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Georg AK, Holl J, Taubner S, Volkert J. Mentalisation-based online intervention for psychologically distressed parents: protocol of a non-randomised feasibility trial of the Lighthouse Parenting Programme-Online (LPP-Online). BMJ Open 2024; 14:e078548. [PMID: 38969386 PMCID: PMC11227772 DOI: 10.1136/bmjopen-2023-078548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 06/12/2024] [Indexed: 07/07/2024] Open
Abstract
INTRODUCTION Online-based interventions provide a low-threshold way to reach and support families. The mentalisation-based Lighthouse Parenting Programme is an established intervention aimed at preventing psychopathological development in children. The objective of this study is to examine the feasibility of an online adaptation of the Lighthouse Parenting Programme (LPP-Online), evaluating (a) recruitment capability, compliance, acceptability and satisfaction with the intervention; (b) the psychometric properties of and the acceptability regarding the adjunct psychological evaluation; and (c) the employed materials and resources. The study will also obtain a preliminary evaluation of participants' responses to the intervention. METHOD AND ANALYSIS In this monocentric, one-arm, non-randomised feasibility trial, n=30 psychologically distressed parents with children aged 0 to 14 years will participate in the LPP-Online for a duration of 8 weeks. The intervention consists of online group sessions and individual sessions, 38 smartphone-based ecological momentary interventions (EMI), and psychoeducational materials (website, booklet). At baseline (T0) and the end of the intervention (T1), parents complete self-report questionnaires as well as 7-day ecological momentary assessments (EMA) via smartphone. During the intervention, additional EMA are completed before and after the daily EMI. An interview regarding parents' subjective experience with the intervention will be conducted at T1. The feasibility of the intervention, the psychological evaluation and the resources will be examined using descriptive and qualitative analyses. The preliminary evaluation of the parents' response to the intervention will be conducted by analysing pre-post changes in questionnaire measures and the 7-day EMA as well as data of additional EMA completed before and after the daily EMI. ETHICS AND DISSEMINATION Ethical approval of the study has been obtained from the local ethics board (Faculty of Behavioural and Cultural Studies, University of Heidelberg). Consent to participate will be obtained before starting the assessments. Results will be disseminated as publications in peer-reviewed scientific journals and at international conferences. REGISTRATION DETAILS German Clinical Trials Register (DRKS00027423), OSF (https://doi.org/10.17605/OSF.IO/942YW).
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Affiliation(s)
- Anna Katharina Georg
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia Holl
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
- Psychological Institute, Department of Clinical Psychology and Psychotherapy, Heidelberg University, Heidelberg, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Jana Volkert
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
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2
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Wuebken K, Bermpohl F, Boedeker K, Hindi Attar C, Kluczniok D, Schoofs N, Fuchs A, Neukel C, Herpertz SC, Brunner R, Winter SM, Kaess M, Jaite C, Dittrich K. The mediating role of attachment and anger: exploring the impact of maternal early-life maltreatment on child abuse potential. Front Psychiatry 2023; 14:1267038. [PMID: 37965361 PMCID: PMC10641504 DOI: 10.3389/fpsyt.2023.1267038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/02/2023] [Indexed: 11/16/2023] Open
Abstract
Background Maternal early-life maltreatment (ELM) increases the risk of subsequent child maltreatment, but the underlying mechanisms of these intergenerational effects remain largely unknown. Identifying these mechanisms is crucial for developing preventive interventions that can break the cycle of abuse. Notably, previous research has shown that ELM often results in attachment insecurity and altered anger characteristics. Therefore, this study determines whether these characteristics mediate the relationship between maternal history of ELM and child abuse potential. Methods The study sample included 254 mothers, of whom 149 had experienced ELM to at least a moderate degree. Maternal ELM was assessed using the Childhood Experience of Care and Abuse (CECA) interview. Attachment insecurity, trait anger and anger expression, and maternal abuse potential were assessed using the Vulnerable Attachment Questionnaire (VASQ), State-Trait Anger Expression Inventory (STAXI), and Child Abuse Potential Inventory (CAPI), respectively. Results The severity of maternal ELM predicted higher child abuse potential, with attachment insecurity and anger suppression mediating this effect. Specifically, higher levels of maternal ELM were associated with greater attachment insecurity and increased anger suppression, resulting in a higher child abuse potential. Although higher levels of trait anger were directly associated with higher child abuse potential, this parameter did not mediate the relationship with ELM. In addition, no significant associations were observed between outwardly expressed anger and ELM or child abuse potential. All analyses were adjusted for maternal mental disorders, years of education, and relationship status. Discussion Attachment insecurity and anger suppression may serve as pathways linking the maternal history of ELM to the risk of child abuse, even when considering maternal psychopathology. Overall, our findings indicate that interventions aimed at strengthening attachment and improving anger suppression may be beneficial for all mothers with ELM history and high child abuse potential, not just those who suffer from mental illness.
