Exploring the factors affecting child and adolescent psychotherapists' and counsellors' decision‐making in clinical work with parents

This study examined interventions with parents/carers in child and adolescent counselling and psychotherapy (CAP). The aim was to investigate clinicians' rationale behind their decision to work with parents and what types of interventions they use. Furthermore, the nature of clinicians' core training with regard to interventions with parents was investigated. The study used both quantitative data and qualitative textual data from an online survey of 110 CAP clinicians. There was significant agreement, regardless of previous training or level of experience, that clinical work with parents in CAP is beneficial, but little consensus for a rationale or model for best practice. There was a relationship between training, theoretical orientation and whether CAPs felt competent to work with parents. Unexpectedly, a significant number (83%) of integrative practitioners said that there had been ‘little’ to ‘none at all’ focus on working with parents on their core training course. Other unforeseen findings were in the domain of working outside generally accepted boundaries for CAP, with a notable number of clinicians making home visits—24.1% with parents alone and 38.9% with parent and child together—along with 47.2% using phone calls and/or email for coaching and support with parents. Many clinicians were candid about their sense of a lack of competence in working with parents, even though at least half were senior, experienced clinicians. A number of these practitioners made specific reference to the wish for further specialist training, with many asking for signposting to where further training could be obtained.     

Attachment & Child Health (ATTACH) pilot trials: Effect of parental reflective function intervention for families affected by toxic stress

Toxic stressors (e.g., parental violence, depression, low income) place children at risk for insecure attachment. Parental reflective function—parents’ capacity to understand their own and their child's mental states and thus regulate their own feelings and behavior toward their child—may buffer the negative effects of toxic stress on attachment. Our objective was to test the effectiveness of the Attachment and Child Health (ATTACH) intervention, focusing on improving reflective function and children's attachment security, for at-risk mothers and children <36 months of age. Three pilot studies were conducted with women and children from an inner city agency serving vulnerable, low-income families and a family violence shelter. Randomized control trial (n = 20, n = 10 at enrollment) and quasi-experimental (n = 10 at enrollment) methods tested the effect of the ATTACH intervention on the primary outcome of reflective function scores, from transcribed Parent Development Interviews. Our secondary outcome was children's attachment patterns from Ainsworth's Strange Situation Procedure. Despite some attrition, mixed methods analysis of covariance and t tests revealed significant differences in maternal, child, and overall reflective function, with moderate effect sizes. While more children whose mothers received the ATTACH program were securely attached posttreatment, as compared with controls, significant differences were not observed, which may be due to missing observations (n = 5 cases). Understanding the effectiveness of programs like the ATTACH intervention contributes to improved programs and services to promote healthy development of children affected by toxic stress.     

Studying the process of psychoanalytic parent–infant psychotherapy: Embodied and discursive aspects

This paper presents findings from an intensive, mixed methods case study of one session of psychoanalytic parent–infant psychotherapy (PPIP) addressing early relational trauma, and aims to shed light on the multimodal interactive processes that take place in the moment-to-moment exchanges comprising the therapeutic encounter. Different research methods were used on video material from PPIP sessions, including microanalysis of adult–infant interactions, discourse analysis of talk, and coding systems developed to study parent–infant interaction. These different perspectives were brought together with the clinical narrative to illuminate the complex, dynamic processes of parent–infant–therapist interaction. More specifically, the detailed analysis of one interactive episode revealed brief behavioral manifestations of fearful and disoriented states of mind, reflecting dysregulated interaction between mother and infant, which also powerfully affected the therapist. The processes through which the therapist gradually resolves this rupture are also described in detail. Through this pilot study, we were able to show that it is possible to systematically study the process of PPIP. The study contributes to the growing psychotherapy research literature that takes into account both the verbal domain and implicit, interactional processes in therapeutic practice, and underscores the therapist's comprehensive engagement in the therapeutic process.     

The effects of the Newborn Behavioral Observations (NBO) system in early intervention: A multisite randomized controlled trial

The purpose of this pilot study was to evaluate the effect of an infant mental health intervention, the Newborn Behavioral Observations system (NBO), versus usual care (UC) on infant neurodevelopment and maternal depressive symptoms in early intervention (EI). This multisite randomized trial enrolled newborns into the NBO (n = 16) or UC group (n = 22) and followed them for 6 months. Outcome measures included the Battelle Developmental Inventory (BDI-2), Bayley Scales of Infants Development (BSID-III), and Center for Epidemiologic Studies Depression Scale (CES-D). The CES-D and BSID-III were collected at 3- and 6-months post EI entry and the BDI-2 was collected at EI entry and 6-months post-EI entry. We estimated group differences [95% CI], adjusting for program characteristics. At 6 months, the NBO group had greater gains in Communication (b = 1.0 [0.2, 1.8]), Self-Care (b = 2.0 [0.1, 3.9]), Perception and Concepts (b = 2.0 [0.4, 3.6]), and Attention and Memory (b = 3.0 [0.4, 6.0]) than the UC group. The NBO group also had greater decline in maternal postnatal depressive symptoms (b = −2.0 [−3.7, −0.3]) than the UC group. Infants receiving the NBO infant mental health intervention had greater gains in cognitive and adaptive functions at 6 months than infants receiving UC. Caregivers receiving NBO care had greater improvements in maternal depressive symptoms than caregivers receiving UC.     

