Infant mental health home visiting: intervention dosage and therapist experience interact to support improvements in maternal reflective functioning

Stacks, Ann M.; Jester, Jennifer M.; Wong, Kristyn; Huth‐Bocks, Alissa; Brophy‐Herb, Holly E.; Lawler, Jamie M.; Riggs, Jessica; Ribaudo, Julie; Muzik, Maria; Rosenblum, Katherine L.

doi:10.1080/14616734.2020.1865606

Cited by 15 publications

(17 citation statements)

References 67 publications

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“…Building upon previous reports that IMH-HV is an effective intervention that promotes maternal sensitivity, responsivity, and reflective functioning ( Rosenblum et al, 2020 ; Julian et al, 2021 ; Stacks et al, 2021 ), the current study explored the effectiveness of IMH-HV for improving child outcomes among mothers with a history of childhood adversity and current PTSD symptoms. Results indicated positive socioemotional outcomes for children of mothers who received IMH-HV compared to the control group, with the best outcomes seen for children of mothers with low to moderate PTSD symptoms who received the intervention.…”

Section: Discussionmentioning

confidence: 99%

“…A longer duration of treatment of both individual and dyadic psychotherapy may be warranted for mothers with more PTSD symptomology to effect improvement in children’s socioemotional functioning. Some mothers may need a sustained period of intervention to stabilize their symptoms ( Stacks et al, 2021 ). They may need time to experience “being held in the mind of another” ( O’Rourke, 2011 , p. 170) and understanding their own mental states ( Suchman et al, 2018 ) before they can regulate their own emotions well enough to help their child co-regulate.…”

Section: Discussionmentioning

confidence: 99%

“…For mothers with history of relational harm, the “felt sense” of being cared for that fuels mothering may be thin. The therapeutic relationship serves as a corrective emotional experience, but that takes time to develop, especially for mothers with a history of early childhood adversity ( Stacks et al, 2021 ). In addition, once the mother begins to understand her mental states, it will still take time for the child to shift their “expectation” of interactions.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of the infant focuses attention on the developing relationship and enables both the parent and the infant to inform the IMH specialist, via their interactive exchanges, what is going well and what is challenging. The Michigan Model of IMH-HV is an empirically validated approach to enhancing parenting outcomes ( Rosenblum et al, 2020 ; Julian et al, 2021 ; Stacks et al, 2021 ), but research is nascent of its’ impact on the socioemotional wellbeing of the infant. In the presence of a containing, responsive therapist, the parent is helped to grieve unmourned losses, give voice to the fears that went unnoticed in their own childhood, and hear and see the needs of their infant ( Malone and Dayton, 2015 ; Weatherston and Ribaudo, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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Maternal History of Adverse Experiences and Posttraumatic Stress Disorder Symptoms Impact Toddlers’ Early Socioemotional Wellbeing: The Benefits of Infant Mental Health-Home Visiting

et al. 2022

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BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting (IMH-HV) infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age (<24 months at enrollment) and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences (ACEs) parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder (PTSD) symptoms, as well as their toddler’s socioemotional development (e.g., empathy, prosocial skills, aggression, anxiety, prolonged tantrums).ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maternal History of Adverse Experiences and Posttraumatic Stress Disorder Symptoms Impact Toddlers’ Early Socioemotional Wellbeing: The Benefits of Infant Mental Health-Home Visiting

et al. 2022

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“…Future studies should also examine whether low maternal education and MRF interact to predict parenting quality. Several studies report that maternal education is associated with MRF (Sadler et al, 2013;Stacks et al, 2014Stacks et al, , 2021.…”

Section: Caregiving Representations and Mrfmentioning

confidence: 99%

Maternal caregiving representations of the infant in the first year of life: Associations with prenatal and concurrent reflective functioning

Alismail

Stacks

Wong

et al. 2021

Infant Mental Health Journal

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Few studies have examined whether maternal caregiving representations are associated with maternal reflective functioning (MRF), especially when MRF is evaluated longitudinally beginning in pregnancy. This study addresses this gap by evaluating whether prenatal and postnatal MRF are associated with mothers’ caregiving representations assessed at 7 months postpartum, and by exploring theoretically unexpected MRF scores in each of the representational categories. Forty‐seven mothers were recruited during their last trimester of pregnancy from an obstetrics clinic at a university hospital located in a large mid‐western city in the United States. During pregnancy, mothers completed the Pregnancy Interview, and at 7 months postpartum they completed the Parent Development Interview (PDI) and the Working Model of the Child Interview. Results indicate that higher prenatal and postnatal MRF increased the odds of being classified as balanced versus disengaged. At 7 months, MRF also increased the odds of being balanced vs. distorted. Ten mothers who were classified as balanced or distorted had unexpected prenatal MRF scores, and six mothers had unexpected MRF scores when representations were assessed concurrently. Mothers classified as balanced with low MRF scores tended to have a low level of education, whereas mothers classified as distorted with high MRF scores had responses that were hostile, helpless, and role‐reversed.

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From the voices of supervisees: What is reflective supervision and how does it support their work? (Part I)

Barron

Dayton

Goletz

2022

Infant Mental Health Journal

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Reflective supervision/consultation (RS/C) is a relationship for learning that embraces reflection and reflective practice strategies. It is considered best practice within the infant and early childhood mental health (IECMH) field. Based on research with supervisors, essential components of RS/C have been operationalized and used to develop evaluative tools. Little is known, however, about the essential components that supervisees find most useful. This paper, part I of a two‐part series, describes the essential components that supervisees identify as fundamental and ways they believe their work is supported by participation in RS/C. Fifty IECMH professionals located in the United States who received RS/C participated in focus groups or individual interviews. Data were analyzed using a Grounded Theory approach. Essential components of RS/C from the supervisee perspective included supervisee feelings of safety, the development of trust, holding a non‐judgmental stance, being available and present, and consistency and predictability. Additionally, supervisees identified outcomes of RS/C that included components of professional wellness, personal growth, and infant and family engagement. This study adds the supervisee's voice to the identification and operationalization of essential RS/C components and elucidates outcomes of RS/C that supervisees view as connected to their professional role.

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Infant mental health home visiting: intervention dosage and therapist experience interact to support improvements in maternal reflective functioning

Cited by 15 publications

References 67 publications

Maternal History of Adverse Experiences and Posttraumatic Stress Disorder Symptoms Impact Toddlers’ Early Socioemotional Wellbeing: The Benefits of Infant Mental Health-Home Visiting

Maternal History of Adverse Experiences and Posttraumatic Stress Disorder Symptoms Impact Toddlers’ Early Socioemotional Wellbeing: The Benefits of Infant Mental Health-Home Visiting

Maternal caregiving representations of the infant in the first year of life: Associations with prenatal and concurrent reflective functioning

From the voices of supervisees: What is reflective supervision and how does it support their work? (Part I)

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