Action team on triadic attachment and child health (ATTACH): Results of a parental reflective function intervention

Background. Parents suffering from violence, depression and addictions create a toxic stress environment for their children that often leaves parents unable to respond sensitively to them (Center on the Developing Child at... [ view full abstract ]

Background. Parents suffering from violence, depression and addictions create a toxic stress environment for their children that often leaves parents unable to respond sensitively to them (Center on the Developing Child at Harvard University, 2010). This interferes with forming secure parent-child attachments necessary for healthy child development (Bowlby, 1980). Secure attachment is influenced by parental Reflective Function (RF); parents’ capacity to understand and thus regulate their own feelings/behavior toward their child (Fonagy, 2014). Few RF interventions exist and typically focus on mothers’ understanding of their own psychological care-giving representations but do not promote learning RF skills via practice (Suchman, 2014) and ignore co-parents. Building on this research we have developed and pilot tested a RF intervention called ATTACH, designed for at-risk mothers (violence, depression, addictions) and their co-parent. It is intended to be an add-on program to existing parenting programs.

Objectives. This paper will describe effects of two funded ATTACH pilot studies on mothers’ RF and maternal-child interactions.

Methods. The ATTACH project was community-based, employing integrated knowledge transfer via partnering with Calgary Urban Project Society (CUPS), an inner city agency serving vulnerable families. The sample was drawn from CUPS parenting program that did not cover RF. ATTACH completed two 10-12 week pilot studies (randomized controlled trial & quasi-experiment) with 20 families.

Results. Data are being analyzed and will be ready for presentation at the conference. Attrition was very low (<5%); several factors explained high retention: (1) developing strong therapeutic alliances between mothers and ATTACH facilitators (2) offering a nurturing environment.

Conclusion. The World Health Organization (2009) has called for effective programs to address persistent discrepancies in child development. Understanding associations between parental RF and maternal-child interaction and determining the effectiveness of programs like the ATTACH, contributes to ISPCAN’s vision of accelerating innovation to improve environments that support healthy child development.