There is a dearth of good-quality research investigating the outcomes of psychoanalytic parent-infant psychotherapy (PIP). This randomized controlled trial investigated the outcomes of PIP for parents with mental health problems who also were experiencing high levels of social adversity and their young infants (<12 months). Dyads were clinically referred and randomly allocated to PIP or a control condition of standard secondary and specialist primary care treatment (n = 38 in each group). Outcomes were assessed at baseline and at 6-month and 12-month follow-ups. The primary outcome was infant development. Secondary outcomes included parent-infant interaction, maternal psychopathology, maternal representations, maternal reflective functioning, and infant attachment. There were no differential effects over time between the groups on measures of infant development, parent-infant interaction, or maternal reflective functioning. Infant attachment classifications, measured only at the 12-month follow-up, did not differ between the groups. There were favorable outcomes over time for the PIP-treated dyads relative to the control group on several measures of maternal mental health, parenting stress, and parental representations of the baby and their relationship. The findings indicate potential benefits of parent-infant psychotherapy for improving mothers' psychological well-being and their representations of their baby and the parent-infant relationship.

Mothers in prison represent a high-risk parenting population. New Beginnings is an attachment-based group intervention designed specifically for mothers and babies in prison. This cluster randomized trial examined the outcomes for 88 mothers and babies participating in the New Beginnings program and 75 dyads residing in prisons where the intervention did not take place. Outcomes were measured in terms of parental reflective functioning, the quality of parent–infant interaction, maternal depression, and maternal representations. Mothers in the control group deteriorated in their level of reflective functioning and behavioral interaction with their babies over time, whereas the mothers in the intervention group did not. There were no significant group effects on levels of maternal depression or mothers' self-reported representations of their babies over time. An attachment-based intervention may mitigate some of the risks to the quality of the parent–infant relationship for these dyads.

Data about the quality of attachment between infants and parents in high-risk populations suggests that early intervention may be advantageous for positive developmental outcomes for the child. Mothers in prison represent a high-risk parenting population in terms of both attachment histories and economic and social risk factors. New Beginnings was constructed as a short term, experience-based programme for mothers and infants in the Mother and Baby Units of two UK women's prisons. It is based on the early intervention model developed at the Anna Freud Centre. The programme was piloted in 2004-5, with 27 participating dyads. This paper presents an overview of the pilot stage. Our aim is to introduce the thinking that went into the programme and to present initial observations concerning the effect of the programme. We describe the development of a framework for the programme and its preliminary evaluation using pre-and post-interview protocols concerning the mothers' thoughts and feelings about their babies. We used the Parent Development Interview, for both a qualitative analysis of the major themes in connection to child rearing and quantitative measures of reflective capacity in relation to the child on the part of mother-participants.

No abstract

Objectives: A pilot baby clinic in a hostel for homeless families has been established to address the specific attachment and developmental needs of infants living in temporary accommodation. The aim of this study was to assess whether this clinic model was associated with more positive outcomes than mainstream community services in terms of infant development and parent-infant interactions.Design: Parent-infant psychotherapy and health visiting services collaborated to develop a new model of baby clinic which reconfigured the traditional clinic to give priority to infants' affective experiences in a therapeutic group setting. Outcomes for parent-infant dyads in a homeless hostel where this service model was applied were compared with outcomes for parents and infants in hostels which did not have such a service.Methods: Fifty-nine mother-baby dyads participated in evaluation, 30 in the intervention hostel group and 29 living in comparison hostels. Infant mental and motor development was assessed using the Bayley Scales of Infant Development. Interactions between the

This article provides an illustration of how the use of the Adult Attachment Interview (AAI; George, can be extended beyond the research arena to its use as a clinical instrument in parent-infant psychotherapy. The article is based on the ongoing work of the Parent-Infant Project team at the Anna Freud Centre, London, where psychoanalytically trained therapists routinely administer the AAI early in the therapeutic process. In the first part of the article, we introduce the thinking behind the use of the AAI as a clinical tool and its particular relevance to the field of parent-infant psychotherapy. In the second part, we track the accruing clinical picture built up from a case example of the initial clinical sessions with a father who attended the Parent-Infant Project with his partner and two young children, and from the father's AAI. The discussion of the AAI material illustrates the distinct, yet related, interpretations of the parent-infant psychotherapist and the independent AAI coder as each made sense of the father's interview transcript. The resulting dialogue, between the psychodynamicclinical and the attachment-research based approaches to the AAI, aims to highlight the added value the interview provides to the clinical understanding and process in parent-infant psychotherapy, which may ultimately help bridge the gap between the research and clinical domains.RESUMEN: Este ensayo aporta una ilustración de cómo el uso de la Entrevista de la Afectividad Adulta (AAI) puede ser extendido más allá del campo de la investigación para ser utilizado como un instrumento clínico en la sicoterapia entre padre e infantes. Este artículo se basa en el trabajo actual del equipo del Proyecto Padres-Infantes en el Centro Anna Freud, donde terapeutas sicoanalíticamente entrenados dan rutinariamente la mencionada entrevista en los primeros momentos del proceso terapéutico. En la primera parte de este artículo, introducimos el pensamiento que apoya el uso de la AAI como una herramienta clínica, así como la particular relevancia que la misma tiene en el campo de la sicoterapia entre padres e infantes. En la segunda parte damos seguimiento a la imagen clínica procedente de la construcción de un caso que sirve como ejemplo de las sesiones clínicas iniciales, con un padre que asistió al Proyecto Padres-Infantes con su pareja y sus dos niños pequeños, y de la Entrevista de la Afectividad Adulta de dicho padre. La discusión del material de la AAI sirve para ilustrar las distintas, aunque relacionadas interpretaciones del sicoterapeuta de padres e infantes y las del codificador independiente de la AAI, tal como cada una trató de buscar el mejor sentido de la transcrita entrevista del padre. El diálogo resultante, entre los acercamientos a la AAI, tanto los sicodinámico-clínicos como los basados en la afectividad y la investigación, busca subrayar el beneficio adicional que la entrevista les provee a la comprensión y proceso clínicos en la sicoterapia entre padres e infantes, el cual pudiera en última instancia ayudar a l...

No abstract

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.