Tummy time without the tears: The impact of parent positioning and play

The American Academy of Pediatrics (AAP) recommends that infants spend supervised time in the prone (tummy) position to foster motor development and prevent cranial deformities. However, infants may not tolerate the position, and consequently, caregivers may avoid placing their infants in the prone position. The AAP recommends that caregivers provide toys or interaction during tummy time. We evaluated the individual and combined effects of a play mat and experimenter interaction on negative vocalizations and head elevation during tummy time—positive effects were limited. Next, we evaluated a parent-led intervention wherein mothers interacted with their infants, using a toy, while lying chest-to-chest. This intervention was associated with a reduction in negative vocalizations and an increase in head elevation for the majority of infants. Additionally, mothers rated the effectiveness of the parent-led intervention more favorably than the experimenter-led intervention, suggesting the effects of the parent-led intervention were also socially valid.     

Innovation in therapeutic practice with ‘violent youth’: A discourse analysis of the non‐violent resistance approach

Introduction: The introduction of the innovative non‐violent resistance approach (NVR) at a multi‐agency service in east Kent, UK, has presented challenges in terms of the recruitment of the necessary wider professional support for the family, with some professionals seeing the approach as not child‐focused. Aims and objectives: To identify child‐focused themes among professionals, and to compare these with discourses used in NVR and, for comparison, in the Webster‐Stratton approach, to elucidate possible obstacles to the acceptance by professionals of NVR. Methods and analysis: A focus group of experienced professionals was convened to discuss what it means to be child‐focused, and a thematic analysis was conducted. Key texts from NVR and the Webster‐Stratton approach were selected and analysed using Foucauldian discourse analysis. Results: Being child‐focused was considered to require the child's voice being heard, at least by the parents. Power differentials and developmental issues were also highlighted in the discussion. The key text analyses suggests that the Webster‐Stratton approach is communicated through familiar ‘biomedical’ and ‘missionary’ discourses, while surprisingly NVR is communicated through a discourse of ‘war’ as well as the more familiar and child‐focused ‘family values’ discourse. Implications: The ‘war’ discourse used by NVR, in which violent young people are seen as aggressors and oppressors, challenges the traditional discourses of childhood formed around notions of innocence. The implications of these findings are discussed in relation to furthering the adoption of NVR as an effective way of working to help violent children of all ages.     

Effects of individualized video feedback combined with group parent training on inappropriate maternal behavior

The effects of adding individualized video feedback (IVF) to Webster-Stratton's (2000, 2001) group-based parent training program (GT) were evaluated using a multiple baseline design across four mother-child dyads. During all phases of the study, inappropriate maternal behavior was recorded from videotapes of playtime with their preschoolers with developmental disabilities. Results suggested that GT+IVF reduced inappropriate maternal behavior to levels below GT alone.     

Training parent implementation of discrete-trial teaching: effects on generalization of parent teaching and child correct responding

Behavioral skills training was used to teach 3 parents to implement discrete-trial teaching with their children with developmental disabilities. Parents learned to implement discrete-trial training, their skills generalized to novel programs, and the children's correct responding increased, suggesting that behavioral skills training is an effective and efficient method of teaching discrete-trial teaching to parents.     

A Review of Childrearing in African American Single Mother Families: The Relevance of a Coparenting Framework

Clinical research on African American single mother families has focused largely on mother-child dyads, with relatively less empirical attention to the roles of other adults or family members who often assist with childrearing. This narrow definition of “family” fails to take into account the extended family networks which often provide support for African American single mother families and the influence of these other adults on maternal parenting and youth adjustment. Our review integrates the literature on the role of extended family members, highlights the strengths and limitations of this work, and proposes the use of theory and methods from the coparenting literature to guide future study in this area. The relevance of the study of coparenting for family-based intervention efforts targeting African American youth from single mother homes is addressed.     

物体受力分析正误样例组合的学习效果

分别采用正误样例组合、有无错误标记的正误样例组合和有标记的正误样例配对组合设计方法,以物体受力分析正误样例为实验材料,以初中三年级学生为被试进行3项实验,考察了被试物体受力分析图正误样例组合的学习效果。结果表明,正误样例组合的学习成绩显著优于正确样例组合的学习成绩;有标记的正误样例组合的学习成绩显著优于无标记样例组合的学习成绩;有标记正误样例配对组合的学习成绩明显优于正确样例组合的学习成绩。