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Affiliation(s)
- Karolina Wuebken
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Katja Boedeker
- Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Virchow, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Catherine Hindi Attar
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Dorothea Kluczniok
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Nikola Schoofs
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Anna Fuchs
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Corinne Neukel
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine C. Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Romuald Brunner
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Sibylle Maria Winter
- Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Virchow, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Charlotte Jaite
- Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Virchow, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
- Department of Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Hildesheim, Hildesheim, Germany
| | - Katja Dittrich
- Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Virchow, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
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3
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Schneider I, Zietlow AL. [The parent-child relationship in the context of parental mental illness-Possibilities for intervention]. DER NERVENARZT 2023; 94:822-826. [PMID: 37171658 DOI: 10.1007/s00115-023-01491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/13/2023]
Abstract
The parent-child relationship is the earliest and one of the most important close social relationships in a person's life. It begins even during pregnancy, is expressed in interactions and is accompanied by many neurobiological processes. A sensitive interaction with the parent who is well-adapted to the needs of the child, is necessary for a healthy child development; however, parents with mental disorders often face more difficulties in parenting than healthy parents. They tend to exhibit more intrusive or withdrawn behavior and report experiencing increased stress in parenting, which in turn can be a risk factor for the mental disorder. At the same time, parenting can be a great resource. Early recognition of stress in parenting is central to healthy child development and also to the parent's mental health. In addition to disorder-specific treatment for parents, parent-child focused interventions can be used in relationship or interaction disorders. This article presents and discusses different prevention and intervention approaches.
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Affiliation(s)
- Isabella Schneider
- Klinik für Allgemeine Psychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland.
| | - Anna-Lena Zietlow
- Klinische Kinder- und Jugendpsychologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Chemnitzer Straße 46a, 01187, Dresden, Deutschland
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Gervinskaitė-Paulaitienė L, Byrne G, Barkauskienė R. Mentalization-Based Parenting Program for Child Maltreatment Prevention: A Pre-Post Study of 12-Week Lighthouse Group Program. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1047. [PMID: 37371278 DOI: 10.3390/children10061047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/04/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
The aim of this study was to assess the 12-week group version of the mentalization-based Lighthouse Parenting Program for child maltreatment prevention. Parents who might be facing mentalizing difficulties due to challenges in the parent-child relationship were invited to participate in the program. The aim of the program was to promote mentalizing-to encourage parents' curiosity about their children's minds and their willingness to reflect on their own feelings, thoughts, and behaviors. Study participants were 101 parents (82 mothers, 19 fathers). Parenting practices and parental and family adjustment were assessed using the Parent and Family Adjustment Scale and mentalization was measured using Mentalization Scale at pre- and post-intervention assessments. Parents' feedback on the program was gathered after the program. Results revealed that mentalization, parental adjustment, and family functioning improved while coercive parenting practices decreased after the intervention. Study results provide preliminary indications of the benefits of the 12-week Lighthouse Parenting Program for parents referred or self-referred for mental health services due to their own or their child's difficulties.
