INTERFACING INFANT MENTAL HEALTH KNOWLEDGE: PERSPECTIVES OF SOUTH AFRICAN SUPERVISORS SUPPORTING LAY MOTHER–INFANT HOME VISITORS

This article is part of a project investigating the interfacing of clinically and research‐generated knowledge in the field of infant mental health (IMH) with local cultural models of child care and development. The article explores the experiences and challenges reported by psychology‐trained supervisors in supervision with local, lay, trained home visitors. Supervisors and supervisees were drawn from two early intervention programs which apply relational IMH mental health models in socioeconomically deprived townships in South Africa. Literature that considers supervisors’ experiences of conducting supervision with lay counselors has been limited, and even more so in settings where there are marked cultural and contextual differences between supervisors and supervisees. These differences pose particular challenges regarding the finding of a shared theoretical understanding of the work as well as to the establishment of a secure working alliance. While it was found that psychoanalytic and attachment‐informed theories of infant development are applicable in these South African settings, differences in race, language, education, socioeconomic status, and culture between supervisors and supervisees challenge the supervisor–supervisee relationship and require psychological processing and creative solutions to ensure integrity in the application of the model.     

Expanding Possibilities: Flexibility and Solidarity with Under-resourced Immigrant Families During the COVID-19 Pandemic

The novel coronavirus has added new anxieties and forms of grieving to the myriad practical and emotional burdens already present in the lives of underserved and uninsured immigrant families and communities. In this article, we relate our experiences since the COVID-19 crisis to the lessons we have learned over time as mental health professionals working with families in no-cost, student-managed community comprehensive health clinics in academic-community partnerships. We compare and contrast the learnings of flexibility of time, space, procedures, or attendance we acquired in this clinical community setting during regular times, with the new challenges families and therapists face, and the adaptations needed to continue to work with our clients in culturally responsive and empowering ways during the COVID-19 pandemic. We describe families, students, professionals, promotoras (community links), and IT support staff joining together in solidarity as the creative problem solvers of new possibilities when families do not have access to Wi-Fi, smartphones, or computers, or suffer overcrowding and lack of privacy. We describe many anxieties related to economic insecurity or fear of facing death alone, but also how to visualize expanding possibilities in styles of parenting or types of emotional support among family members as elements of hope that may endure beyond these unprecedented tragic times of loss and uncertainty.     

Family Science in the Context of the COVID-19 Pandemic: Solutions and New Directions

The coronavirus disease 2019 (COVID-19) pandemic has precipitated substantial global disruption and will continue to pose major challenges. In recognition of the challenges currently faced by family scientists, we share our perspectives about conducting family research in the context of the COVID-19 pandemic. There are two primary issues we address in this article. First, we present a range of potential solutions to challenges in research, resulting from the pandemic, and discuss strategies for preserving ongoing research efforts. We discuss approaches to scaling back existing protocols, share ideas for adapting laboratory-based measures for online administration (e.g., using video chat platforms), and suggest strategies for addressing missing data and reduced sample size due to lower participation rates and funding restrictions. We also discuss the importance of measuring COVID-19 relevant factors to use as controls or explore as moderators of primary hypotheses. Second, we discuss how the COVID-19 pandemic represents a scientifically important context for understanding how families adjust and adapt to change and adversity. Increased stress precipitated by the pandemic, varying from acute stress associated with job loss to more chronic and enduring stress, will undoubtedly take a toll. We discuss ways that family scientists can contribute to pandemic-related research to promote optimal family functioning and protect the health of family members.     

Lessons from the Transition to Relational Teletherapy During COVID-19

When the World Health Organization declared the coronavirus outbreak a pandemic, clinicians were challenged to maintain continuity of care. Teletherapy became the primary means of service delivery for many who had never or only sparingly used it. The Family Institute at Northwestern University, in response to encouraging findings with respect to the effectiveness of teletherapy and recognizing advantages with respect to access to care, launched our teletherapy services in 2018. As a relationship-based organization, we were keen to exploit the opportunity that teletherapy provides to integrate additional members of the client system into the treatment. Over these two plus years, we have learned a great deal. Our learning was greatly accelerated by our transition to a 100% teletherapy practice in the wake of the pandemic. Teletherapy is a different context. Intentionally managing the context’s constraints and exploiting its strengths is key to providing high-quality couple and family therapy. This step is often overlooked or resisted when teletherapy is an occasional add-on to a face-to-face practice.     

Evaluation of early relational disturbance in high-risk populations: Borderline personality disorder features,maternal mental state,and observed interaction

Despite the longstanding theoretical association in the attachment literature between maternal trauma history and disturbances in the mother–infant interaction, few studies have investigated mechanisms of transmission of traumatogenic relational patterns in high-risk mother–infant dyads. This study investigated interrelationships among maternal trauma history, distorted maternal representations (DMRs, i.e. disturbed thoughts and feelings about the infant and self-as-parent), maternal mentalisation (i.e. capacity to conceive of self and other's intentions in terms of mental states including thoughts, feelings, and desires), and quality of interaction in a clinical sample of mothers with Borderline Personality Disorder (BPD) features and their infants (N = 61). Measures used included the Childhood Trauma Questionnaire, Parent Development Interview, Mother–Infant Relationship Scale, Borderline Symptom Checklist-23, and the Emotional Availability Scales. The results indicated BPD features mediated the relationship between maternal trauma history and DMRs predicting disturbance in interaction. In addition, analyses showed that maternal mentalisation had a buffering effect between DMRs and maternal non-hostility and yet the severity of BPD features moderated the relationship between mentalisation and DMRs. The findings suggest postpartum borderline pathology may adversely impact the experience of being a parent for women with a relational trauma history including deficits in mentalisation (i.e. hypermentalising) and disturbances in the mother–infant interaction. Implications for research and clinical practice are discussed.     

