The Circle of Security Parenting Program (COS-P): A Randomized Controlled Trial of a Low Intensity, Individualized Attachment-Based Program With at-Risk Caregivers

Zimmer‐Gembeck, Melanie J.; Rudolph, Julia; Edwards, Elia-Jade; Swan, Kellie; Campbell, Shawna Mastro; Hawes, Tanya; Webb, Haley J.

doi:10.1016/j.beth.2021.07.003

Cited by 8 publications

(9 citation statements)

References 53 publications

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“…Twenty-seven studies included a control group. Of these, 20 studies implemented a wait-list control group where participants received the intervention after an extended waiting period during which no treatment was delivered ( n = 16) or caregivers received weekly brief telephone check-ins ( n = 4, Thomas and Zimmer-Gembeck, 2011, 2012; Webb et al, 2017; Zimmer-Gembeck et al, 2021). The waiting period often lasted the duration of the intervention, with an average waiting time of 12 weeks, ranging from 2 weeks (Ritzi et al, 2017) to 10 months (Havighurst et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…Three of six studies (one RCT and two pre-post) found improvements in teacher-and parent-reported externalising behaviours among children who participated in Intensive Play Therapy and Circle of Security (Huber et al, 2015b;Ritzi et al, 2017;Wicks et al, 2018). The adapted Circle of Security Parenting program did not yield any improvements in externalising behaviours via RCT (Zimmer-Gembeck et al, 2021), quasi-experimental (Maxwell et al, 2021) nor pre-post evaluation (Krishnamoorthy et al, 2020). Four of five studies (all pre-post) observed significant reductions in children's internalising symptoms on both parent and teacher-report measures post-treatment (Eadie, 2017;Huber et al, 2015b;Krishnamoorthy et al, 2020 parent;Wicks et al, 2018).…”

Section: Intervention Impactmentioning

confidence: 93%

“…Huber et al (2015aHuber et al ( , 2015b evaluated the standard 20-week programme comprising psychoeducation on attachment theory and exploration of individualised videos of each parent-child dyad. The other three studies evaluated the Circle of Security Parenting Program -a lessintensive eight-session adapted version of the original programme (Krishnamoorthy et al, 2020;Maxwell et al, 2021;Zimmer-Gembeck et al, 2021). Two studies assessed the impact of intensive child-centred play therapy for children who had experienced trauma with emotional and behavioural concerns (Ritzi et al, 2017;Wicks et al, 2018).…”

Section: Intervention Characteristicsmentioning

confidence: 99%

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Targeted community-based programmes for children’s mental health: A systematic review and meta-analysis of the Australian literature

Savaglio

Yap

O’Donnell

et al. 2022

Aust N Z J Psychiatry

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Objective: No synthesis of the Australian evidence regarding targeted prevention and early intervention for mental health concerns among young children exists. This review aimed to (1) describe the types of targeted community-based mental health programmes evaluated in Australia to support children aged 1–9 years exhibiting internalising and/or externalising symptoms and (2) examine their impact on children’s internalising and externalising symptoms and disorder diagnosis. Method: A systematic review and meta-analysis was conducted (PROSPERO: CRD42021255257). Four databases (PsycINFO, PsycArticles, MEDLINE and CINAHL) were searched for Australian studies published in the past 10 years that quantitatively evaluated the impact of a targeted programme on children’s mental health. The National Institute of Health Quality Assessment Tools were used to evaluate the study quality. Results: Forty-two studies were included; the majority (67%) were medium quality. The mean sample size was 142 (SD = 170), children’s average age was 5.78 years (SD = 2.44) and 58% were male. Aboriginal and Torres Strait Islander children were underrepresented. Studies evaluated 16 programmes that targeted (1) externalising symptoms ( n = 20 studies, n = 6 programmes), (2) internalising symptoms ( n = 14 studies, n = 7 programmes) or (3) both, termed transdiagnostic programmes ( n = 8 studies, n = 3 programmes). Externalising programmes achieved a significant moderate mean reduction in externalising behaviours (standardised mean differences = −0.56), internalising programmes yielded a small mean improvement in anxiety symptoms (standardised mean differences = −0.25) and 57% reduced odds of anxiety disorder diagnosis. Evidence supporting transdiagnostic programmes was inconclusive. Conclusion: Parenting-focused programmes targeting young children’s internalising or externalising behaviours have the largest local evidence base supporting their effectiveness. Limitations include a lack of engagement with fathers, triangulation of outcomes, homogeneity and implementation reporting. Greater implementation and evaluation of community-driven integrated and systemic approaches that identify, engage and support Australia’s most disadvantaged cohorts of young children and their families are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Intervention Impactmentioning

confidence: 93%

Section: Intervention Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Targeted community-based programmes for children’s mental health: A systematic review and meta-analysis of the Australian literature

Savaglio

Yap

O’Donnell

et al. 2022

Aust N Z J Psychiatry

View full text Add to dashboard Cite

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“…Besides the high costs and long duration of this intervention, CPP demands that certain conditions are met, such as a safe and stable family situation over a relatively long period of time, which limits the implementation of this program in practice. Several studies evaluating attachment-based interventions for parents (at risk for) child maltreatment have shown that short-term attachment-based interventions (duration shorter than 3 months) can also be effective in promoting the quality of parent-child interactions and children's well-being [31][32][33]-although such optimistic findings are not consistently reported [34,35]. Advantages of short-term attachment-based interventions are that the costs are relatively low and that completing these interventions in this hard-to-reach population of families is less challenging.…”

