Newborn behavioral observations system in rural Pakistan: A feasibility and acceptability study

The Newborn Behavioral Observations (NBO) system is a relationship-based tool that helps parents recognize their infant's competencies and learn their behavioral cues, with the goals of enhancing parental responsiveness and satisfaction in the infant-parent relationship. In our study, a pediatrician integrated the NBO into 44 pediatric health care visits of infants in rural Pakistan villages, under the remote guidance of two U.S.-based child psychiatrists. A clinician then gave the mothers a survey about their experience of the NBO and found that the mothers were highly satisfied, reporting greater appreciation of their infant's strengths, greater understanding of their infant's behavioral cues, stronger attachment to their infant, and greater self-confidence as a mother. In their consideration of these results, the authors explore cultural reasons for the mothers’ responses and generate hypotheses to inform an outcome study of a similar intervention. This was a feasibility and acceptability study and was not randomized, had no control group, and did not use objective measures of outcome.     

The risk of low risk: First time motherhood,prematurity and dyadic well-being

Premature birth has a well-documented impact on infants, mothers and their dyadic interactions. First time motherhood in the context of low risk premature birth—relatively unexplored in the literature—is a specific experience that sits at the nexus of premature infancy, motherhood and the processes that underpin dyadic connection. This qualitative study analyzed semistructured interviews with first time mothers of low risk premature babies. Findings were generated in response to research questions concerning mothers’ meaning-making, bonding and identity. Findings demonstrated that maternal meaning-making emerged from a dyadic framework. When mothers or their infants were considered outside of a dyadic context, surplus suffering inadvertently occurred. Findings have important implications for infant mental health practice in medical settings, for postnatal support in the aftermath of premature birth, and for understanding the meaning of risk.     

“What support would you find helpful?” The relationship between treatment expectations,therapeutic engagement,and clinical outcomes in parent–infant psychotherapy

The aim of this study was to investigate the impact of pretreatment expectations on clinical outcomes and engagement in Parent–Infant Psychotherapy (PIP). Sixty-one mothers who were experiencing mental health difficulties and who were receiving PIP with their young infants participated in the study. A mixed-methodology was used to examine participants’ expectations through transformation content analysis of pretreatment interviews; recurring themes were classified and quantified. Further statistical analyses explored relationships between the quantified themes of parental expectations and clinical outcomes and engagement in treatment. No significant correlation was found between expectations and engagement. One of the six clinical outcomes significantly correlated with parental expectations. Improved reflective functioning (RF) was predicted by participants describing expectations of wanting to improve their parent–infant relationship through the treatment, and expressing concerns about discussing their past experiences. These two expectations predicted improvements in RF independently and when combined. These results indicate that PIP may be more effective for some mothers than others and that assessing future clients’ expectations before beginning PIP may be beneficial.