Mentalizing Makes Parenting Work: A Review about Parental Reflective Functioning and Clinical Interventions to Improve It

Abstract

In the last decade several studies have investigated the role of parental reflective functioning (RF), defined as the parental ability to understand his/her child’s mental states, on the child’s development. Herein, a narrative review on parental RF is presented aimed at (1) presenting an overview of the existing empirical studies, (2) pinpointing unrequited questions, and (3) identifying future research directions. Specifically, the current review focused on (a) the impact of parental RF on the quality of caregiving and the child’s attachment security, (b) the effect of parental RF on the child’s emotion regulation and the child’s RF, (c) maternal RF in women with a history of neglect and abuse, (d) the efficacy of mentalization-based clinical interventions, and (e) the recently developed Parental Reflective Questionnaire. The following terms “maternal RF,” “paternal RF,” “parental RF,” “parental mentalization,” “maternal mentalization,” and “paternal mentalization” were searched in titles, abstracts, and main texts using Medline, Web of Science, and Scopus databases. Next, a search in Mendeley was also conducted. Inclusion criteria comprised original articles if they refer to the RF Scale (Fonagy et al., 1998) and were published in an English language, peer-reviewed journal before July, 2016. According to exclusion criteria, dissertations, qualitative or theoretical papers, and chapters in books were not taken into account. The review includes 47 studies that, taken together, supported the notion that higher parental RF was associated with adequate caregiving and the child’s attachment security, whereas low maternal RF was found in mothers whose children suffered from anxiety disorders, impairment in emotion regulation, and externalizing behaviors. In addition, higher parental RF was associated with better mentalizing abilities in children. However, unexpected findings have emerged from the most recent randomized controlled trials that tested the efficacy of mentalization-based interventions in high risk samples of mothers, raising questions about the suitability of the verbal measures in capturing the mentalizing processes at the root of the parental capacity to be adequately responsive to the child’s emotional needs.

Maternal Mentalization and Behavior Under Stressful Contexts: The Moderating Roles of Prematurity and Household Chaos

“…Past research has focused on how mentalization promotes sensitive behavior (e.g., Camoirano, ), leaving out the question of whether (and why) mentalization may not guide behavior under certain conditions. Deater‐Deckard () proposed that stress acts as an obstacle to parents' attempts to respond appropriately to their children's needs by promoting less under‐controlled, more reactive parenting.…”

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

“…Studies have suggested that reflective parenting programs improve RF and parenting (Bammens, Adkins, & Badger, ; Pajulo et al., ; Sadler et al., ; Suchman, DeCoste, Castiglioni, et al., ; Suchman et al., ; Suchman, Ordway, de las Heras, & McMahon, ). Yet, it remains unclear whether changes in RF lead to the changes in parenting behavior or whether these changes happen simultaneously (see Camoirano, ; Sleed, Baradon, & Fonagy, ; Suchman et al., ). Therefore, it is important to measure both outcomes in intervention studies that aim to improve parenting.…”

Mothers’ and fathers’ mind‐mindedness influences physiological emotion regulation of infants across the first year of life

“…On the other hand, the mental component of mind‐mindedness (mentalizing) may enable parents to respond to and interact with their infant in an attuned manner, both on a conscious and an unconscious level (e.g., by being sensitively responsive to infant cues, synchronous, cooperative, warm, and autonomy granting; Camoirano, 2017; Zeegers et al., 2017). The importance of parents’ “mind‐minded” stance on infants’ developing emotion regulation may become more evident in an example of the parent and infant interacting in a peekaboo game.…”