Family Minds: A randomized controlled trial of a group intervention to improve foster parents’ reflective functioning

Abstract

Family Minds is a brief group psychoeducational parenting intervention designed to increase the reflective functioning (RF) and mentalization skills of foster parents. RF is important for foster parents who have to build relationships with children whose adverse experiences increase their risk for psychosocial challenges. A randomized controlled trial (RCT) for Family Minds was conducted in Texas with 89 foster parents. The main aims of this study were to examine whether the intervention could significantly increase the RF/mentalization skills of the foster parents and decrease their parenting stress. After 6 weeks, compared with the control group, intervention foster parents improved their RF via a lowering of pre-mentalizing and also significantly decreased parenting stress related to parent–child dysfunctional interactions. Other measures of RF and parenting stress showed no significant differences between groups. Foster child behavior was not significantly different between groups, although data at 6 months showed a possible lowering of internalizing symptoms for children of intervention parents. This RCT provides some encouraging evidence that Family Minds may increase RF in foster parents, improve parental sensitivity and their ability to emotionally regulate, decrease parenting stress related to challenging interactions with their foster children, and possibly decrease children's internalizing behavior.

The efficacy of group delivered mentalization-based parenting interventions: A systematic review of the literature

“…For example, the intervention longest in duration, the Reflective Fostering Programme (Midgley et al, 2019), did not lead to a significant change in PRF, whereas the shortest programme, Family Minds (Adkins et al, 2018;Adkins et al, 2021;Bammens et al, 2015), found significant improvements in PRF in three studies.…”

“…2017) was used in three studies. In two of the studies evaluating the Family Minds programme for foster carers significant differences in PRF were found between the intervention and control groups with large effect sizes (Adkins et al, 2018;Adkins et al, 2021). Midgley at al.…”

Parental Reflective Functioning and Its Association With Parenting Behaviors in Infancy and Early Childhood: A Systematic Review

“…Accordingly, it would be necessary to adjust the interval and frequency of post-treatment follow-ups to determine whether and how the changes in both constructs are related to each other. For more frequent follow-up assessments, new instruments developed for less time-consuming PRF assessments could be helpful, such as the Mini-PRFI described earlier or the Reflective Functioning Five Minute Speech Sample that is currently being validated ( Adkins et al, 2021 ). Moreover, the difference in the rate of change could also apply to the self-focused and child-focused dimensions of PRF, especially since self-focused PRF contains complex reflections on mothers’ own negative emotional experiences that could be particularly difficult for high-risk mothers to access.…”

How does the ‘environment’ come to the person? The ‘ecology of the person’ and addiction

“…This issue of the contextual conditions of mental disorders was a foundation of psychoanalysis when Sigmund Freud developed his influential conceptual framework of the Oedipus conflict that, today of course, requires more subtle interpretations and clarifications. In psychoanalysis, the patient’s relationships with parents are a central theme of therapeutic reflection and intervention[ 90 ].…”