Does knowing translate to doing? Practitioners’ experiences of Circle of Security-Parenting (COS-P) training and implementation

This study sought to understand how practitioners perceive and experience the Circle of Security-Parenting (COS-P) training, and further, how they integrate and implement it into practice, and how these experiences influence their use and understanding of the program and its underlying model. A thematic analysis of semistructured interviews at two time points (shortly after training and 3–6 months after training) was used to explore 12 practitioners’ experiences of COS-P training and subsequent implementation. Three main themes were identified; clinical salience, personal salience, and partial use of the program. The findings reflected participants’ common perception that the model is relevant and generalizable to a wide variety of contexts. It also highlighted potential barriers to implementation, particularly practitioners’ experiences using only components of the COS-P program in isolation. The results suggest practitioners’ assumptions about client complexities, vulnerabilities, and/or incapacities, can prompt practitioners to withhold the use of COS-P (in part or whole), thereby potentially neglecting key components required for client change. The only participants who implemented the COS-P training in full had additional training in Circle of Security.     

The effect of prenatal adversity on externalizing behaviors at 24 months of age in a high-risk sample: Maternal sensitivity as a moderator

The purpose of this study was to examine the moderating role of maternal sensitivity on the association between prenatal adversity and externalizing behaviors at 24 months of age in a diverse, high-risk sample. We hypothesized that among children with higher prenatal adversity, high maternal sensitivity would serve as a protective factor. Participants were 247 primarily low-income, diverse dyads. Results indicated a significant interaction effect of maternal sensitivity and prenatal adversity on externalizing problems. The association between prenatal adversity and externalizing behaviors was significant only among children who experienced low prenatal adversity, with higher maternal sensitivity associated with lower externalizing behaviors. These findings indicate that, in the absence of high prenatal risk, responsive and sensitive parenting can buffer children in an otherwise high-risk sample from the development of externalizing behaviors.     

Utilizing Latinx Cultural Wealth to Create a College-Going Culture in High School

Capitalizing on Latinx students’ aspirational, linguistic, social, navigational, familial, resistant, perseverant, and spiritual community cultural wealth (CCW) can help school counselors empower Latinx students. We outline and integrate critical race theory and CCW and demonstrate how communities of color bring assets and protective factors with them to their educational settings. We also examine how school counselors can utilize these eight forms of CCW to promote postsecondary opportunities for Latinx youth. Aprovechar las ventajas que ofrece la riqueza cultural de la comunidad (CCW, por sus siglas en inglés) de estudiantes latinxs y su capital aspiracional, lingüístico, social, familiar, espiritual, de navegación, de resistencia y de perseverancia puede ayudar a los consejeros escolares a empoderar a estudiantes latinxs. Perfilamos e integramos la teoría crítica de la raza y el modelo de CCW y demostramos cómo las comunidades de color aportan recursos y factores de protección a sus entornos educativos. También examinamos cómo los consejeros escolares pueden utilizar estas ocho formas de CCW para potenciar las oportunidades disponibles para jóvenes latinxs después de su educación secundaria.     

Assessment of Person-Centered Care in Gerontology Services: A new tool for healthcare professionals

Background/Objective: Retirement homes and other gerontology services are frequently criticized due to their lack of flexibility and tailored attention, leading to homogeneous treatment which compromises patients’ control of their lives. This study aims to develop and validate the first Spanish instrument for healthcare professionals to assess the degree of person-centered attention delivered by senior care centers. Method: A total of 844 healthcare professionals (mean age = 39.94 years old; SD = 10.56) with a mean of 6.56 years (SD = 6.15) of work experience participated in the study. The psychometric properties of the questionnaire developed were analyzed using both classical test theory and item response theory models. Results: The internal structure was unidimensional with an explained variance of 55.23%. Reliability was outstanding: internal consistency (α = .96, ω = .96) and test-retest (r = .88; ICC = .93). The total score was significantly correlated with two similar questionnaires, with associated variance of 58.83% and 55.20% respectively. Conclusions: The new instrument allows healthcare professionals to assess the level of person-centered care provided by gerontology centers with excellent reliability and validity.     

The dark side of Instagram: Predictor model of dysmorphic concerns

Background/ObjectiveDysmorphic concern are excessive preoccupation about one or several physical characteristics perceived as defects, usually unnoticeable by others. This study was intended to explore the relationship between Instagram use and dysmorphic concerns through appearance-related comparisons, ideas of reference and problems with emotion regulation, and find out whether this relationship is moderated by gender. Method: The sample was comprised of 796 participants (M_age = 22.49; SD = 3.56; 54% women). Results: The results showed a non-significant direct effect between Instagram use and dysmorphic concerns. However, the relationship between these variables was statistically significant through appearance-related comparisons, ideas of reference about “laughing, commenting” and difficulties in emotion regulation. Gender did not moderate any relationship. Conclusions: Men and women who made the most use of Instagram were equally vulnerable to dysmorphic concerns when they tended to compare their appearance with other users, had problems regulating their emotions, and showed interpretative biases related to the belief that others could make comments about them or laugh at them because of their imperfections. The implications of the study are discussed.