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Affiliation(s)
| | - Gerry Byrne
- Department of Social Policy and Intervention, University of Oxford, Oxford OX1 2ER, UK
| | - Rasa Barkauskienė
- Institute of Psychology, Vilnius University, LT-01513 Vilnius, Lithuania
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Talia A, Georg A, Siepe B, Gullo S, Miller-Bottome M, Volkert J, Neukel C, Kaess M, Bempohl F, Herpertz SC, Taubner S. An exploratory study on how attachment classifications manifest in group psychotherapy. RESEARCH IN PSYCHOTHERAPY (MILANO) 2022; 25:653. [PMID: 36373392 PMCID: PMC9893045 DOI: 10.4081/ripppo.2022.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/29/2022] [Indexed: 11/09/2022]
Abstract
Recently, attachment-informed researchers and clinicians have begun to show that attachment theory offers a useful framework for exploring group psychotherapy. However, it remains unclear whether patients with differing attachment classifications would behave and speak in distinct ways in group therapy sessions. In this study, we conducted an exploratory analysis of the discourse of patients in group therapy who had independently received different classifications with gold standard interview measures of attachment in adults. Each patient participant attended one of three mentalization-based parenting groups. Before treatment, the Adult Attachment Interview (AAI) or the Parent Development Interview (PDI) were administered to each patient, and interviews were transcribed and coded to obtain the patient's attachment classification. Groups included 2, 5, and 5 patients, respectively, and any session was led by at least two co-therapists. A total of 14 group sessions were transcribed verbatim. Sessions were analysed through a semi-inductive method, in order to identify markers that would typify patients of different attachment classifications in session. Through transcript excerpts and narrative descriptions, we report on the differing ways in which patients of different attachment classifications communicate in group psychotherapy, with the therapist and with each other. Our work provides useful information for group therapists and researchers regarding how differences in attachment status may play out in group sessions.
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Affiliation(s)
- Alessandro Talia
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, East Foreview Building, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
| | - Anna Georg
- University Hospital Heidelberg, Institute for Psychosocial Prevention, Heidelberg, Germany
| | - Björn Siepe
- University Hospital Heidelberg, Institute for Psychosocial Prevention, Heidelberg, Germany
| | - Salvatore Gullo
- Department of Psychological, Pedagogical, Exercise and Training Sciences, University of Palermo, Palermo, Italy
| | | | - Jana Volkert
- Medical School Berlin, Faculty for Natural Sciences, Berlin, Germany
| | - Corinne Neukel
- Department of General Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, University Hospital Bern, Bern, Switzerland,Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix Bempohl
- Department of Psychiatry and Neurosciences, Medial University Charité, Berlin, Germany
| | - Sabine C. Herpertz
- Department of General Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
| | - Svenja Taubner
- University Hospital Heidelberg, Institute for Psychosocial Prevention, Heidelberg, Germany
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6
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[Parental Mentalization and Early Parent-Child Interaction in Mothers with Affective Disorders or Borderline Personality Disorder: A Systematic Review]. Prax Kinderpsychol Kinderpsychiatr 2022; 71:220-244. [PMID: 35301922 DOI: 10.13109/prkk.2022.71.3.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The ability to mentalize is central in the context of the parent-child relationship.The parental competence to see the child'smental state as an independent individual is an essential prerequisite for perceiving and interpreting child signals appropriately.These abilities are crucial but not always available under elevated stress levels when confronted with a child's affects and parenting challenges. Despite the clinical and conceptual relevance of mentalization with borderline personality disorder (BPD) and affective disorders, the subject has rarely been systematically addressed in parents.This review provides a systematic overview of parental mentalization in mothers with affective disorders or BPD and its impact on the quality of maternal interactive behaviour. The findings generally revealed a negative association between mothers' parental mentalization and depression or BPD, which varied greatly depending on the mentalization constructs. Both psychiatric diagnosis and current severity of symptoms were found to be relevant. However, some positive aspects of mentalization were not markedly impaired. Further, a lowermentalizing abilitywas associatedwith reduced sensitive behaviour in depressedmothers. The results contribute to a better understanding of the association between mentalization and maternal psychopathology and help refine early interventions in parent-child settings.
