Internet Mentalization Informed Video Feedback (MI-VF) Intervention to Improve Parental Sensitivity in Mother-Infant Dyads with Maternal Depressive Symptoms: Study Protocol for a Randomized Controlled Feasibility Trial

Abstract

Background: Depressive symptoms in the postpartum period are a highly prevalent mental health problem. COVID-19 restrictions have increased maternal clinical symptoms during the postpartum period, leading to a high demand for mental health assistance and the need for cost-effective care adjusted to this new context. Video feedback (VF) has been a particularly cost-effective strategy in early interventions focused on maternal sensitivity. However, these interventions usually do not include mentalization as one of the critical elements involved in sensitive and attachment relationships. Also, these interventions are generally carried out in face-to-face settings. This study's main goal is to evaluate the feasibility and acceptability of a brief internet mentalization informed with VF to improve the sensitive response in mother-baby dyads with postpartum depressive symptoms attended in primary health centers.Methods/design: This randomized feasibility trial will include 60 mother-baby dyads. Participants will be randomized and allocated in a 1:1 ratio. A random number sequence will be computer-generated in varying block sizes (2&4) and stratified by center. The intervention aims to improve maternal sensitivity and mentalizing by using a model based on video-feedback methodology in a virtual modality. The intervention consists of four sessions plus one pre-intervention assessment session and psychoeducational cards. Control dyads will receive only psychoeducational cards once a week. Additionally, dyads from both groups will receive the health center’s treatment as usual. A MI-VF manual guides each intervention session, but its application is tailored to each dyad, VF therapists will receive one weekly group supervision session. Data will be collected at baseline, 4 weeks and 3 months follow-up. The main goal of this trial is to assess feasibility outcomes (recruitment rate and data completion) and change in maternal sensibility.Discussion: This study will inform parameters for the future implementation of a large randomized controlled clinical trial, contributing to the current scarce evidence on mentalization informed interventions that use VF as their primary intervention strategy. Also, this study will provide a cost-effective internet-based intervention model, feasible to be implemented in public health settings.Trial registration: NCT04748731

Emotional Availability: Clinical Populations and Clinical Applications

“…They recommended that an interventionist experienced in this type of disability is needed to be able to "take in" how a child with this disability and a typical parent of such a child might present, e.g., many of them seeming quite avoidant and the parents quite directive. Several additional studies have posted descriptions of randomizedcontrolled trials that will not be discussed here since they are ongoing trials and findings are not yet available (Baraldi et al, 2020;Lebiger-Vogel et al, 2015;Matthess et al, 2020;Olhaberry Huber et al, 2021;Whittingham et al, 2020a), and so the work continues.…”