Providing Continuity in Infant Mental Health Services for Medically Fragile Infants and Their Families

Having a baby who is prenatally or postnatally diagnosed with a medical condition places considerable stress on the parents, infants, and their developing relationship. Infant mental health (IMH) services offer an opportunity to address the challenges and support the parent-infant relationship. The present study outlined a continuum of care IMH program embedded within various medical settings of a large metropolitan children's hospital. Applications of IMH principles within the fetal care center, neonatal intensive care unit, high risk infant follow-up clinic, and the patient's home are described. Descriptive data about families served across settings and a case study are provided in order to illustrate the implementation of this unique IMH intervention model.

Child-Parent Psychotherapy with Infants Hospitalized in the Neonatal Intensive Care Unit

Hospitalization in the Neonatal Intensive Care Unit (NICU) is a stressful and potentially traumatic experience for infants as well as their parents. The highly specialized medical environment can threaten the development of a nurturing and secure caregiving relationship and potentially derail an infant's development. Well-timed, dose-specific interventions that include an infant mental health approach can buffer the impact of medical traumatic stress and separations and support the attachment relationship. Many psychological interventions in the NICU setting focus on either the parent's mental health or the infant's neurodevelopmental functioning. An alternative approach is to implement a relationship-based, dyadic intervention model that focuses on the developing parent-infant relationship. Child-parent psychotherapy (CPP) is an evidence-based trauma-informed dyadic intervention model for infants and young children who have experienced a traumatic event. This article describes the adaptation of CPP for the NICU environment.

Trauma Treatment in Young Children with Developmental Disabilities: Applications of the Child-Parent Psychotherapy (CPP) Model to the Cases of "James" and "Juan"

This case study series investigates the application of the Child-Parent Psychotherapy (CPP) model for young children with developmental disabilities who were exposed to trauma.  Two Latino clients and their families were selected for systematic write-up: "James," 14 months old  who, following medical trauma (surgery and stroke) showed global developmental delays; and "Juan," 6 years 2 months old with autism in the context of early exposure to domestic violence  and a history of physical and emotional abuse. Utilizing the CPP model, we addressed the families’ histories of traumatic events, including domestic violence, medical trauma, and attachment concerns associated with parental adjustment to diagnosis.  The CPP model was selected with the goal of strengthening the relationship between each child and his caregivers; restoring the child’s sense of safety, attachment, and appropriate affect; and improving the child’s behavioral and social functioning.  Clinical insights regarding the application of the CPP model for young children with developmental disabilities who were exposed to trauma are offered. In addition, cultural applications for Latino families are explored.