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

Abstract

From birth, infants grow and develop in their capacity to show feelings, to communicate both verbally and through their gestures and facial expressions, to think, and to relate socially. We now know that early relationships affect how well infants develop, and that problems in an infant's early relationships are linked to later problems in social relationships, emotional health, thinking, and problem solving. Increasingly, parents seem to be recognizing the importance of their relationships with their infants, and when this is not going well, many seek help.

Child Maltreatment, Adolescent Attachment Style, and Dating Violence: Considerations in Youths with Borderline-to-Mild Intellectual Disability

“…After receiving CPP, mothers show higher levels of empathy and interactiveness with their children and children demonstrate an increase in attachment security and less disorganized behavior (Lieberman et al, 1991;Toth et al, 2002). Unfortunately, existing attachment-based interventions tend to focus on very young children (Bakermans-Kranenburg et al, 2003;Cohen et al, 1999), and there is continued need for interventions to address the needs of older children and adolescents. Muller (2009; provides an introduction to specific interventions for adults who have experienced intrafamilial trauma and have developed an avoidant attachment style, which can be extended developmentally to adolescents.…”

Predictors of outcome in infant and toddlers functional or behavioral disorders after a brief parent–infant psychotherapy

“…The parent-child therapies have in common to target parent-child relationships [9,20,21,30,32], despite different points of entry into the family system: representations, behaviors, or a combination of the two. The psychodynamic psychotherapies focus on the mother's representations concerning the child [13,17,29]: the therapist works on mother's projections onto the child, in particular on a core conflictual relationship with the child and a similar conflict in the mother's past history, in order to increase the mother's ability to differentiate her child from herself and to respond accurately to her child's needs.…”

“…The behavior-oriented therapies, such as interactional guidance, aim to directly modify mother-infant interactions, without any reference to the mother's past history [35]: videotaped interactions of mother and infant are used by the therapist to help the mother recognize positive interactions and to develop appropriate responsiveness and confidence in her parenting role. The infant-led psychotherapies, such as the program called watch, wait, and wonder (WWW), focus on the infant and work both at representational and at behavioral level [9,38]: the mother is asked to observe and follow her infant's initiations during a first part of the session, then with the therapist to discuss her observations and experiences of the infant-led play, trying to understand the themes and relational issues that occurred.…”

“…The outcomes of these therapies have been generally positive, even 6 months or more after the end of the treatment [9,10,13,31,42]. In a population of children aged 30 months or less with functional or behavioral disorders, Robert-Tissot et al [42] compared infant-parent psychodynamic psychotherapy and interactional guidance.…”

“…Only a few differential treatment effects were observed: there was a greater improvement in self-esteem in psychodynamic psychotherapy and a greater improvement in maternal sensitivity in interactional guidance. Cohen et al [9,10], in a similar population, compared mother-infant psychodynamic psychotherapy and infant-led psychotherapy (WWW). In both interventions, positive effects were observed in infant symptoms, parenting stress, maternal intrusiveness and mother-infant conflict.…”