Infant mental health home visiting in the context of an infant—toddler court team: Changes in parental responsiveness and reflective functioning

Abstract

This article describes an infant–toddler court team in Michigan, the community‐based participatory research approach to the implementation evaluation, and the resulting changes in parenting. Like other court teams, Michigan's Baby Court is led by a science‐informed jurist, and all service providers are knowledgeable about the developmental needs of young children and engage in collaborative communication throughout the case. Relationship‐based treatment in the form of infant mental health home‐visiting was provided to families. Sixteen parents participated in pre‐ and posttest evaluation visits to assess changes in parents’ reflective functioning and interactions with their child. Findings suggest improvements in parents’ responsiveness, positive affect, and reflective functioning, with moderate effects. Higher risk parents demonstrated significant changes in reflective functioning, as compared to those at lower risk. These findings add to and support the limited literature on the effectiveness of infant–toddler court teams, which include relationship‐based and trauma‐informed services.

Prenatal Reflective Functioning as a Predictor of Substance-Using Mothers' Treatment Outcome: Comparing Results From Two Different RF Measures

“…Earlier studies similarly show mixed results regarding whether less or more vulnerable individuals benefit more from parenting interventions. Some studies suggest, similarly to our PRF results, that more vulnerable individuals benefit more from parenting interventions, perhaps simply because they need them more (Robinson and Emde, 2004 ; Paris et al, 2015 ; Stacks et al, 2019 ). Actually, Stacks et al ( 2019 ) even found that only mothers with low PRF (3 or below) received benefits from their early home-visiting intervention.…”

“…Slade et al ( 2020 ) similarly showed in their high-risk mothers undergoing the Minding the baby-intervention that maternal prenatal PRF predicted higher post-natal PRF. On the contrary, Stacks et al ( 2019 ) found that only those with the lowest pre-intervention PRF ( ≤ 3) showed increased PRF after an infant mental health home visiting intervention. This is in line with other findings that the most vulnerable individuals, such as those with trauma, attachment insecurity, or high psychological distress, may benefit more from parenting interventions than less vulnerable parents (Robinson and Emde, 2004 ; Paris et al, 2015 ; Stacks et al, 2019 ).…”

Stressed Mothers Receiving Infant Mental Health-Based Early Head Start Increase in Mind-Mindedness

“…Techniques often involve carefully observing the ways and times in which pregnancy, birth, and early parenting experiences evoke the parent’s prior trauma and/or painful relationship history ( Weatherston et al, 2020 ). Recent research has demonstrated that IMH-based visiting models are associated with mothers’ greater sensitivity in interactions with their infants and toddlers ( Rosenblum et al, 2020 ) and with mothers’ increased mentalization, to date, assessed as parental reflective functioning ( Stacks et al, 2019 , 2022 ); reflective functioning refers to the parent’s capacity to hold awareness of the infant’s internal mental states ( Slade, 2005 ). Hence, a next step in this evolving research is to examine any potential IMH-based intervention effects on mothers’ mentalization, assessed as their appropriate MRC in interactions with their children.…”

Reflective parenting home visiting program: A longitudinal study on the effects upon depression, anxiety and parenting stress in first-time mothers

“…Reflective parenting program appears to be particularly effective. Exploring maternal thoughts, experiences and feelings, promoting her mentalization capacity, supporting sensitive, responsive parenting skills seem crucial in promoting maternal mental health ( Allen and Fonagy, 2006 ; Ammerman et al., 2010 ; Fonagy and Target, 1998 ; Slade, 2005 , 2007 ; Slade et al., 2019 ; Stacks et al., 2019 ).…”

“…In such direction, Reflective Parenting Programs (RPPs) have proved to be especially effective ( Slade, 2007 ; Slade et al., 2019 ; Stacks et al., 2019 ). RPPs are based on Fonagy's concept of mentalization and target the development of maternal Reflective Functioning (RF) in mothers ( Fonagy et al., 2002 ; Slade, 2005 , Slade et al., 2019 ).…”