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Volkert J, Taubner S, Byrne G, Rossouw T, Midgley N. Introduction to Mentalization-Based Approaches for Parents, Children, Youths, and Families. Am J Psychother 2021; 75:4-11. [PMID: 34724808 DOI: 10.1176/appi.psychotherapy.20210020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Family members mentalize when they try to understand each other's behavior on the basis of intentional mental states. This article aims to introduce and briefly describe how the concept of mentalization can provide a useful framework for clinicians to understand psychopathology of children, youths, and families. The authors further outline how mentalization-based techniques and interventions can be applied to build epistemic trust and to reestablish mentalizing in families by presenting clinical vignettes of initial sessions from various clinical settings in the United Kingdom and Germany. The article concludes with a brief summary about the current evidence for mentalization-based interventions with children, adolescents, and families and provides an outlook for future clinical and research work.
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Affiliation(s)
- Jana Volkert
- Department of Psychology, MSB Medical School Berlin, Berlin (Volkert); Institute for Psychosocial Prevention, University of Heidelberg, Heidelberg, Germany (Volkert, Taubner); Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom (Byrne); North East London National Health Service Foundation Trust, London (Rossouw); Anna Freud Centre and University College London, London (Midgley)
| | - Svenja Taubner
- Department of Psychology, MSB Medical School Berlin, Berlin (Volkert); Institute for Psychosocial Prevention, University of Heidelberg, Heidelberg, Germany (Volkert, Taubner); Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom (Byrne); North East London National Health Service Foundation Trust, London (Rossouw); Anna Freud Centre and University College London, London (Midgley)
| | - Gerry Byrne
- Department of Psychology, MSB Medical School Berlin, Berlin (Volkert); Institute for Psychosocial Prevention, University of Heidelberg, Heidelberg, Germany (Volkert, Taubner); Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom (Byrne); North East London National Health Service Foundation Trust, London (Rossouw); Anna Freud Centre and University College London, London (Midgley)
| | - Trudie Rossouw
- Department of Psychology, MSB Medical School Berlin, Berlin (Volkert); Institute for Psychosocial Prevention, University of Heidelberg, Heidelberg, Germany (Volkert, Taubner); Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom (Byrne); North East London National Health Service Foundation Trust, London (Rossouw); Anna Freud Centre and University College London, London (Midgley)
| | - Nick Midgley
- Department of Psychology, MSB Medical School Berlin, Berlin (Volkert); Institute for Psychosocial Prevention, University of Heidelberg, Heidelberg, Germany (Volkert, Taubner); Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom (Byrne); North East London National Health Service Foundation Trust, London (Rossouw); Anna Freud Centre and University College London, London (Midgley)
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8
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Family Minds: A randomized controlled trial of a group intervention to improve foster parents' reflective functioning. Dev Psychopathol 2021; 34:1177-1191. [PMID: 33583462 DOI: 10.1017/s095457942000214x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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.
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9
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[The Role of Partnership Status and Relationship Satisfaction in Inpatient Mother-Child Treatment in Postpartum Mental Disorders]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:134-153. [PMID: 33565952 DOI: 10.13109/prkk.2021.70.2.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The Role of Partnership Status and Relationship Satisfaction in Inpatient Mother-Child Treatment in Postpartum Mental Disorders The study examines the partnership status and satisfaction in connection with symptoms of postpartum mental disorders, mother-child attachment and outcome of inpatient mother-child treatment. Two sub-studies were carried out. In the first study, N = 126 mothers with postpartum mental disorders who went to a preliminary consultation for inpatient mother-child treatment stated their symptom burden (SCL-90), mother-child attachment (PBQ) and satisfaction with their partner relationship (PFB-K). Mothers with stressed relationships showed the highest level of symptom burden and impaired attachment. Mothers without a partner reported the least amount of impairment in mother-child attachment. In the second study, N = 41 mothers were examined over the course of inpatient treatment (within-subject design with a waiting-list). The initial relationship satisfaction was not predictive of symptom reduction or improvement in mother-child attachment. An increase in satisfaction during the treatment was though correlated with an improvement in mother-child attachment.
