Helping Parents With Mental Health Problems To Parent Young Infants: A Randomized Controlled Trial (RCT) Of Parent-Infant Psychotherapy (PIP)

The research part of the Parent-Infant Project is funded by Big Lottery, and it is trying to find the best methods for helping mothers with mental health problems and other indicators of social deprivation.

The randomized controlled trial (RCT) aims to identify the specific benefits for infants from therapies which include them and their mothers as opposed to routinely available services which are often focussed on mental health issues alone.

The project is also developing research measures to establish how effective community-based parent-infant intervention services are (i.e. not just private services, but those available to the more deprived sectors of society).

This latter aspect of the project involves a relatively new area of research and our staff are at the cutting edge of innovative developments.

Purpose and Rationale Of The Study

Infants and their caregivers influence each other enormously, and the parenting that infants receive shapes their development. When a mother or father of a young infant has a serious mental health problem, therefore, the real patient is the parent-infant relationship.

In our understanding of infant development, the child is the product of the continuous dynamic interaction of the child and the experience provided by his or her family and social context, with equal weight given to the effects of the child and to his or her social environment.

The child is not independent of his or her environment, but that environment does play a significant part in determining the child's experience. For this reason, the way in which a child develops cannot be described without analyzing the effects of the environment on the child.

Furthermore, the parent's problems impact on the child just as the experience of the infant creates sizeable challenges for the parent. We believe that addressing either in isolation, normally treating the parent without considering the infant, will often be only partially effective as an intervention.

In effect, when the assumption is made that addressing the parent's problem alone will be sufficient to rectify the problems already experienced by the child, the infant is excluded from consideration.

This proposed project builds on the tradition of relationship-focused interventions for parents of young infants. It intends to extend this tradition in three ways.

Firstly by investigating the outcomes of parent-infant psychotherapy (PIP) comapred with routinely available services ("treatment as usual") for families experiencing difficulties.

Secondly, we recognize that many of those who are currently in need of this type of intervention have no access to it, partly because it is not considered a treatment option for adult disorders, but also because psychotherapy services are less frequently offered to families who are disadvantaged socially.

We therefore consider that it is important to demonstrate the value of parent-infant treatment with families who do not normally have access to parent-infant psychotherapy.

Thirdly, an important reason why parents of young infants are rarely offered relationship-based therapy is because the parents themselves do not necessarily see the presence of the child in the therapy as relevant to their problems.

We wish to use the study to explore the expectations, beliefs and experiences of parents concerning parent-infant psychotherapy and other services in order to arrive at a better understanding of the barriers that parents experience in relation to this type of treatment.

Clinical papers from the project appear in a range of magazines, books and peer-reviewed journals. Members of the project's staff also regularly present their work to a variety of professional forums.

A book which describes the Parent-Infant Project's model of Parent-Infant Psychotherapy was published by Routledge in November 2005. It has become a standard text book for practitioners in Brazil, Canada, Denmark, Germany, Italy, Russia, South Africa and the USA, as well as the UK. Click here for more information about this volume.

For more information, please contact the research psychologist, Michelle Sleed, by email on Michelle.Sleed@annafreud.org or telephone 020 7443 2216.

To view other pages of the Parent-Infant Project, follow the links below: