Infant-Parent Psychotherapy PPT

Infant-Parent Psychotherapy

• IPP is a rapidly developing field of clinical practice, based on the work of such pioneers as Selma Fraiberg and her colleagues (as cited in Wright, 1986).
• According to Stella Acquarone, the Infant-Parent Psychotherapy is a new approach within psychoanalysis.
• Roots in the fields of psychology - psychodynamic, behavioral, cognitive, humanistic, biopsychological, sociocultural - but the stem is clinical.
• The aim of IPP:
• To understand and facilitate normal communication and the development of emotions and relationships.
• Child-Parent Psychotherapy (CPP)
• Ages 0 to 5

• To consctruct a psychodynamic context: using both ideas and technical instruments of psychoanalysis integrated with other theories.
• Besides parents...
• Infant-parent psychotherapy added to any one of those roles and careers allows practitioners to intervene early, confident that best outcomes will appear very quickly and last longer.

A case study of Shona:

• 23-years-old female in a stable relationship with her boyfriend.
• Shona's mother: dreaming of her daughter getting pregnant and preoccupied with this dream.
• 1 month later, Shona was pregnant.
• Her mother tried to make Shona abort.
• The pregnancy became a nightmare and she eventually wanted a late abortion, which did not happen.
• Long and painful delivery.
• Nurses noted the lack of interest and bonding between the mother and baby (referral to Dr. Acquarone).

Reference list

• Acquarone, S. (2004). Infant-Parent Psychotherapy: A Handbook. London: Karnac
• Craig, O., & Sherwell, P. (2006, Oct 29). Babies on the couch. The Telegraph. Retrieved

from http://www.telegraph.co.uk/news/uknews/1532661/Babies-on-the-

couch.html

• Harman, S., Schultz, S., & Siegel, C. (n.d.). When to Consider Mental Health Services.

Infant Parent Psychotherapy Practice. Retrieved from http://www.

infantparentpsychotherapy.com/index.html

• Jordan, B. (2011). Focusing the lens: The infant's point of view. Discussion of “Brief

interventions with parents, infants, and young children: A Framework for

thinking”. Infant Mental Health Journal,32(6), 687-693. doi:10.1002/imhj.20328

• Joyce, A. (2006). A Book Review Essay [Review of the book Infant-Parent

Psychotherapy: A Handbook]. Parent Infant Clinic. Retrieved from

http://www.infantmentalhealth.com/autism_initiatives_publications.htm

• Newman, L., , & Stevenson, C. (2008). Issues in Infant—Parent Psychotherapy for

Mothers with Borderline Personality Disorder.Clinical Child Psychology and

Psychiatry, 13(4), 505-514. doi:10.1177/1359104508096766

• Pekarsky, J. Focuses of Work in Infant-Parent Psychotherapy [PDF document].

Retrieved from http://www.healthychild.ucla.edu/First5CAReadiness/

Conferences/materials/InfantParentTherapy.pdf

• Singleton, J. & Roth, N. (n.d.). Infant / Parent Psychotherapy: Clinical Understanding &

Treatment [PowerPoint slides]. Retrieved from http://www.google.com/url?sa=

t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CF0QFjAC&url=http%3A%2F

%2Fwww.utahbabywatch.org%2Fdocs%2Fforeiproviders%2Feipn%2Fbehavior0

12308%2Fcritical_issues.ppt&ei=ZTh7T__zHKHy0gHlo8SbBg&usg=AFQjCNF

DyvM_dlXBu0nzwZo6ozZeqQyTuA

• Wright, B. M. (1986). An Approach to Infant-Parent Psychotherapy. Infant Mental

Health Journal, 7(4), 247-263.

• Zeanah, Jr. C. (Eds.). (2009). Handbook of Infant Mental Health. New York, NY: The

Guilford Press.

High-Risk Population

Who do you think can be in this high-risk popluation?

Thank You!

