Adding “Circle of Security – Parenting” to treatment as usual in three Swedish infant mental health clinics. Effects on parents’ internal representations and quality of parent‐infant interaction

Abstract

. Adding "Circle of Security -Parenting" to treatment as usual in three Swedish infant mental health clinics. Effects on parents' internal representations and quality of parent-infant interaction. Scandinavian Journal of Psychology, 59,[262][263][264][265][266][267][268][269][270][271][272] This study presents effects of adding Circle of Security-Parenting (COS-P) to an already established comprehensive therapeutic model for early parentchild intervention in three Swedish infant mental health (IMH) clinics. Parents' internal representations and quality of parent-infant interaction were studied in a clinical sample comprised of 52 parent-infant dyads randomly allocated to two comparable groups. One group consisted of 28 dyads receiving treatment as usual (TAU) supplemented with COS-P in a small group format, and another group of 24 dyads receiving TAU only. Assessments were made at baseline (T1), 6 months after inclusion (T2) and 12 months after inclusion (T3). Changes over time were explored in 42 dyads. In the COS-P group, the proportion of balanced representations, as assessed with Working Model of the Child Interview (WMCI), significantly increased between T1 and T3. Further, the proportion of emotionally available interactions, as assessed with Emotional Availability scales (EA), significantly increased over time in the COS-P group. Improvements in the TAU-group were close to significant. Limitations of the study are mainly related to the small sample size. Strength is the real world character of the study, where COS-P was implemented in a clinical context not otherwise adapted to research. We conclude by discussing the value of supplementing TAU with COS-P in IMH treatment.

Effects of an attachment-based parent intervention on mothers of children with autism spectrum disorder: preliminary findings from a non-randomized controlled trial

“…The control participants were recruited independently of the intervention group in 2018. Though COSP is designed for caregivers of preschool-aged children, we targeted older children (aged 4–12 years), similar to a previous study [ 45 ] because of the difficulty in diagnosing ASD in the preschool period. Participation was limited to mothers in order to simplify the gender composition of each group.…”

“…A series of studies have reported that COS-Intensive and COSP effectively improve child attachment [ 37 ] as well as behavior and emotional functioning [ 41 ]. Some of these studies have performed RCTs to demonstrate the statistical significance of the improvement in sensitivity [ 42 , 43 ], responsiveness [ 44 ], balanced representations, and emotionally available interactions [ 45 ] of mothers. In addition, a meta-analysis pooling data from trials of the COS-Intensive and COSP protocols indicated improvement in the self-efficacy of caregivers along with decreases in their depressive symptoms [ 46 ].…”

Parent and practitioner perspectives on Circle of Security Parenting (COS‐P): A qualitative study

“…The remaining COS‐P studies report a range of positive outcomes, including greater emotional availability and more balanced representations of the infant (Risholm Mothander et al., 2018), reduced caregiving helplessness (Kohlhoff et al., 2016), and reduced depression symptoms (Coleman, 2014; Kim et al., 2018; Maupin et al., 2017). However, methodological limitations mean that current evidence can be described as promising at best.…”

Factors contributing to continuity and discontinuity in child psychopathology from infancy to childhood: An explorative study

“…Infant regulatory difficulties, expressed as excessive crying, eating and sleeping difficulties, aggression, fears and anxieties, parental stress and psychopathology and disturbed parent–infant relationships are common complains during infancy ( Barlow et al, 2016 ). At times, these early symptoms and the related parental stress and strained parent–child relationship become severe enough that they lead to a referral for treatment in an infant mental health (IMH) clinic ( Hemmi et al, 2011 ; Mothander et al, 2018 ). The goal of the current study is to trace these infants into late childhood and assess their current socioemotional and psychiatric functioning.…”

“…Likewise, utilizing attachment theory, Lyons-Ruth (1996) outlined the interplay between a mother’s failure to respond to her infant’s appropriate attachment needs, reflecting her own distress and developmental history, the development of disorganized attachment in her child, and the emergence and continuity of the child’s aggressive behavior. In line with this conceptualization, early interventions sought to improve the infant’s wellbeing by focusing simultaneously on the infant, the parents, and the parent–infant relationship ( Barlow & Svanberg, 2009 ; Mothander et al, 2018 ). These interventions have proven to be effective in improving parenting skills, parent–child interactive patterns, and the child’s socioemotional wellbeing ( Bakermans-Kranenburg et al, 2005 ; Bergström et al, 2020 ; Fukkink, 2008 ), as well as in reducing parental stress and psychopathology ( Huber et al, 2016 ).…”