Mother-Infant Psychotherapy Informed by Polyvagal Theory

This article illustrates the psychotherapeutic treatment of a 2-month-old male experiencing separation distress and problems in his regulatory system that were influencing the relationship with his mother. The baby was the product of a pregnancy complicated by maternal mental illness, homelessness, alcohol and drug exposure, lack of prenatal care, and a complicated delivery that required a 12-day hospital stay in the Neonatal Intensive Care Unit. The mother-infant psychotherapy was carried out over a two-year period and demonstrates the sensitive care needed when working with an overaroused and fearful baby and the critical ways that holding the mother in mind allows her in turn to hold her baby in mind. In this situation, the therapist provided an emotionally attuned interpersonal therapeutic relationship and created features of safety in the environment that helped develop new models of trust. We report here on an innovative program that provides health, mental health, onsite childcare, parenting education, and in-patient substance abuse services to mothers who are pregnant and/or parenting infants in the first three years of life. The specific purpose of the article is to discuss the mother-infant therapeutic treatment of a constitutionally challenged baby who was over aroused and fearful, and that we consider serves as an example for showing the favorable ways that holding the mother in mind free her to be emotionally available to the infant.     

Emotion Regulation in Families of Children with Behavior Problems and Nonclinical Comparisons

The current study compared parents’ emotion regulation (ER) in clinical (those with a child with externalizing behavioral problems) and low-risk comparison families. Additionally, mediation models were explored with parent ER predicting child behavior problems through child ER. Participants were 60 families with children (71.7% boys; 73% Caucasian) ages 2 through 8 years (M?=?4.62; SD?=?1.69) from a rural population in the United States: 34 clinical families referred for parent training and 26 nonclinical families. A blocking design was used to balance the two groups on key demographic characteristics. Parents’ and children’s ER was assessed using parent-report surveys and structured behavioral observations. Analyses indicated higher rates of parental emotion dysregulation (specifically, more difficulty when upset with achieving goal-directed behaviors, p?=?.01, d?=?0.67; controlling impulses, p?=?.01, d?=?0.64; limited use of ER strategies, p?=?.02, d?=?0.62; and more negative verbalizations to their child during the observed task, p?<?.01, d?=?0.73) and child emotion dysregulation (specifically, more difficulty as reported by parents, p?<?.01, d?=??2.42) in the clinical group. Mediational analyses indicated there were indirect paths from parental ER to children’s behavioral problems through child ER. Findings from this research suggest a need to measure and target ER in both parents and their children when working with families who are referred for treatment of child behavior problems.     

Force versus fury: Sex differences in the relationships among physical and psychological threat potential,the facial width‐to‐height ratio,and judgements of aggressiveness

Individuals with larger facial width‐to‐height ratios (FWHRs) are judged as more threatening, and engage in more threat‐related behavior, than do individuals with smaller FWHRs. Here we identified components of threat potential that are related to the FWHR. In Study 1, the FWHR was correlated positively with physical threat potential (bicep size) in women and with both physical and psychological (anger proneness) threat potential in men. Behavioral aggression was measured in a subset of these participants using the Point Subtraction Aggression Paradigm (costly aggression) and a Money Allocation Task (non‐costly aggression). Psychological (but not physical) threat potential predicted non‐costly aggression and physical (but not psychological) threat potential predicted costly aggression. In Study 2, a separate set of participants judged the anger proneness, strength, or aggressiveness of male participants photographed in Study 1. Participants’ judgements of all three characteristics were associated with the FWHR, and there were sex differences in how aggressiveness was conceptualized (for women, aggressiveness was associated with anger proneness, for men, aggressiveness was associated with strength). These results are consistent with the hypothesis that the FWHR may be an adaptation to cue the threat potential of men.

     

Prospective Associations of Coping Styles With Depression and Suicide Risk Among Psychiatric Emergency Patients

Suicide is the second leading cause of death for those ages 13–25 in the United States. Coping is a mediator between stressful life events and adverse outcomes, and coping skills have been incorporated into interventions (e.g., cognitive-behavioral therapy, dialectical behavior therapy, safety-planning interventions) for suicidal populations. However, longitudinal research has not directly examined the prospective associations between multiple coping styles and suicide-related outcomes in high-risk samples. This study identified cross-sectional and 4-month longitudinal associations of coping styles with suicide risk factors (i.e., depression, suicidal ideation, suicidal behavior) in a sample of 286 adolescent and young adult psychiatric emergency patients. Positive reframing was the coping style most consistently associated with positive outcomes, whereas self-blame and disengagement were consistently associated with negative outcomes. Active coping protected against suicidal behavior for males, but not for females. This was the first study to examine longitudinal relationships between coping and suicide-related outcomes in a high-risk clinical sample. Findings suggest that clinical interventions with suicidal adolescents and young adults may benefit from a specific focus on increasing positive reframing and reducing self-blame.     

Learning About Parenting Together: A Programme to Support Parents with Inter-generational Concerns in Pune,India

Rapid developments in the last few decades have brought about dramatic changes in Indian social life, particularly affecting new middle-class families. Inter-generational conflicts, high academic pressures, and modern anxieties lead to stress both in parents and in children. There is a need for parenting programmes that respond to these specific concerns, in order to reduce parenting stress and improve family well-being. This study aimed to develop and evaluate a parenting programme in Pune, India, based on a ‘theory of change’. In this pilot programme, parents were encouraged to learn in a group format about fostering autonomy in children, promoting academic potential in a stress-free manner and remaining in connection with adolescents. Facilitated by a psychologist, parents participated in four sessions involving ‘creativity and play’, ‘self-awareness and bonding’, and ‘communication’. The intervention was based on validated psychotherapeutic approaches and parenting methods to support parents in their learning. Some 16 in-depth interviews were conducted with parents before and eight interviews after the intervention to understand their learning experiences. Additional feedback was gathered from observation notes and debriefings after each session. The results show that the attention for playful quality time helped parents to (re)gain a more creative and flexible attitude towards spending time with their children. Second, parents learned to reflect on their frameworks of meaning (rooted in their own upbringing), listen attentively and communicate more mindful with their children. Furthermore, this study shows that an activity-based approach, connecting parents in co-creating new parenting paradigms, while supporting them with stress-reducing tools, is a useful way of engaging this target group. The study concludes by offering new perspectives for counsellors working with families in countries undergoing rapid change.     

Cultural Competence and School Counselor Training: A Collective Case Study

This collective case study investigated the experiences of bilingual counselors‐in‐training who assessed school‐wide cultural competence in public schools. Analysis and interpretation of data resulted in the identification of 5 themes: eye‐opening experiences, recognition of strengths, the role of school leaders, road maps for change, and empowering marginalized groups. Implications and recommendations are discussed. Este estudio de caso colectivo investigó las experiencias de consejeros bilingües en formación que evaluaron la competencia cultural institucional en escuelas públicas. El análisis e interpretación de los datos dieron como resultado la identificación de 5 temas: experiencias reveladoras, reconocimiento de puntos fuertes, el papel de los líderes académicos, hojas de ruta para el cambio y empoderamiento de grupos marginalizados. Se discuten las implicaciones y recomendaciones.