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

Abstract

The efficacy of parent-child psychotherapies is widely recognized today. There are, however, less data on predictive factors for outcome in infants and toddlers and their parents. The aim of this study was to highlight predictive factors for outcome after a brief psychotherapy in a population of 49 infants and toddlers aged 3-30 months presenting functional or behavioral disorders. Two assessments were performed, the first before treatment and the second a month after the end of the therapy. These assessments included an evaluation of the child's symptoms, and of depressive or anxiety symptoms in the parents. The assessments after therapy show complete or partial improvement in the child's symptoms for nearly three quarters, and a decrease in the number of anxious and depressive mothers, and also in the number of depressive fathers. Three independent factors appear as predictive of unfavorable outcome for the child: frequency and intensity of behavioral problems and fears, and the absence of the father at more than two-thirds of consultations. The outcome for the mother is associated solely with her anxiety score at the start of the therapy. This study underlines the particular difficulties involved in the treatment of infants and toddlers presenting behavioral disturbances and emotional difficulties, and the value of involving the father in treatment.

Emotional-Behavioral Functioning, Maternal Psychopathologic Risk and Quality of Mother–Child Feeding Interactions in Children with Avoidant/Restrictive Food Intake Disorder

“…Intervention programs focused on the parent-infant relationship appeared to promote child's ARFID resolution [74] and video-feedback treatment specifically focused on mother-infant interaction has proven to produce better outcomes compared to treatments focused only on the mother or child [75]. However, some studies have underlined that the lack of father's involvement may compromise the efficacy of the therapy [76]. Moreover, the use of the coding system of SVIA allows to obtain information on different domains of interactions (child, mother and dyad) and, revealing both difficulties and strengths, may be useful for both assessment and more targeted intervention programs, showing the best entry point for clinical intervention.…”

Common therapeutic elements of interventions aimed at enhancing parent–child early relationships.

“…The models that serve as a source of inspiration for this work have shown clinical prominence and are based upon sound theoretical foundations. They all have empirical evidence that supports their effectiveness in the improvement of parent–child interaction, of the child’s level of attachment security, and of correlated indices (e.g., maternal anxiety and depression, cortisol production in children, and externalizing behaviors; Barlow, Bennett, Midgley, Larkin, & Wei, 2016; Barlow, Schrader-McMillan, et al, 2016; Berlin, Zeanah, & Lieberman, 2016; Fonagy, Sleed, & Baradon, 2016; Hervé et al, 2009; Schechter at al., 2006). This evidence base (both at the theoretical foundations as well as at the effectiveness research level) is one of the main strengths of this approach.…”