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Minding the baby: enhancing reflectiveness to improve early health and relationship outcomes in an interdisciplinary home-visiting program.
Open accessAbstract
® (MTB), an interdisciplinary, mentalization-based intervention in which home visiting services are provided by a team that includes a nurse practitioner and a clinical social worker. Families are recruited during mother's pregnancy and continue through the child's second birthday. Analyses revealed that intervention families were more likely to be on track with immunization schedules at 12 months, had lower rates of rapid subsequent childbearing, and were less likely to be referred to child protective services. In addition, mother-infant interactions were less likely to be disrupted at 4 months when mothers were teenagers, and all intervention infants were more likely to be securely attached, and less likely to be disorganized in relation to attachment at one year. Finally, mothers' capacity to reflect on their own and their child's experience improved over the course of the intervention in the most high-risk mothers.
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“Strong parental reflective functioning is associated with more secure attachment relationships, and is thus a target of many attachment-focused interventions for parents with and without SUDs (Pajulo et al., 2006; Paris et al., 2015; Sadler et al., 2013; Stover et al., 2017; Zayde et al., 2020)”
From Home‐based family recovery supports: Feasibility, acceptability, and adoption of training home visitors in “Mothering from the Inside Out” (2025) · cites this paper as Sadler et al., 2013
In the citing paper
“Conversely, children whose mothers received the intervention were significantly more securely attached and less disorganized”
From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Sadler et al., 2013
In the citing paper
“Results showed that maternal RF improved in both groups without significant differences between mothers who received the MTB intervention and those who did not.”
From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Sadler et al., 2013
In the citing paper
“A significantly different improvement in maternal reflective functioning was found only in mothers in the intervention group who had absent or very low RF before the birth of the child (PI-RF < 3).”
From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Sadler et al., 2013
In the citing paper
“Among other outcomes, a cluster randomized controlled trial (Sadler et al., 2013) investigated the improvement in reflective functioning in mothers who received the MTB intervention and in mothers who received the standard care at their local community health center when the children were 2 years old.”
From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Sadler et al., 2013
In the citing paper
“In addition, they highlighted that maternal RF develops not only during the 1st years of life, but also throughout adolescence, thus they argued that the young age of the mothers in their sample could have contributed to their unexpected findings.”
From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Sadler et al., 2013
In the citing paper
“However, two recent studies (Sadler et al., 2013; Fonagy et al., 2016) found a general improvement in the mother-child relationship, but quite notably they did not find a significant increase in PDI-RF when comparing the outcomes of mentalization-based treatment with the outcome of other interventions.”
From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Sadler et al., 2013
In the citing paper
“Consistent with these findings, data from a home-based mentalization intervention with maternal a sample suggested that infants in the intervention (vs. controls) were more likely to have a secure attachment and show less disorganization at one year of age (Sadler et al., 2013).”
From Investigating the association between parental reflective functioning and distress tolerance in motherhood. (2015) · cites this paper as Sadler et al., 2013
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Metadata
- Authors
- Sadler, L. S., Slade, A., Close, N., Webb, D. L., Simpson, T., Fennie, K., & Mayes, L. C.
- Affiliations
- Yale University (US)
- Corresponding author
- Sadler, Lois S.
- Venue
- Infant Mental Health Journal
- Publisher
- Wiley
- Published
- 2013-08-08
- Volume
- 34
- Issue
- 5
- Pages
- 391-405
- ISSN
- 0163-9641 (ISSN-L)
- 1097-0355
- PMC
- PMC3774299
- OpenAlex
- W1527140437
- Cited by
- 313
- References
- 48
- Citations by year
- 2026: 17 · 2025: 17 · 2024: 23 · 2023: 31 · 2022: 25 · 2021: 34 · 2020: 28 · 2019: 28 · 2018: 29 · 2017: 29 · 2016: 21 · 2015: 20 · 2014: 8 · 2013: 3
- FWCI
- 17.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Infant Mental Health Journal (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Nursing Research (P30NR008999)
- National Center for Research Resources (UL1RR024139)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD057947, R21HD048591)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Keywords
- mentalization-based interventions, home visits, maternal attachment, secure attachment, disorganized attachment, vaccination schedule, child protective services referrals, adolescent mothers, high-risk mothers
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