Speaking for the baby: A therapeutic intervention with adolescent mothers and their infants

Adolescent mothers frequently experience problems in mother-infant interaction. However, intervention can be very difficult, particularly when complicated by unresolved conflicts involving relationships in the young woman's past. This article describes a therapeutic intervention, based on the work of Fraiberg, which allows the young mother to learn to interpret her infant's cues while also encouraging her to express her own emotions in the context of the mother-infant relationship. Two case studies are discussed to illustrate the use of the technique as part of a program of mother-infant intervention.     

An advocacy intervention program for women with abusive partners: Six-month follow-up

Presented the 6-month follow-up findings of an experimental intervention designed to provide postshelter advocacy services to women with abusive partners. The intervention involved randomly assigning half the research participants to receive the free services of an advocate, 4 to 6 hours per week, for the first 10 weeks postshelter. One hundred forty-one battered women were interviewed about their experiences immediately upon their exit from a domestic violence shelter: 95% of the sample were interviewed 10 weeks thereafter (postintervention), and 93% were successfully tracked and interviewed 6 months later. At the 6-month follow-up, participants in both groups reported increased social support, increased quality of life, less depression, less emotional attachment to their assailants, and an increased sense of personal power. Although women in both groups reported some decrease in physical abuse over time, there were no statistically significant differences between those with and those without advocates, and abuse continued to be a problem for many women. Those who were still involved with their assailants continued to experience higher levels of abuse and had been more economically dependent upon the men prior to entering the shelter. Women who had worked with advocates continued to report being more satisfied with their overall quality of life than did the women in the control group. The authors thank the Editor and anonymous reviewers for their helpful comments. Thanks also to all present and past staff of the Community Advocacy Project, who helped in data collection and analyses. This work was supported by National Institute of Mental Health Grant 1R01 MH 44849.     

The welcome baby program: A community-based volunteer prevention model of caring,sharing, and support for new parents

Primary prevention is one of the most important components of any community child abuse and neglect program. Welcome Baby is a community-based, volunteer primary prevention program that offers caring, sharing, and support to parents of newborns through hospital visitation and follow-up contacts during the adjustment period that surrounds the birth of a baby. Program goals include personal support for the new mother, prevention of child abuse and neglect by providing support and information for all parents, reinforcement of strengths and support for quality parenting, improving emotional preparation for parenthood, and early identification and intervention for families with the potential for maltreatment. Program rationale and conclusions agree with research findings that early and consistent support and intervention with high-risk families improve the quality of parent-child interaction and significantly reduce the risk of maltreatment. This article outlines the basic philosophy, goals, and operations of this community prevention program.     

An integrated model for intervention with infants,preschool children,and their maltreating parents

Service delivery systems for maltreating parents need to be comprehensive, integrated, and coordinated in order to address the ecological, developmental, and psychotherapeutic needs of maltreating families. This article presents a center-based, intensive model of intervention for multiproblem, maltreating families. The program described addresses the needs of the entire family; incorporates the evaluation and treatment of the child's, as well as the parent's, development; and provides services in a multifamily group milieu. The following interventions are integrated in the treatment approach: (1) family milieu approach, (2) assistance with functioning of the “parental ego,” (3) traditional therapies, and (4) developmental-structuralist approach to parent-child interaction. Challenges encountered and solutions employed in working with maltreating families are discussed. A detailed case study is presented to illustrate the types of interventions used.     

Using psychoanalytic concepts to inform interpretations and direct interventions with a baby in working with infants and parents

Abstract

How can some classical Freudian concepts such as defense, transference, infantile sexuality, and the role of the body ego and superego in the first year of life be applied to help the analyst working with parent–infant dyads? The case of a newborn that could not look at her mother, who did not feel empathy towards this child conceived as a result of an egg donation, was understood using Winnicott’s notion of early superego and the lack of libidinal pleasure. The notion of defenses towards primitive anxiety and the role of unconscious maternal functioning were helpful in helping the child as well as the parents to regulate their interactions.     

