Modeling as an infant mental health intervention

Within the context of family therapy focused on the behavioral problems of a six year old, several observations of inappropriate interactions between the parents and their infant concerned the therapist. In consultation with an infant specialist it was decided that the therapist would avoid identifying parent-infant interactions as a further problem and would, instead, begin to model appropriate interactions during the on-going therapy sessions. The infant, initially passive, began to respond to the therapist and gradually the parents became more appropriate in their interactions with their infant. It was concluded that the modeling process minimized the stress and eliminated the need to process feelings of anger and guilt often associated with professional identification of family problems.     

Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort

Pregnancy and the early post partum period are widely understood as a critical period for the infant’s emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offspring aged 12 months. The study used longitudinal data from a prospective cohort study on Australian pregnant women and their children. Data were available for 282 mothers and their children. Maternal depressive and anxiety symptoms were measured in early pregnancy, trimester three of pregnancy, six and 12 months postpartum. Social and emotional development in children was measured using the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 12 months. Using growth curve analysis of 4 waves of repeated measurement to examine intercept and slope, we found that both initial maternal depression and anxiety symptom levels, and the growth of these symptoms over time, predicted more problems with children’s social and emotional development. In the final model anxiety accounted for 19% of the variance in child socio-emotional problems and depression 23% of variance. The results emphasise the importance of perinatal maternal mental health as a potential risk factor for child development. This carries important implications for policy development, such as the need to build early identification and early intervention models in to the current clinical practice for perinatal care, specifically, to develop targeted screening, assessment and interventions to address maternal mental health issues for at-risk parents during pregnancy, and continuing monitoring of young children whose mothers have experienced perinatal mental health difficulties.     

The development and evaluation of a community mental health education program for seminarians

American Journal of Community Psychology -     

The effects of an interdisciplinary infant stimulation—parent education intervention program upon infant development

An eight month infant-stimulation/parent-education program was presented to mother-child dyads participating in one of three types of classes: a structured twenty-two session group, an unstructured twenty-two session group, or a structured eleven session group. Infants (2–15 months) in all intervention groups as well as those from a control group were tested three times (pre-test, mid-test, post-test) during the course of the program using the Bayley Mental Test of Infant Development and the Uzgiris-Hunt Ordinal Scales of Psychological Development. Results tend to indicate that the intervention strategy was an effective method of parent education in enhancing infant gains on developmental indices. The results are discussed in relation to a preventative psychotherapeutic model.     

The Michigan infant mental health home visiting model

Selma Fraiberg's pioneering work with infants, toddlers, and families over 40 years ago led to the development of a field in which professionals from multiple disciplines learned to work with or on behalf of infants, very young children, their parents, and the relationships that bind them together. The intent was to promote social and emotional health through enhancing the security of early developing parent–child relationships in the first years of life (Fraiberg, 2018). Called infant mental health (IMH), practitioners from fields of health, education, social work, psychology, human development, nursing, pediatrics, and psychiatry specialize in supporting the optimal development of infants and the developing relationship between infants and their caregivers. When a baby is born into optimal circumstances, to parents free of undue economic and psychological stressors and who are emotionally ready to provide care and nurturing for an infant's needs, an IMH approach may be offered as promotion or prevention, with the goal of supporting new parent(s) in developing confidence in their capacity to understand and meet the needs of the tiny human they are coming to know and care for. However, when parental history is fraught with abandonment, loss, abuse or neglect, or the current environment is replete with economic insecurity, threats to survival due to interpersonal or community violence, social isolation, mental illness, or substance abuse, the work of the IMH therapist may require intervention or intensive treatment and becomes more psychotherapeutic in nature. The underlying therapeutic goal is to create a context in which the baby develops within the environment of a parent's nurturing care without the psychological impingement that parental history of trauma or loss or current stressors such as isolation, poverty, or the birth of a child with special needs, can incur.     