Presented by Jisoo Ahn

High-Risk Population

Watch, Wait & Wonder (Elisabeth Muir)

• Parent-child interaction is port of entry
• Parent-child play time: parent follows child’s lead
• Discussion with therapist: therapist follows parent’s lead
• Video tape review

• Parents with a history of:
• Being abused or abusing;
• Loss of previous children by death, abandonment, or court removal;
• Severe marital conflicts, psychiatric hospitalization, substance abuse, social isolation, or conflicted attachment to the infant.
• Personality disorders

What is IPP?

Parenting Issues

Intervention Program

Focuses of Work in IPP

Understanding the Baby

Kind of Approach

Aim

In Dr. Acquarone's clinic (UK):

Infant Psychoanalysis

Why Is It a New Approach?

"With our new approach, instead of starting with a child or adult and projecting back to the baby, we start with the baby and project forward"

(Acquarone, p. xix)

• Direct work with babies and their parents
• Largely influenced by attachment theory
• Neuroscientific and infant research
• Little evidence of infants' vulnerability to adverse emtoional environments available
• "Infant-Parent Psychotherapy: A Handbook"

Change in parent's sense of self, and experience/expectations

Freeing child from misperceptions

Promoting more realistic expectations and greater understanding of child

Securing needed resources/services

Promoting parent's understanding of child in interaction

• Use of therapeutic relationship as an agent of change

• Exploration of parent’s history

• Offering information about the child

• Offering information about resources/services

• Direct intervention with child during infant-parent sessions

• At initial appointments, troubled babies are initially assessed by a pediatrician to ensure that the problem is not physical.
• If ailments are ruled out, observation begins.
• Observation begins by watching mother, father and child interact.
• Then, the psychotherapist will 'interview' the baby.
• His likes, how he comforts himself, who he looks at, his posture, and who he imitates.
• From the interview, she can suggest a range of helpful options for the mother, and explain to her how her child is perceiving her.

• Very expensive:
• An initial consulation can cost up to £100.
• A three-week intensive course costs £29,000.
• In US, each session can cost as much as $250 (£130).

• The COS protocol is an attachment-based early intervention method.
• Four key aspects:
• 1) the COS graphic provides an overarching organization
• 2) a learning tool for caregivers
• 3) helping clinicians
• 4) a treatment plan
• Relationship-based, parent education, assessment, and individualized treatment planning are the cornerstones of the protocol and four facets of how the COS is used in early intervention.

The Dynamics of the Infant Space

Why Intervening Early is so effective?

Early Intervention

• The brain development
• Emotions and the basic emotional system
• Interactions
• Ecology
• Early relationships
• Attachment theory:
• Secure
• Avoidant
• Ambivalent/Resistant
• Disorganized

• Not only is it possible to thus detect the first signs of emotional problems, but also inherently pathological processes that could otherwise lead to permanent organic damage can be corrected.

• Childbirth is a crucial time for parents.
• First emotions are being imprinted.
• The brain is being wired.
• Earlier interventions are much shorter.
• It is cost-effective.
• The quality of family life is improved.

"The resulting disorders are extremely difficult to treat because the developmental faults lie in the earliest, preverbal foundations of the personality" (Wright, 1986, p. 252-253).

The Still-Face Experiment

When should parents/caregivers seek for help?

Parenting skills:

Innate or Learned?

Zero to Three (US):

Good parents vs. Bad parents

When to Consider Mental Health Services

The Process of Diagnosis

• A national, nonprofit organization
• Mission: to promote the health and development of infants and toddlers.

• Sleeping or feeding difficulties
• Developmental concerns, including medical issues and hospitalization
• Sibling relationships
• Parenting difficulties
• Emotional relationship between parent and child
• Parental depression, including prenatal and postpartum depression
• Stress or anxiety regarding the child or parenting
• Change, loss, trauma or other life issues that affect parents, children, or the parent-child relationship
• Parental history of abuse and neglect
• Substance abuse and/or addiction problems