This study presents effects of adding Circle of Security-Parenting (COS-P) to an already established comprehensive therapeutic model for early parent-child intervention in three Swedish infant mental health (IMH) clinics. Parents' internal representations and quality of parent-infant interaction were studied in a clinical sample comprised of 52 parent-infant dyads randomly allocated to two comparable groups. One group consisted of 28 dyads receiving treatment as usual (TAU) supplemented with COS-P in a small group format, and another group of 24 dyads receiving TAU only. Assessments were made at baseline (T1), 6 months after inclusion (T2) and 12 months after inclusion (T3). Changes over time were explored in 42 dyads. In the COS-P group, the proportion of balanced representations, as assessed with Working Model of the Child Interview (WMCI), significantly increased between T1 and T3. Further, the proportion of emotionally available interactions, as assessed with Emotional Availability scales (EA), significantly increased over time in the COS-P group. Improvements in the TAU-group were close to significant. Limitations of the study are mainly related to the small sample size. Strength is the real world character of the study, where COS-P was implemented in a clinical context not otherwise adapted to research. We conclude by discussing the value of supplementing TAU with COS-P in IMH treatment.
The parental functioning and its influence upon infant mental health development have been extensively studied but there are few clinical studies investigating less severe psychiatric problems among mothers and fathers in the same family.
This study focuses on the emotional well-being of mothers and fathers who bring their infants to an Infant Mental Health Clinic.
The studied sample is comprised of 63 families with 0-47-month-old infants where the mothers completed the Center for Epidemiological Study-Depression Scale (CES-D), including 43 families in which the CES-D was completed by both parents. In 44 families, the mothers also filled in the Swedish Parental Stress Questionnaire (SPSQ), including 32 where the SPSQ was completed by both parents. The children were independently classified with the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC 0-3).
Altogether, 54% of the mothers and 11% of the fathers reported depressive symptoms above the CES-D clinical cut-off. Self-rated depressive symptoms and parental stress were strongly related. The mothers' self-rated depressive symptoms were associated with the severity of their infant's problems, but the association was not specific to the DC 0-3 Axis I classification. The mothers' stress level was marginally related to DC 0-3 Axis II relationship classification.
The results indicate that the inclusion of systematic parental self-ratings in infant mental health assessments could add clinical information facilitating the planning of family oriented interventions.