Effects of emotionally oriented parental interventions: a systematic review and meta-analysis.

Objective: This systematic review and meta-analysis investigates the effects of emotionally oriented parental interventions. Background: Several emotionally oriented parental interventions have been developed during the last decade. Some of these have gained popularity and spread across several continents. The literature is growing and consists of qualitative studies; intervention only, quasi-experimental, case-control studies; and randomized controlled trials. They indicate effects for parents and children. However, no systematic review or meta-analysis has, to our knowledge, summarized the results. Method: Using several search engines, we located 8,272 studies. After abstract and full-text screening, 33 studies were assessed for bias and included in the study. Outcomes for parents and children were extracted and combined into three constructs for parents and two for children. Meta-analyses were conducted for each construct to estimate the effect of the interventions using a robust Bayes meta-analysis. Results: The results indicate the presence of a small to medium effect on parents' mental health, behavior, and use of emotionally oriented parenting, as well as on children's internalizing and externalizing difficulties. Most participants were recruited from the general population, and clinical settings were rare. The results show little evidence of publication bias. Conclusion: There is evidence of a small to medium effect of emotionally oriented interventions on parents and children. Systematic review registration: https://osf.io/un3q4/.

Like Taking a Magnifying Glass Into Everyday Life: Vulnerable Parents' Experiences With Video Guidance in an Infant Mental Health Clinic.

Background: Parents are a central focus in clinical infant mental health interventions because of the key importance of the caregiver-infant relationship, especially when dyads are burdened by psychosocial and parental mental health problems. However, knowledge is scarce about the lived experience of vulnerable parents who undergo video-based guidance. Aim: The study explores how parents in an infant-psychiatric outpatient clinic who struggled to mentalize and remain emotionally connected to their infant experienced helpful and challenging elements in video guidance. Method: We analyzed the interviews of a strategic sample of 12 parents after undergoing Marte Meo video guidance, using a team-based, reflexive thematic analysis (TA). Results: We identified four main themes: (a) Handling initial feelings of fear and loss of control; (b) Filming as a disturbing or agentic experience; (c) Feeling validated or devalued in the therapeutic relationship; and (d) Bringing insights from video guidance into everyday life. Therapeutic and existential factors became apparent in the main themes of adjustment to the guidance, experiences with filming, the therapeutic relationship and integration of new experiences. Conclusion: The parents' sense of agency, dignity, and shame may be important for their ability to integrate new ideas about themselves. Implications: Video guidance for vulnerable parents in specialized clinical treatment should address relational challenges, parental mental health, and issues of recognition.

Learning to mentalize: Exploring vulnerable parents' experiences of change during video guidance in an infant mental health clinic.

BACKGROUND: Interventions that promote infant mental health face challenges when applied for parents who struggle with psychosocial and psychological burdens. Video-based guidance using the Marte Meo method is used in specialized clinical settings with high-risk families to improve parent-child interaction, parental sensitivity and mentalizing. However, knowledge about the lifeworlds of these parents and their experiences of the therapeutic process during video guidance is limited. AIM: This qualitative study explores how parents in an infant mental health outpatient clinic who had difficulties mentalizing and maintaining an emotional connection with their infants experienced the change process during Marte Meo video guidance. METHODS: We identified a strategic sample of parents with difficulties mentalizing and maintaining an emotional connection with their infants through the Parent Development Interview. Twelve parents received video guidance and were afterwards interviewed in-depth. The research interviews were qualitatively analysed via a team-based reflexive thematic analysis. RESULT: We identified four themes: a) feeling inadequate or disconnected as a parent; b) discovering the infant as a relating and intentional person; c) becoming more agentic and interconnected; and d) still feeling challenged by personal mental health issues. CONCLUSION: Parents described positive changes in their interactions, in mentalizing their infants, the relationship and themselves as parents, in their experiences of self-efficacy and on a representational level. They also described increased confidence and improved coping despite ongoing personal mental health challenges. The findings suggest that video guidance using the Marte Meo method can be a critical intervention for vulnerable parents but should be coordinated with parents' primary treatments when complex parental mental health issues are involved.

