Six‐month follow‐up of two mother–infant psychotherapies: Convergence of therapeutic outcomes

Abstract

Fifty-eight mothers and infants participating in two infant-mother psychotherapeutic interventions in a comparative infant-mother clinical intervention study were followed six months after treatment ended. One treatment was an infant-led psychotherapy, Watch, Wait, and Wonder (WWW). The other was a more traditional mother-infant psychodynamic psychotherapy (PPT). Infants ranged in age from 10 to 30 months at the outset of treatment, which took place in weekly sessions over approximately five months. Results indicated that positive effects observed from the beginning to the end of treatment in both treatment groups in infant symptoms, parenting stress, and mother-infant interaction were maintained or improved further at six-month follow-up. Additionally, decreased maternal depression, gains in infant cognitive development and emotion regulation, and improved infant-mother attachment security or organization had been observed posttreatment only in the WWW group. Interestingly, between the posttreatment to follow-up period the PPT group also showed such gains. Thus, for these variables it would be more accurate to say that the outcomes were similar for the two treatment groups but change emerged at a different pace. Nevertheless, an advantage persisted in the WWW group in This research was supported by a grant from Health Canada National Health and Postdoctoral Award from the Ontario Mental Health Foundation to Mirek Lojkasek. The first three authors played equal roles in the planning and execution of this research. We are grateful to Melanie Barwick for her collaboration on a part of this study as well as to Myrna Brown, Samantha Callender, Heather Davidson, Heather MacDonald, and Mirella Pugliese for their careful attention to detail in coordination, data collection, and coding and to Lennox White for audiovisual assistance. We are indebted to Susan Goldberg and Jane Washington for coding the Strange Situation videotapes. We also are deeply indebted to the families whose cooperation provided the data on which this study was based. Direct correspondence to: Nancy J. Cohen, Hincks-Dellcrest Institute, 114 Maitland Street, Toronto, Ontario, Canada M4Y 1E1; e-mail: nancy.cohen @utoronto.ca. • N. J. Cohen et al.relation to mothers' comfort dealing with infant behaviors and their ratings of parenting stress which improved more in this group from the end of treatment to follow-up. The direct inclusion of the infant as an initiator in WWW was set forth as an explanation of differentially timed treatment effects.RESUMEN: A 58 madres y sus infantes que participaron en dos intervenciones sicoterapéuticas dentro de un estudio de intervención clínico comparativo, se les dio seguimiento durante los seis meses posteriores al tratamiento. Uno de los tratamientos fue la sicoterapia guiada por el infante, de Observar, Esperar y Preguntarse (WWW). La otra fue una sicodinámica sicoterapia materno-infantil más tradicional (PPT). Los infantes tenían entre 10 y 30 meses al principio del tratamiento, el cual se llevó a cabo en...

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

“…There was no association between the child's symptoms and the anxious or depressive state of the father; however, the small amount of data concerning these factors for the fathers does not enable conclusions to be drawn. After the therapy, improvement is observed for both children and parents [10,18,42]. For around three quarters of the children, complete or partial improvement of the symptoms was observed, and around half the children returned to a level of functioning that corresponds to the SCL norm [42].…”

“…The outcomes of these therapies have been generally positive, even 6 months or more after the end of the treatment [9,10,13,31,42]. In a population of children aged 30 months or less with functional or behavioral disorders, Robert-Tissot et al [42] compared infant-parent psychodynamic psychotherapy and interactional guidance.…”

“…Only a few differential treatment effects were observed: there was a greater improvement in self-esteem in psychodynamic psychotherapy and a greater improvement in maternal sensitivity in interactional guidance. Cohen et al [9,10], in a similar population, compared mother-infant psychodynamic psychotherapy and infant-led psychotherapy (WWW). In both interventions, positive effects were observed in infant symptoms, parenting stress, maternal intrusiveness and mother-infant conflict.…”

Postpartale Depression: Mögliche Auswirkungen auf die frühe Mutter-Kind-Interaktion und Ansätze zur psychotherapeutischen Behandlung

“…kindlichen Dysregulation wurden sowohl durch die traditionelle psychodynamische MutterSäuglings-Kurzzeittherapie als auch durch neuere, die Interaktion fokussierenden Methoden erreicht (z.B. Cohen et al, 2002;im Überblick Cooper u. Murray, 1998;Stern, 1998). Field und Mitarbeiter (1997) konnten in ihrer sorgfältigen Therapiestudie einen günstigen Einfluss verschiedener therapeutischer Techniken auf die mütterliche depressive Symptomatik und die Qualität der Mutter-Kind-Interaktion sowie eine Besserung frühkindlicher Verhaltensauffälligkeiten nachweisen.…”

Psicoterapia mãe-bebê: uma intervenção no contexto da prematuridade

“…As díades submetidas à W.W.W. apresentaram vantagens persistentes relacionadas à melhora materna no manejo de tensões entre a díade, resultado da inclusão direta da criança como guia do tratamento (Cohen et al, 2002).…”