty mothers participated, guided by trained paraprofessional counselors under the supervision of trained CETA supervisors. Across eight to nine sessions, they learned tools to manage stress, regulate emotions, and engage more warmly with their children. As one participant shared,
“I learned to control my emotions and see the positive side of things. I hug my children now. I listen more.”
The data told a parallel story: significant improvements in depression, posttraumatic stress, and anxiety, alongside declines in harsh parenting practices and increases in emotional closeness. These were not just therapeutic outcomes—they were shifts in the relational fabric of families.
The pilot was intentionally small, but its impact was outsized. All participating CETA trainees became certified providers by the project’s end, expanding the local mental health workforce in a community where such expertise is scarce. The project also strengthened partnerships with INFAM, a local organization that helped connect women to care and provided culturally grounded guidance throughout implementation.
This early-stage work became the foundation for something larger. Drawing on these promising findings, Dr. Miller-Graff’s team secured a major grant from the National Institute of Child Health and Human Development (NICHD) to launch a full-scale clinical trial involving 300 mothers in SJL. The new study will build on this foundation, deepening knowledge of how supporting mothers’ mental health transforms family life across generations.
At its heart, this project illustrates what happens when science and empathy meet. It reminds us that healing—especially in contexts of adversity—takes root in relationships: between researchers and communities, mothers and children, trauma and resilience.
In San Juan de Lurigancho, each session of CETA became more than therapy. It became a practice of hope, a small but powerful act of reimagining what safety and love can look like amid hardship.
Through work that honors both rigor and relationship, Piloting the Common Elements Treatment Approach with Mothers in Lima, Peru embodies the spirit of MRI-supported research: illuminating how connection itself can be a pathway to healing.