Selma Fraiberg's pioneering work with infants, toddlers, and families over 40 years ago led to the development of a field in which professionals from multiple disciplines learned to work with or on behalf of infants, very young children, their parents, and the relationships that bind them together. The intent was to promote social and emotional health through enhancing the security of early developing parent–child relationships in the first years of life (Fraiberg, 2018). Called infant mental health (IMH), practitioners from fields of health, education, social work, psychology, human development, nursing, pediatrics, and psychiatry specialize in supporting the optimal development of infants and the developing relationship between infants and their caregivers. When a baby is born into optimal circumstances, to parents free of undue economic and psychological stressors and who are emotionally ready to provide care and nurturing for an infant's needs, an IMH approach may be offered as promotion or prevention, with the goal of supporting new parent(s) in developing confidence in their capacity to understand and meet the needs of the tiny human they are coming to know and care for. However, when parental history is fraught with abandonment, loss, abuse or neglect, or the current environment is replete with economic insecurity, threats to survival due to interpersonal or community violence, social isolation, mental illness, or substance abuse, the work of the IMH therapist may require intervention or intensive treatment and becomes more psychotherapeutic in nature. The underlying therapeutic goal is to create a context in which the baby develops within the environment of a parent's nurturing care without the psychological impingement that parental history of trauma or loss or current stressors such as isolation, poverty, or the birth of a child with special needs, can incur.

Purpose To evaluate the effectiveness of Mom Power, a multifamily parenting intervention to improve mental health and parenting among high-risk mothers with young children in a community-based randomized controlled trial (CB-RCT). Methods Participants (N = 122) were high-risk mothers (e.g., interpersonal trauma histories, mental health problems, poverty) and their young children (age < 6 years), randomized either to Mom Power, a parenting intervention (treatment condition) or weekly mailings of parenting information (control condition). In this study, the 13-session intervention was delivered by community clinicians trained to fidelity. Pre- and post-trial assessments included mothers’ mental health symptoms, parenting stress and helplessness, and connection to care. Results Mom Power was delivered in the community with fidelity and had good uptake (>65%) despite the risk nature of the sample. Overall, we found improvements in mental health and parenting stress for Mom Power participants but not for controls; in contrast, control mothers increased in parent-child role-reversal across the trial period. The benefits of Mom Power treatment (vs. control) were accentuated for mothers with interpersonal trauma histories. Conclusions Results of this CB-RCT confirm the effectiveness of Mom Power for improving mental health and parenting outcomes for high-risk, trauma exposed women with young children.

Intimate partner violence (IPV) is a pervasive social issue with broad physical and mental health implications. Although 35%-56% of women report IPV victimization with more than one violent partner, few studies have identified factors that increase the risk of experiencing IPV across multiple partners (i.e., IPV reengagement). In the current study, multilevel modeling was used to examine the roles of trauma exposure, mental health, and sociodemographic factors in the risk for reengagement in a sample of women (N = 120) with IPV victimization. Participants were drawn from a randomized control trial of an intervention for mothers who had experienced IPV. The results revealed that more psychological but less sexual IPV was associated with increased reengagement. Higher degrees of posttraumatic reexperiencing symptoms were associated with less reengagement. Depressive symptoms were also significantly associated with reengagement such that lower levels of positive affect and increased somatic symptoms were associated with increased reengagement. Higher income levels and less housing instability were associated with more reengagement, β range = −.13-.16. Finally, compared to the control condition, participation in the intervention program was significantly associated with lower levels of reengagement at 8-year follow-up, β = −.75, p = .001. These findings suggest that it is not what happened (i.e., experiences of abuse) but rather a woman's posttraumatic experience (i.e., posttraumatic stress and depressive symptoms) that creates risk for reengagement. The findings support the long-term effectiveness of a brief intervention in reducing reengagement.This research was funded by the Blue Cross and Blue Shield of Michigan Foundation. The views expressed in this article do not necessarily reflect those of the granting agency.

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Early relational health between caregivers and children is foundational for child health and well‐being. Children and caregivers are also embedded within multiple systems and sectors, or a “child‐serving ecosystem”, that shapes child development. Although the COVID‐19 pandemic has made this embeddedness abundantly clear, systems remain siloed and lack coordination. Fostering relational health amongst layers of this ecosystem may be a way to systematically support young children and families who are facing adversity. We integrate theory, examples, and empirical findings to develop a conceptual model informed by infant mental health and public health frameworks that illustrates how relational health across the child‐serving ecosystem may promote child health and well‐being at a population level. Our model articulates what relational health looks like across levels of this ecosystem from primary caregiver‐child relationships, to secondary relationships between caregivers and child‐serving systems, to tertiary relationships among systems that shape child outcomes directly and indirectly. We posit that positive relational health across levels is critical for promoting child health and well‐being broadly. We provide examples of evidence‐based approaches that address primary, secondary, and tertiary relational health, and suggest ways to promote relational health through cross‐sector training and psychoeducation in the science of early development. This model conceptualizes relational health across the child‐serving ecosystem and can serve as a template for promoting child health and well‐being in the context of adversity.