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Cited by 124Psychoanalysis and Psychopathology ResearchMaternal Mental Health During Pregnancy and PostpartumPsychotherapy Techniques and Applications

RANDOMIZED CONTROLLED TRIAL OF PARENT-INFANT PSYCHOTHERAPY FOR PARENTS WITH MENTAL HEALTH PROBLEMS AND YOUNG INFANTS: Parent-Infant Psychotherapy Randomized Controlled Trial

Fonagy, Peter, Sleed, Michelle, Baradon, Tessa·2016·Infant Mental Health Journal
DOI 10.1002/imhj.21553
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Abstract

There is a dearth of good-quality research investigating the outcomes of psychoanalytic parent-infant psychotherapy (PIP). This randomized controlled trial investigated the outcomes of PIP for parents with mental health problems who also were experiencing high levels of social adversity and their young infants (<12 months). Dyads were clinically referred and randomly allocated to PIP or a control condition of standard secondary and specialist primary care treatment (n = 38 in each group). Outcomes were assessed at baseline and at 6-month and 12-month follow-ups. The primary outcome was infant development. Secondary outcomes included parent-infant interaction, maternal psychopathology, maternal representations, maternal reflective functioning, and infant attachment. There were no differential effects over time between the groups on measures of infant development, parent-infant interaction, or maternal reflective functioning. Infant attachment classifications, measured only at the 12-month follow-up, did not differ between the groups. There were favorable outcomes over time for the PIP-treated dyads relative to the control group on several measures of maternal mental health, parenting stress, and parental representations of the baby and their relationship. The findings indicate potential benefits of parent-infant psychotherapy for improving mothers' psychological well-being and their representations of their baby and the parent-infant relationship.

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  • In Fonagy et al. (2016), there was no significant increase in maternal PDI-RF when mothers who received psychoanalytic PIP strongly focused on mentalizing were compared to mothers who only underwent standard intervention.

    “A recent, randomized controlled trial (Fonagy et al., 2016) which investigated, among other outcomes, the change in maternal RF, yielded similar results and found no significant increase in maternal PDI-RF when mothers who received psychoanalytic PIP which strongly focused on the mothers’ mentalizing, were compared to mothers who only underwent standard intervention.”

    From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Fonagy et al., 2016

  • Fonagy et al. (2016) conducted a randomized controlled trial investigating, among other outcomes, the change in maternal reflective functioning.

    “A recent, randomized controlled trial (Fonagy et al., 2016) which investigated, among other outcomes, the change in maternal RF, yielded similar results and found no significant increase in maternal PDI-RF when mothers who received psychoanalytic PIP which strongly focused on the mothers’ mentalizing, were compared to mothers who only underwent standard intervention.”

    From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Fonagy et al., 2016

  • PDI-RF scoring is influenced by mental-state talk; extensive use of mental-state talk can lead to assigning an RF score of at least 3 even when it does not indicate a genuine ability to mentalize.

    “In fact, extensive use of mental state talk inevitably led to assigning an RF score of at least 3, even though the use of mental-state talk is not always indicative of a real ability to mentalize.”

    From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Fonagy et al., 2016

  • The PIP intervention is effective in changing mothers' representations of their child and specifically reducing feelings of helplessness and hostility toward their child.

    “Fonagy and co-workers interpreted this finding as supporting the efficacy of the PIP intervention in changing the mothers’ representations of their child and specifically reducing feelings of helplessness and hostility toward their child.”

    From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Fonagy et al., 2016

  • In Fonagy et al. (2016), only mothers in the PIP group showed a significant decrease in representational risk, particularly in the Helplessness and Hostile subscales.

    “In their study, only mothers in the PIP group showed a significant decrease in representational risk, particularly in the Helplessness and in the Hostile subscales.”

    From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Fonagy et al., 2016

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Authors
Fonagy, P., Sleed, M., & Baradon, T.
Affiliations
  • Anna Freud Centre (GB)
  • University of the Witwatersrand (ZA)
Corresponding author
Sleed, Michelle
ORCID
Venue
Infant Mental Health Journal
Publisher
Wiley
Published
2016-03
Volume
37
Issue
2
Pages
97-114
ISSN
0163-9641 (ISSN-L)
DOI
10.1002/imhj.21553
OpenAlex
W2289516537
Cited by
124
References
92
Citations by year
2026: 12 · 2025: 10 · 2024: 11 · 2023: 15 · 2022: 10 · 2021: 14 · 2020: 19 · 2019: 12 · 2018: 9 · 2017: 10 · 2016: 1
FWCI
14.27
Type
journal article
Language
en
Open access
closed
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm)
Locations
  • Infant Mental Health Journal (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
Big Lottery Fund
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
parent-infant psychotherapy, psychoanalytic psychotherapy, maternal mental health, infant development, parent-infant interaction, maternal representations, maternal reflective functioning, infant attachment, parental stress, social adversity, young infants
MeSH terms
Adult, Mental Disorders, Child Development, Female, Follow-Up Studies, Humans, Infant, Male, Mother-Child Relations, Mothers, Object Attachment, Patient Compliance, Psychotherapy, Socioeconomic Factors, Linear Models, Treatment Outcome, Young Adult

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