Perceptions of infant boys' behavior and mental health: Relation to infant attachment

Two studies were conducted to determine the impact of infants' attachment classifications and behaviors on naive adults' impressions of their behavior and mental health. In Study 1, three groups of 44 adults viewed a videotape of episode 8 of the Strange Situation for either an avoidant, a resistant, or a secure male infant. After viewing the videotape, they made judgments about aspects of the infant's mental health. Adults viewed the resistant baby as less socially competent and more negative in affect than the other two babies and the secure baby as the least independent of the three babies. Parents rated babies as more intelligent than did nonparents. In Study 2, 15 parents were matched on race and gender with 15 nonparents. All adults viewed a videotape of the reunions of two secure, two avoidant, and two resistant male infants. Avoidant babies were viewed as more socially competent and independent than secure babies and the C2 baby was viewed as the least intelligent, least independent, least socially competent, and most affectively negative of the infants. Results are interpreted as underscoring the need to educate parents and paraprofessionals about the importance of infant distress and physical contact with parents.     

The role of the infant mental health therapist in the framework of preventive mental health

The role of the infant mental health therapist is differentiated from that of other infant interventionists as being a secondary prevention treatment approach employing the techniques of long-term, insight-oriented psychotherapy. Such an approach encourages the caregiver to recall his or her own childhood experiences and conflicts to gain an understanding of feelings directed at his or her own baby. The prevention models of Caplan are considered as is the development of the work of Fraiberg and her colleagues.     

The Papago Psychology Service: A community mental health program on an American Indian reservation

A community psychology service run by the Papago Indian tribe and staffed largely by Papago Indians who have been trained as mental health workers is described. This service is unique among mental health services for Indians in that the tribe has complete control of the funds for the service and sets its own policies. It was developed for a rather traditional Indian group, and the culture, the traditions, and the wishes of the Papago community were respected. Consultation with medicine men was built into the program from the start, and adaptation of mental health techniques to fit the culture is stressed. Before this clinic was established, few mental health resources were directly available to the reservation. Similar to other Indian tribes, the Papagos are economically disadvantaged, with an unemployment rate of over 50%, low educational attainment, and very high rates of alcoholism, suicide, and vehicular accidents. The topics covered are the tribe's view of health programs for its people, the present Papago community and traditional means of treatment, traditional psychotherapy adapted to Papago culture, the indigenous Papago mental health worker, and the non-Indian professional consultant.     

Effects of the community mental health centers program on the growth of mental health facilities in nonmetropolitan areas

Using a quasi-experimental design, changes in the numbers of mental health facilities between 1964 and 1974 were examined for a sample of 50 nonmetropolitan catchment areas that established a Community Mental Health Center (CMHC) before January 1973 and a sample that did not. Compared to non-CMHC areas, CMHC areas had a slightly greater number of general hospital psychiatric units in 1974. Nevertheless, the rate of increase in such units over the 10-year period was not significantly different between the two types of areas. Other findings supported the conclusion that the number of outpatient and day/night facilities continued to increase in areas not participating in the CMHC program, but that the program produced even greater numbers of such facilities in areas that did participate. This growth, though, occurred both through introducing additional facilities and supplanting existing ones.     

The importance of cooperation among child health professionals and agencies in an inner city infant mental health service

The clientele of our Infant Mental Health Service mainly consists of unwed teenage mothers and babies beset by medical, social, and psychological complications. Efforts to help these families usually extend beyond the caregiver-infant dyad and may include working with grandmothers, pediatricians, and high-risk neonatology nurses, as well as outside social agencies and foster homes. Thus, cooperation among various disciplines, departments, and agencies'is indispensible in infant mental health practice. Problems and successes in building and maintaining such cooperation, its impact on clinical practice, staff work, administrative functioning, and therapeutic strategies are discussed. Clinical examples illustrate the nature of the cooperation.     

