From reactive to reflective: Evidence for shifts in parents’ state of mind during brief under-fives psychoanalytic psychotherapy

Abstract

This article describes a study that was designed to examine the impact of brief psychoanalytic psychotherapy with children under-five years of age and their families. The work took place in a Child and Adolescent Mental Health Service (CAMHS) in England, to which children are routinely referred with a range of behavioural and emotional problems. The study examined the hypothesis that through formulating the emotional forces that underpin the family’s here-and-now experiences and bringing into the frame the child’s perspective, a shift in the parents’ states of mind from being less reactive and more reflective would be observed. Further, the less reactive parental state would result in the child feeling more contained, and impact positively in relation to symptom presentation. Using clinical description and quantitative data drawn from the videotaped clinical material the hypothesis was tested on seven families. The prediction was borne out, significantly so in relation to the parents being less blaming and more reparative in their comments. Parental reports also highlighted that six of the seven children exhibited a significant reduction / termination of symptoms for which they had been originally referred. The therapeutic process underlying these results is considered.

Keywords

brief psychoanalytic psychotherapy outcome study parental states of mind under-fives

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References

Baradon

Broughton

Gibbs

James

Joyce

Woodhead

(2005). The practice of psychoanalytic parent–infant psychotherapy: Claiming the baby. New York: Routledge.

Barrows

(1999). Fathers in parent-infant psychotherapy. Infant Mental Health Journal, 20, 333–345.

Barrows

(2000). Making the case for a dedicated infant mental heath service. Psychoanalytic Psychotherapy, 24, 111–128.

Ben-Aaron

Harel

Kaplan

Patt

(2001). Mother-Child and Father-Child Psychotherapy. London & Philadelphia: Whurr Publishers.

Berg

(2000). Beyond the dyad: Parent-infant psychotherapy in a multi-cultural society: Reflections from a South African perspective. Paper read at the 7th Congress of the W.A.I.M.H., July, 2000. Montreal.

Bick

(1964). Notes on infant observation in psychoanalytic training. International Journal of Psychoanalysis, 45, 558–566.

Bion

W. R.

(1962). Learning from Experience. London: Maresfield Reprints.

Brafman

A. H.

(2001). Untying the Knot. Working with Children and Parents. London & New York: Karnac Books.

Cramer

(1995). Short-term dynamic psychotherapy for infants and their parents. Child and Adolescent Psychiatric Clinics of North America, 4, 649–659.

10.

Cramer

(1998). Mother-infant psychotherapy: A widening scope in technique. Infant Mental Health Journal, 9, 151–167.

11.

Cronbach

L. J.

(1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–333.

12.

Daws

(1999). Brief psychotherapy with infants and their parents. In Laniado

Horne

(Eds). The handbook of child and adolescent psychotherapy. London: Routledge.

13.

Emanuel

. (2002). Parents united: Addressing parental issues in work with infants and young children. The International Journal of Infant Observation, 5, 103–117.

14.

Fraiberg

Adelson

Shapiro

(1975). Ghosts in the nursery. Journal of the American Academy of Child Psychiatry, 14, 387–421.

15.

Hopkins

(1992). Infant-parent psychotherapy. Journal of Child Psychotherapy, 18, 5–17.

16.

Hopkins

(1994). Therapeutic interventions in infancy: Two contrasting cases of persisting crying. Psychoanalytic Psychotherapy, 8, 141–152.

17.

Klein

(1926–1961). The writings of Melanie Klein. Vol. 1-4. London: The Hogarth Press & The Institute of Psycho-Analysis.

18.

Landis

J. R.

Koch

G. G.

(1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.

19.

Likierman

(1988). Maternal love and positive projective identification. Journal of Child Psychotherapy, 14, 29–46.

20.

Main

Kaplan

Cassidy

(1985). Security in infancy, childhood, and adulthood: A move to the level of representation. In Bretherton

Waters

(Eds.), Growing points of attachment theory and research. Monograph of the Society for Research in Child Development, 50 (1-2, Serial No. 209).

21.

Manzano

Palacio-Espasa

(1993). Las terapias en psiquiatria infantil y en psicopedagogia. Barcelona & Buenos Aires: Ediciones Paidos.

22.

Miller

(1992). The relation of infant observation to clinical practice in an under five’s counselling service. Journal of Child Psychotherapy, 18, 19–32.

23.

Miller

(2000). An under five’s counselling service and its relation to questions of assessment. Assessment in Child Psychotherapy. London: Duckworth.

24.

Norman

(2004). Transformation of early infantile experiences: A 6-month-old in psychoanalysis. International Journal of Psychoanalysis, 85, 1103–1122.

25.

Nunnally

J. C.

Bernstein

I. H.

(1994). Psychometric Theory, 3rd Edition. New York: McGraw-Hill.

26.

Palacio-Espasa

(1993). La pratique psychothérapique avec l’enfant. Bayard Editions. Milano: Cortina.

27.

Pozzi

(2003a). A three-year-old-boy with ADHD and Asperger’s syndrome treated with parent-child psychotherapy. The Journal of the British Association of Psychotherapists, 41, 16–31.

28.

Pozzi

(2003b). Psychic hooks and bolts: Psychoanalytic work with children under five and their families. London: Karnac Books.

29.

Pozzi-Monzo

M. E.

Tydeman

(2007). Innovations in parent-infant psychotherapy. London: Karnac Books.

30.

Stern

(1998). The motherhood constellation. London: Karnac Books.

31.

Thomson Salo

(2001). Some principles of infant-parent psychotherapy. Australian Journal of Psychotherapy, 20, 36–59.

32.

Trad

P. V.

(1993). Short-term parent-infant psychotherapy. New York: Basic Books.

33.

Winnicott

D. W.

(1941). The observation of infants in a set situation. In Winnicott

(Ed) Through Paediatrics to Psychoanalysis. London: Karnac Books.