Where is the infant in infant intervention? A review of the literature on changing troubled mother-infant relationships.

Abstract

Four intervention models that aim to reduce problematic caregiver-infant relationships are reviewed within the context of attachment theory. These models include support, guidance, psychotherapy and infant-led psychotherapy. Most empirical research has evaluated support and guidance and a few studies have evaluated psychotherapy. The bulk of these studies report improvements in the caregiver-infant relationship and the infant's developmental outcome, suggesting a variety of interventions may be effective. However, although it is agreed that infants actively contribute to their relationships and development, and that in infant intervention changes in the caregiver-infant relationship are essential, only a few interventions directly include the infant and work with the caregiver-infant dyad. Most interventions work with the more verbal partner, the caregiver. Future research is needed to address the specific gains Preparation of this manuscript was partially supported by a grant from the Ontario Ministry of Community and Social Services, Children's Services Branch.

The roles of child reactivity and parenting context in infant pain response

“…Further, stress may moderate the relation between materna1 pain response and child pain behavior. DBerences in sensitivity are related to parents' experiences with their own parents' behavior, and to parents' perceptions of theû relationships with their children (Lojkasek, Cohen, & Muir, 1994). Sensitivity has been found to decrease with increases in negative personality traits (Fish & Stifter, 1993), covert anxiety (Biringen, 1990), and stress (Pianta, Sroufe, & Egeland, 1989).…”

Brief mother–infant treatment: Psychoanalytically informed video feedback

“…Despite important exceptions, many intervention efforts actually focus on the parent, to the point where Lojkasek, Cohen, and Muir (1994) asked " Where is the infant in infant intervention?" A unique study by Weinberg and Tronick (1998) evaluated the outcome of an early intervention in which only the mother was treated.…”

Trauma-Exposed Infants and Toddlers: A Review of Impacts and Evidence-Based Interventions

“…The complex and attachment-dependent nature of early childhood trauma emphasizes the need for therapeutic interventions that can include the caregiver-child relationship (Lojkasek, Cohen & Muir, 1994). As discussed, trauma occurring within the developmental framework of early childhood has a direct impact on typical attachment processes, including trust formation and co-regulation which has an impact on the child's arousal modulation and agency/exploration (Pynoos et al, 2009;Van der Kolk, 2005).…”

“…As discussed, trauma occurring within the developmental framework of early childhood has a direct impact on typical attachment processes, including trust formation and co-regulation which has an impact on the child's arousal modulation and agency/exploration (Pynoos et al, 2009;Van der Kolk, 2005). Important considerations for treatment include the intervention's ability to address and repair disrupted attachment processes by taking into consideration the primary caregivers present and past trauma and their experience of the child's trauma as well as whether the intervention is able to increase levels of mutual sensitivity (Lojkasek et al, 1994). Ford, Albert and Hawke (2008) suggest that interventions for early childhood trauma should emphasize increasing the ability of the child and the caregiver to consciously control and co-regulate their internal alarm system.…”

“…CPP aims to address the young child's experience of trauma through the lens of the relationship, by increasing mutual sensitivity and responsiveness between the infant and the caregiver (Tucker, 2006), addressing the observable behavior of the infant (Jones, 2006;Lojkasek et al, 1994), and naming the unconscious processing that may be occurring as a result of the caregiver's prior attachment systems and experiences (Jones, 2006). The structure of the CPP model includes caregiver-child sessions that are structured to enable the parent and child to engage in free-play and spontaneous reactions to each other.…”