The mental health of pilots: An overview

The impact and long-term psychological consequences of the 11th September 2001 terrorist attacks in the USA involving commercial aircraft are likely to be far-reaching. Pilots were directly affected by these events though it is too early to comprehend the specific psychological and occupational repercussions. While psychologists have written much on the selection of commercial and military aircrew, surprisingly little has been published on the mental health of pilots. They are a unique occupational group in terms of their selection, training, lifestyle, frequent competency and medical checks, as well as the nature and changing demands placed on them. Their 'office' is normally a cramped flight deck on board an aircraft at altitudes of thousands of feet. While some aspects of their job and lifestyle appear attractive to some, their working conditions are, at worst, inhospitable and unpleasant. This paper provides an overview of current research on the mental health of pilots, gathered from a number of different fields and specialities within commercial and military aviation. The review covers their lifestyle, psychological requirements for medical certification, psychological problems amongst air crew, personality factors, disruption to personal relationships, reactions to incidents and accidents, alcohol and drug misuse, suicide by aircraft and environmental challenges. Flight crew should have easy access to psychological support; however, many pilots are distrusting of mental health professionals. Further research is needed to improve an understanding of mental health issues among pilots, especially in order to better understand the psychological impact of the terrorist attacks upon them.     

Introduction to the special section: The development of infant mental health home visiting in Michigan state government

This issue of the Infant Mental Health Journal presents the first papers from a tripartite evaluation study of state-sponsored infant mental health home visiting program in Michigan, United States. This series of studies has been led by Kate Rosenblum PhD and Maria Muzik MD, Department of Psychiatry, the University of Michigan and faculty from the Michigan Collaborative for Infant Mental Health Research for the State of Michigan, Department of Health and Human Services, Mental Health Services for Children, to fulfill the requirements of state legislation (State of Michigan Act No. 291, Public Acts of 2013) that required that all home visiting programs meet certain requirements to be established as an evidence-based practice. In this introduction, we provide a historical context for the delivery of infant mental health home visiting through the community mental health system in the state of Michigan.     

The training of community mental health clinicians as infant specialists

This article describes the training program and collaborative effort between the Department of Mental Health, the Child Development Project at the University of Michigan, and community mental health agencies. The in-service training is described with special attention to content and process, including the role of case supervision. The effect of the training program as a catalyst to service development is noted.     

The significance of reflective supervision for infant mental health work

Parent–infant work is inherently relational and occurs in the intersubjective space between parent, infant, and worker. This space can be charged with primitive, unmet needs of both parent and infant, and this in turn can trigger these same states in the worker. The challenge for workers is to remain open to being affected by and responsive to these feeling states when their own early and possibly preconscious responses and coping strategies are being stirred. If these remain out of awareness, they can manifest as avoidance and denial, and this can be reflected in the system and result in limited service delivery. This article emphasizes the significance of reflective supervision for parent–infant work and suggests that it needs to be an integral part of the system of service delivery. I am grateful to the infant mental health workers who allowed me to use examples of their work in this article, and thank Dr Jon Jureidini for his encouragement and support.     

The father's role in the facilitation of infant mental health

Many recent studies have focused on the nature and significance of father-infant relationships. These studies show that men are as capable of behaving sensitively as women are, although cultural sex-stereotypes usually prevent them from assuming a prominent role in child care. Nevertheless, most infants become attached to both their parents during the first year of life although they tend to establish primary relationships with their primary caretakers. During the second year of life, fathers encourage boys to focus attention on their fathers. This may facilitate the development of gender identity. In addition, the security of the father-infant attachment relationship may affect the infant's orientation to novel social situations. Fathers also affect infants indirectly via their influence on the children's mothers.     

The changing practices of an infant psychiatry program: The McGill experience

The present paper describes the development of a university-based infant psychiatry program. The paper initially highlights the organizational structure of the program that involves some 20 professionals, then reports on 57 infants who presented with disruptive behavior disorders and ends by describing an innovative treatment program for fathers and an attempt to help teenage mothers in caring for their infants. © 1997 Michigan Association for Infant Mental Health