Psychotherapeutic intervention with mothers and children in day care.

Abstract

The increasing use of day care permits opportunities for early intervention with children whose behavior indicates developing problems. Since these usually reflect difficulties in the relationships between children and parents, a relatively brief child-led intervention involving the parent, which appears helpful and effective, is described and illustrated with case examples.

Watch, wait, and wonder: Testing the effectiveness of a new approach to mother-infant psychotherapy

“…Even though recent evidence suggests that the relation between sensitivity and attachment is statistically modest (De Wolff & van IJzendoorn, 1997) because of the centrality of infant -parent attachment relationships and their potential for change, interventions have focused on altering maternal sensitivity and responsiveness to infants' signals. This has been done by changing maternal behavioral directly (e.g., Bakermans-Kranenburg et al, 1998;McDonough, 1992), by altering the mother's mental representation of her relationship with her infant, which is presumed to effect behavioral change toward the infant (Bakermans-Kranenburg et al, 1998;Cramer et al, 1990;Fraiberg et al, 1987;Lieberman et al, 1991;Robert-Tissot et al, 1996;Stern, 1995), or by working at the representational and behavioral level simultaneously (Muir, 1992;Muir & Thorlaksdottir, 1994).…”

“…The work of Mahrer et al and Johnson et al was refined for use in clinical settings by Muir, Stupples, and Guy (1989) and developed further in the context of the Toronto Infant -Parent Program (see Muir, 1992;Muir & Thorlaksdottir, 1994;Muir, Lojkasek, & Cohen, in press). Another form of infant-led psychotherapy, "floor time" (Greenspan, 1992) focuses on specific developmental and relational goals, working on the assumption that sensitive and appropriate responsiveness is essential.…”

Observant parents: Intervening through observation

“…Typically we find these problems have developed as a result of the conflict between the infant's need to establish an affective relational connection, and the mother's interactional constrictions related to her internal representations of her own early attachment relationship with her mother (Lieberman, 1992;Main, 1995;E. Muir, 1992, E. Muir & Thorlaksdottir, 1994. Provided that the problem is primarily focused in the relationship between mother and infant, and if there are no counter-indications, we offer WWW as an intervention.…”

“…WWW has been explored in recent years in clinical programmes (E. Muir, 1992; E. Muir rt al. 1989), in a day care setting (E. Muir & Thorlaksdottir, 1994), and in a rehabilitative programnie for drug and alcohol addicted mothers and their infants and young children (Mannle, 1997). I t has also been researched in comparative clinical studies (De Gangi & Greenspan, 1997; Cohen d aZ.…”

“…Muir ef nl. 1989;E. Muir & Thorlaksdottir, 1994;Wesner et al 1982) employs both the idea of obsmafion, (i.e., observation of the infant by the parent, and a parallel, concurrent observation of the mother-infant pair by the clinician), and also discussion of the parent's obsmationsand hcr emotional experience while observing her infant.…”