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Radley J, Sivarajah N, Moltrecht B, Klampe ML, Hudson F, Delahay R, Barlow J, Johns LC. A Scoping Review of Interventions Designed to Support Parents With Mental Illness That Would Be Appropriate for Parents With Psychosis. Front Psychiatry 2021; 12:787166. [PMID: 35153857 PMCID: PMC8828543 DOI: 10.3389/fpsyt.2021.787166] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022] Open
Abstract
The experience of psychosis can present additional difficulties for parents, over and above the normal challenges of parenting. Although there is evidence about parenting interventions specifically targeted at parents with affective disorders, anxiety, and borderline personality disorder, there is currently limited evidence for parents with psychotic disorders. It is not yet known what, if any, interventions exist for this population, or what kinds of evaluations have been conducted. To address this, we conducted a scoping review to determine (1) what parenting interventions have been developed for parents with psychosis (either specifically for, or accessible by, this client group), (2) what components these interventions contain, and (3) what kinds of evaluations have been conducted. The eligibility criteria were broad; we included any report of an intervention for parents with a mental health diagnosis, in which parents with psychosis were eligible to take part, that had been published within the last 20 years. Two reviewers screened reports and extracted the data from the included reports. Thirty-eight studies of 34 interventions were included. The findings show that most interventions have been designed either for parents with any mental illness or parents with severe mental illness, and only two interventions were trialed with a group of parents with psychosis. After noting clusters of intervention components, five groups were formed focused on: (1) talking about parental mental illness, (2) improving parenting skills, (3) long-term tailored support for the whole family, (4) groups for parents with mental illness, and (5) family therapy. Twenty-three quantitative evaluations and 13 qualitative evaluations had been conducted but only eight interventions have or are being evaluated using a randomized controlled trial (RCT). More RCTs of these interventions are needed, in addition to further analysis of the components that are the most effective in changing outcomes for both the parent and their children, in order to support parents with psychosis and their families.
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Affiliation(s)
- Jessica Radley
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Bettina Moltrecht
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Marie-Louise Klampe
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Felicity Hudson
- School of Psychological Science, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom
| | - Rachel Delahay
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Jane Barlow
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Louise C Johns
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Oxford Health NHS Foundation Trust, Oxford, United Kingdom
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Neukel C, Hillmann K, Bertsch K, Bermpohl F, Kluczniok D, Möhler E, Reck C, Resch F, Kaess M, Brunner R, Herpertz SC. [Impact of early life maltreatment of women on the mother-child relationship : Data from mother-child dyads from Heidelberg and Berlin]. DER NERVENARZT 2019; 90:235-242. [PMID: 30643951 DOI: 10.1007/s00115-018-0662-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Early life maltreatment can have severe and long-lasting consequences for the directly affected individual as well as for the next generation. Data from our research including mother-child dyads from Heidelberg and Berlin show that early life maltreatment is associated with behavioral and neural changes including personality traits and attachment style of the affected mothers that negatively affect their relationship with their child. The children of these mothers affected by early life maltreatment have an elevated risk to be maltreated and to develop mental disorders. They also show a heightened cortisol concentration and a reduced inhibition control. It seems to be of importance whether the mother has experienced early life maltreatment but is resilient, meaning that she has not developed a mental disorder (up to the time of examination) or whether in addition to the early life maltreatment she has developed a mental disorder later in life. Children of mothers with early life maltreatment and a lifetime mental disorder seem to be especially exposed to stress and show the greatest impairments and risks. Based on the existing data from our research practical and clinical implications are discussed and one possible intervention in the form of a training of mentalization competencies for parents is presented.
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Affiliation(s)
- C Neukel
- Klinik für Allgemeine Psychiatrie, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland.
| | - K Hillmann
- Klinik für Allgemeine Psychiatrie, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland
| | - K Bertsch
- Klinik für Allgemeine Psychiatrie, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland
| | - F Bermpohl
- Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Deutschland
| | - D Kluczniok
- Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Deutschland
| | - E Möhler
- Klinik für Kinder- und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland
| | - C Reck
- Lehr- und Forschungseinheit Klinische Psychologie des Kindes- und Jugendalters & Beratungspsychologie, LMU München, Leopoldstr. 13, 80802, München, Deutschland
| | - F Resch
- Klinik für Kinder- und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland
| | - M Kaess
- Klinik für Kinder- und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Bolligenstraße 111, Stöckli, 3000, Bern 60, Schweiz
| | - R Brunner
- Klinik für Kinder- und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universität Regensburg, Universitätsstraße 84, 93053, Regensburg, Deutschland
| | - S C Herpertz
- Klinik für Allgemeine Psychiatrie, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland
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