Two-year follow-up of an interdisciplinary cognitive-behavioral intervention program for obese adults

Intervention programs for treating adiposity which focus on dietary change and physical exercise often do not lead to the desired long-term reduction in weight. This article reports on the effectiveness of M.O.B.I.L.I.S., a standardized theory-driven intervention program. Participants are taught cognitive-behavioral strategies of goal setting, action planning, barrier management, and self-monitoring. Persons with obesity (N=316) responded to a public advertisement to participate in the intervention program (IG) or comparison group (CG; quasi-experimental design). Assessments were conducted at four time points, with the last assessment being conducted two years after baseline. At the 24-month follow-up, the IG showed weight loss of 5.57%, whereas the CG lost 1.12% of their weight (t1-t4, p < .01). The results yielded significant interaction terms (group x time), indicating that the intervention had a substantial effect on food choice and level of physical exercise (p < .01). The IG showed significantly enhanced self-efficacy, stronger goal intentions, and more detailed implementation intentions than the CG at follow-ups. The intervention program has the potential to evoke enduring changes in the cognitions we hypothesized to be responsible for inducing obese adults to begin and continue regular exercise and healthy eating behavior, resulting in substantial weight loss.     

Training program in psychosocial intervention for high-risk infants and their families

A multidisciplinary training program for psychosocial intervention in the Neonatal Intensive Care Unit (NICU) was developed. The purpose of the program was to train mental health and health care professionals in a psychosocial preventive intervention model for high-risk infants and their families throughout the infants' hospital course in the NICU. The program was divided into modules that include assessment and intervention with the infant, parents, family, and larger caregiving environment. Over a 3-year period 40 trainees from 9 disciplines were trained. A randomized clinical trial was conducted which showed the positive effects of the intervention. A clinical service including inpatient and outpatient follow-up has been established in the NICU based on the psychosocial model developed from the training program.     

Children of parents with unipolar depression: A controlled 1-year follow-up

An earlier cross-sectional study indicated that children's health and adjustment is at risk when their parents are depressed. Here, we report the associated longitudinal changes in children and families when parental depression either remits or continues. Comparisons are made among three groups established at a 1-year follow-up: previously depressed parents whose symptoms have remitted (N = 34 remitted parents), previously depressed parents who continue to be depressed (N = 23 nonremitted parents), and sociodemographically matched control families (N = 95). Although remitted parents and their family social environments improved, their children were still functioning more poorly than children of controls. Both the children and the families of nonremitted parents continued to function more poorly than controls. A social-environmental framework indicates that parents' functioning as well as family stressors and resources are concurrently and predictively linked to children's health.     

A clinical interview for parents of high-risk infants: Concept and applications

The birth and hospitalization of a preterm infant are stressful and emotionally demanding experiences for parents. The Clinical Interview for Parents of High-Risk Infants (CLIP) is a semistruc tured clinical interview that may be used as a one-time assessment or as a cornerstone for ongoing psychosocial work with parents. The interview assesses early parental adaptation and alerts the clinician to areas of concern as identified by the parents. The interview enables parents to consolidate emotionally their experiences relative to the infant's high-risk status. The CLIP has utility both for planning psychosocial care in the intensive care nursery, and for discharge preparation. The rationale underlying the design of the CLIP is presented, the interview is described, and clinical applications are discussed.     

A cognitive-behavioral intervention program for students with special reading disabilities

Interaction among cognitive, meta-cognitive, and emotional factors seems to play a determining part in achievement behavior and especially in scholastic performance. In this study some preliminary results are presented of the implementation of a multidimensional cognitive-behavioral psychoeducational program especially designed for students with reading disabilities in which parents and teachers also take part. The aim of the program was to provide students with appropriate emotional and cognitive skills with which to address their learning problems. First results on the efficacy of the implemented program to 20 primary school boys and girls with special reading disabilities encourage research on management of learning problems with focus on cognitive and emotional aspects in which parents and teachers contribute. Research including a control group is necessary.     

A follow-up program for suicide attempters: evaluation of effectiveness.