Section: Treatment Focus On Enhancing the Parent-child Relationshipmentioning

confidence: 99%

Testing an attachment- and trauma-informed intervention approach for parents and young children after interparental violence: protocol for a randomized controlled trial

Asdonk

Kesarlal

Schuengel

et al. 2022

Trials

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Background Interparental violence has persistent adverse effects on victimized parents and children. Young children, including infants and toddlers, are at particular risk to develop long-lasting negative outcomes, and yet specific evidence on effective intervention approaches for this vulnerable group is still lacking. This study will test the effectiveness of an attachment- and trauma-informed intervention approach in a sample of parent-child dyads who have experienced severe interparental violence. We test the individual and combined effects of two interventions: (1) “Nederlandse Interventie Kortdurend op Atypisch oudergedrag” (NIKA; Dutch, short-term intervention focused on atypical parenting behavior) aimed at improving the attachment relationship and (2) eye movement desensitization and reprocessing (EMDR) therapy aimed at reducing parental post-traumatic stress disorder (PTSD) symptoms. Methods This study uses a multicenter randomized controlled design across multiple domestic violence shelters in the Netherlands. We aim to recruit 150 parent-child dyads with children aged between 0.5 and 6 years old. The study design consists of two phases. During the first phase for testing the effect of NIKA only, eligible dyads are randomly allocated to either NIKA or a waitlist usual care group. A pre-test is conducted prior to the treatment period and a post-test takes place directly afterwards (6 weeks after the pre-test). Phase 2 follows directly for testing the effects of EMDR and the combination of NIKA and EMDR. Parents who report clinical PTSD symptoms are randomly allocated to either EMDR therapy or a waitlist usual care group. Parents who do not report clinical PTSD symptoms only receive care as usual. Six weeks later, a post-test of phase 2 is conducted for all participating dyads. Primary study outcomes are disrupted parenting behavior, sensitive parenting behavior, and parental PTSD symptoms. Secondary study outcomes include PTSD symptoms and behavioral and emotional problems of the child. Discussion This study will inform and enhance the clinical field by providing new insights regarding effective treatment combinations for traumatized parents and their young children after interparental violence. Trial registration Netherlands Trial Register (NTR) NL9179. Registered 7 January 2021

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“…Zimmer‐Gembeck et al. (2022) carried out a randomized controlled trial of COS‐P, individually delivered to 85 Australian caregivers (51 COS‐P, 34 waitlist control). The caregivers had reported parenting distress and child disruptive behaviors.…”

Section: Introductionmentioning

confidence: 99%

Introducing Norwegian parents to the Circle of Security Parenting program during the postpartum period: A qualitative descriptive study

Glavin

Solberg

Saether

2023

Public Health Nursing

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Objective: Public health nurses in Norway provide a range of health promotion and primary prevention services to families in the postpartum period. The study objectives were to describe parents' experiences of: 1) being introduced to the Circle of Security Parenting program during a home visit and 2) participating in a parent group meeting.Design: Qualitative descriptive study. Sample:A purposeful sample of 24 caregivers (n = 15 mothers, n = 9 fathers) parenting an infant. Measures:In-depth, semi-structured interviews were conducted to document participants experiences. Content analysis was used to code and categorize the data.Findings: Three main categories with seven subcategories reflected the parents' experiences: 1) Confidence-building home visit, 2) Awareness-raising parental group, 3) Dissemination of knowledge. Conclusions:The parents experienced the home visit as being on their family's terms and reassuring. The parental group session started a reflection process which made them aware of the importance of being present for their child, how to modify their communication and have a common understanding of childrearing. The parents thought the group was a great way to introduce the Circle of Security Parenting program and experienced it as a continuation of the information presented at the home visit. The introduction provided them with new knowledge. K E Y W O R D Schild health clinic, Circle of Security Parenting, home visit, parental groups, public health nursing BACKGROUNDThe transition to parenthood may cause parents to feel uncertain about their new role and the expected changes to daily routines. Some new parents also express feeling poorly prepared to assume this new role (Barimani et al., 2017). Previous studies have indicated the need to improve parents' preparation for parenthood and noted the importance of including fathers in education and preparation (Deave et al., 2008;Martins, 2019). The work of public health nurses (PHN) in Norway consists of health promotion and primary prevention. The target group for PHNs in Norway is primarily individuals and families through the provision of child health clinics (CHC), school health services, and youth health services (Norwegian Directorate of Health, 2017). Municipalities are responsible for managing the services in accordance with Norwegian laws and regulations (Norwegian Board of Health, 2012). Public health nurses have a central role in this service and are the health care workers who meet with families most frequently. In 2019 nearly all children (98.9%) 428

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The Circle of Security Parenting Program (COS-P): A Randomized Controlled Trial of a Low Intensity, Individualized Attachment-Based Program With at-Risk Caregivers

Cited by 8 publications

References 53 publications

Targeted community-based programmes for children’s mental health: A systematic review and meta-analysis of the Australian literature

Targeted community-based programmes for children’s mental health: A systematic review and meta-analysis of the Australian literature

Testing an attachment- and trauma-informed intervention approach for parents and young children after interparental violence: protocol for a randomized controlled trial

Introducing Norwegian parents to the Circle of Security Parenting program during the postpartum period: A qualitative descriptive study

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