Virtual care delivery of whole family assessment and intervention with infants and preschoolers: a thematic analysis of clinician and family experiences

Developmentalists have demonstrated that the quality of relationships established by infants with their proximal social environment is crucial for lifecourse development. However, studies of parent–infant relationships have mostly centred on the mother–child dyad. Stemming from family systems theory that considers interactions within the whole family as critical for an individual's personal development, a group of family therapists and researchers in Lausanne (Switzerland) tried to bridge the gap between systemic and developmental thinking by stressing the need to establish the mother–father–infant triad as a collective unit of study. In response, they created the Lausanne Trilogue Play (LTP), a method to systematically assess the quality of mother–father–infant interactions. The LTP is an observational situation during which parents are asked to play with their infant in four parts: (i) one parent plays with the infant, while the other parent is ‘simply present’; (ii) the parents switch roles; (iii) all three play together; (iv) the parents discuss in front of the infant. The theoretical model underpinning the LTP is the family alliance model, which postulates that the quality of the coordination demonstrated by the triad to achieve this task can be assessed mainly through careful observation of non‐verbal behaviours as indicators of the achievement of four interactive functions (i.e., participation, organisation, focalisation, affect sharing); fulfilment of these functions determines the quality of relational functioning within the system. This article introduces the clinical, theoretical, and empirical foundations of using the LTP method with the family alliance model; its use in clinical and research contexts; and the most recent advances in the field of research on mother–father–infant interactions based on the LTP situation.

Section: The Ltp As a Clinical Toolmentioning

confidence: 99%

The Lausanne Trilogue Play: bringing together developmental and systemic perspectives in clinical settings

Tissot,

Favez

2023

“…The trialogue approach -imagined and real -captures the freshness of new thinking about the new father in family therapy (see Lim et al, 2023) and the challenge of bringing infant mental health training into academic teaching of next-generation family therapists (see Elliott, Cousins, et al, 2023). We also hoped to shine a light on emerging evidence-based infant-family interventions (see Philipp et al, 2023;Tissot & Favez, 2023). Finally, we wished to feature new evidence on the intergenerational influence of parents' relational history for their offspring's attachment security (Olsson et al, 2023).…”

Section: N Fa N T M En Ta L H E a Lt H A N D Fa M I Ly T H Er A P Y: ...mentioning

confidence: 99%

Family therapy and infant mental health: exploring the potential space

Opie,

McIntosh

2023

For this special issue, we sought perspectives on the contributions of the infant to their family's development, including recovery from intergenerational trauma and the contribution of the family to the infant's relational security. This special issue features a series of 12 invited papers from a diverse group of professionals, including infant mental health specialists, Indigenous and non‐Indigenous family therapists, academic family therapy teaching staff, and developmental psychology and systemic researchers. The contributions span several methodologies – ranging from curated conversations and qualitative research to conceptual insights, theoretical discussions, intervention reports, and new intergenerational empirical data. Through this editorial, we provide a brief overview of the collective works, spotlighting the invaluable synergistic contributions that infant mental health and family therapy approaches provide, while highlighting the untapped potential at their intersection.

“…The most intensively studied of these approaches involve clinical applications of the Lausanne Trilogue Play (LTP; Fivaz‐Depeursinge & Corboz‐Warnery, 1999) and Lausanne Family Play (LFP; Fivaz‐Depeursinge & Corboz‐Warnery, 1999). Other examples include mentalisation‐based treatment for families (MBT‐F; Asen & Fonagy, 2021), reflective family play (RFP; Philipp et al., 2023, this issue), and triadic child parent psychotherapy (Iwaoka‐Scott & Lieberman, 2015). For the most part, the expositions of existing interventions are triadic only (e.g., triadic CPP); few models have expanded to incorporate work with grandparents, siblings, same‐sex couples, or various other family configurations.…”

Section: Introductionmentioning

confidence: 99%

Initiating the dialogue between infant mental health and family therapy: a qualitative inquiry and recommendations

Opie,

Booth,

Rossen

et al. 2023

Self Cite

This qualitative study explores infant‐family mental health experts' perspectives and experiences regarding the inclusion of infants in the family therapy setting. Infant socioemotional development is relational in nature and evolves in the context of both dyadic attachment relationships and broader multi‐person co‐parenting systems. Given this, we sought to understand why family therapy interventions involving families with infants rarely include the infant in a triangular or family systemic approach. Interviews were completed by clinical and/or research experts whose work integrates tenets of both infant mental health (IMH) and family theory and therapy. All interviewees brought at least 5 years of expertise and were actively engaged in the field. Interviewees expressed consistent beliefs that infants have a rightful and helpful place in family therapy approaches. They maintained that infants' innate social drive and communicative capacities position them to make meaningful and clinically significant contributions within family and systemic psychotherapy contexts. Noting that infants have remained on the periphery of these practices, experts advocated expansion and greater integration between IMH and family therapy, while preserving each field's distinctive identity. Experts reported that the interplay between IMH and family therapy fields has been uni‐directional as family systems concepts are embedded within IMH approaches, but few IMH premises are incorporated in mainstream family therapy practices. The disconnect was attributed to multiple factors, including graduate and professional training and theoretical, clinical, research, and sociocultural barriers, which were mutually reinforcing. Experts also identified clinical gains for both infants and family members when infants were meaningfully included in family interventions. Common ground was identified between the disciplines, with a belief that relationally distressed young children and parents are best served by clinical engagement with their network of relationships. Results call for greater collaboration between disciplines to challenge existing traditions and to more fully include infants in mainstream family therapy. Recommendations for integration of family therapy and IMH in clinical, theoretical, research, training, and sociocultural domains are offered.