Suicide attempters are a high-risk group in relation to ultimately completing suicide and are usually "treated and released" with little or no follow-up care. A 4-month follow-up outreach program for suicide attempters seen in the emergency room was developed with an emphasis on continuity and quantity of "treatment" received. Suicide attempters were randomly assigned to the "follow-up outreach" or "normal" treatment programs. Measures for the evaluation of effectiveness were (a) incidence of suicide reattempts and purposive accidents and (b) prevalence of drug misuse and excessive use of alcohol. The experimental group showed a statistically significant reduction in suicide reattempts and excessive use of alcohol, while the reduction of drug abuse, although not statistically significant, did conform to a trend indicating improvement. Purposive accidents occured at a relatively equal rate among both groups.     

Home-based intervention for infants with developmental disorders

A hom-based therapeutic program for infants with developmental disorders is described. The program is used at the Institute for Psychophysiological and Speech Disorders, Belgrade, Yugoslavia. Significant changes in infant developmental competence provide support for the use of parents as direct intervention agents for their infants. Positive changes in marital and family relationships are important side effects of parent involvement in the therapeutic habilitation of their children.     

Prem Baby Triple P a new parenting intervention for parents of infants born very preterm: acceptability and barriers

Over 10% of preterm infants develop major disabilities, 50% develop behavioural problems and 40% need special education ( [Huddy et al., 2001] and [0185] ). Prem Baby Triple P is a new variant of the Positive Parenting Program (Triple P) adapted specifically for parents of very preterm infants. The aim of this study is to assess the acceptability of Prem Baby Triple P to parents of infants born preterm and to test whether parental attributions and parental perception of infant health/developmental status are barriers to intervention acceptability. One hundred and twenty-three parents of preterm infants participated, 83 parents of very preterm infants and 40 parents of preterm infants. In addition, 32 parents of term infants participated as a comparison group. The acceptability of Prem Baby Triple P was moderately high and did not differ significantly across the three groups. Parental attributions were not found to be barriers to intervention acceptability and parental perceptions that their infant is less healthy/developmentally delayed facilitated Prem Baby Triple P acceptance in parents of infants born very preterm. This suggests that the planned Prem Baby Triple P content is acceptable to parents of infants born very preterm and sensitised to medical and developmental issues. These findings, as social validation data, will contribute towards the further development of Prem Baby Triple P and a future randomised controlled trial.     

Group intervention with children of parents with aids

This paper describes a format for group intervention with children of parents with AIDS. Therapeutic factors specific to group work with these children and special issues regarding AIDS are discussed. The stages of development of such groups are outlined, with particular attention paid to themes of grief and loss. Suggestions for future work in this area are given.     

An intervention program for adolescents with behavior problems

Adolescents with behavior problems (aged 12 to 14) attending a regular public high school were in need of an intervention program. The purpose was to enhance their personal and interpersonal functioning as well as to structure a stimulating learning environment. In order to improve their social, educational, and psychological functioning, program objectives were established to help students develop the ability to listen to one another, respect others as well as their opinions, become aware of their own emotions and those of their peers, and recognize and minimize derogatory remarks toward one another. To attain these objectives, relaxation sessions, magic circle activities, art sessions, future planning groups, and decision-making groups were used. Meetings with teachers enabled them to examine and improve their attitudes and relationship with students. Upon completion of the program, the adolescents manifested less disruptive classroom behavior, increased their class participation, and displayed a more positive attitude toward school. The achievement of these behavioral changes indicates that a psychologically oriented intervention program is a feasible addition to a conventional curriculum. Teachers learned the basic skills of program formation, implementation, and evaluation, and most importantly, revitalized their attitude toward troubled students and their profession.     

A behavioral program for disruptive junior high school students: Results and follow-up

The 5-year annual and 4-year follow-up results of a collaborative community mental health center-junior high school program for disruptive students are presented. The program is a comprehensive, behavioral, in-school, regular education project characterized by a token economy, parent contracting, major subjects taught in the morning, small class enrollment, small group and individualized instruction, an early release from school contingency option and frequent parent-school communications. Annual controlled outcome results revealed that the program led to significant and consistent reductions in expulsions, suspensions, and grade failure, and variable, often significant, gains in attendance and achievement. Follow-up findings indicated that former program students in senior high school achieved a significantly higher entry rate, greater attendance, better classroom conduct, and a lower frequency of withdrawal from school.One second cohort student had been advanced a grade and was thus added to the original first cohort of 14 students.