Finding focus in a difficult landscape: Therapists' experiences with challenging video guidance processes for parent-infant dyads.

Marte Meo video guidance uses filmed interaction of the actual parent-infant dyad in the guidance of caregivers. Exploring the challenges that therapists meet in the guidance of parent-infant dyads may illuminate important aspects of the method itself as well as the therapists' role and requirements. This could lead to method development and improved practice, but is hitherto little addressed. In this paper, we explore how skilled therapists experience and handle challenging or failing guidance processes with parent-infant dyads. We analyzed interviews with 13 Marte Meo therapists/supervisors using team-based reflexive thematic analysis. Four main themes were identified: promoting relational growth in a coercive context, building an alliance that feels safe for the parents, looking at positive moments in difficult lives, and handling intense feelings as a therapist. Our findings show that therapists experience specific therapeutic and ethical challenges with a vulnerable subgroup of parent-infant dyads where child protective issues arise, where caregivers' insecurities impede the therapeutic relationship, and where caregivers have unsolved relational or mental health problems. The therapists' role becomes pivotal and demanding with regard to the therapeutic alliance, the therapeutic interventions in the guidance process, and their own need for regulation, supervision, and structure. Identification of these vulnerable dyads early in the process could facilitate a better adaptation and practice of video guidance. Our findings suggest a need for supporting structures, clinical supervision, and training that address these challenges.

La guía de video Marte Meo usa interacciones filmadas de las propias díadas. Explorar los retos que en la guía surgen de las díadas progenitor-infante pudiera dar luz al papel de los terapeutas y requisitos, así como a importantes aspectos del método mismo. Esto podría llevar al desarrollo del método y una práctica mejorada, sin embargo, hasta el presente ha sido poco estudiada. Exploramos cómo los hábiles terapeutas experimentan y manejan los retos o los fallos en los procesos de guía. Analizamos entrevistas con 13 terapeutas/supervisores de Marte Meo usando análisis temáticos de reflexión basados en el equipo de trabajo. Se identificaron cuatro temas principales: promover el crecimiento de la relación dentro de un contexto coercitivo; construir una alianza en la que los progenitores se sientan seguros; prestar atención a momentos positivos en vidas difíciles; y manejar sentimientos intensos como terapeuta. Nuestros resultados muestran que el terapeuta experimenta retos éticos y terapéuticos específicos con un vulnerable subgrupo de díadas progenitor-infante donde surgen asuntos de protección al niño, donde las inseguridades de los cuidadores impiden la relación terapéutica, y donde los cuidadores tienen problemas de relación o de salud mental no resueltos. El papel de los terapeutas se convierte en esencial y exigente con respecto a la alianza, a las intervenciones terapéuticas, así como a la propia necesidad de regulación, supervisión y estructura. La temprana identificación de estas díadas pudiera facilitar una mejor adaptación a la guía del video. Nuestros resultados sugieren la necesidad de estructuras de apoyo, supervisión clínica y entrenamiento para manejar estos retos.

La guidance interactive par vidéo Marte Meo ("Par mes propres forces") utilise une interaction filmée de vraies dyades. L'exploration des défis qui se posent dans la guidance de dyades parent-bébé peuvent illuminer le rôle des thérapeutes ainsi que les besoins et les aspects importants de la méthode en elle-même. Cela pourrait mener au développement de la méthode et à une pratique améliorée mais n'a jusque-là guère été abordé. Nous explorons ici comment des thérapeutes expérimentés vivent et gèrent les processus de guidance qui forment un défi ou qui échouent. Nous avons analysé des entretiens avec 13 thérapeutes/superviseurs Marte Meo utilisant une analyse thématique de réflexion et menée en équipe. Quatre thèmes principaux ont été identifiés: la promotion de la croissance relationnelle dans un context coercif; la construction d'une alliance que les parents trouvent sûre; le fait de voir des moments positifs dans des vies difficiles; et le fait d'avoir à faire à des sentiments intenses en tant que thérapeute. Nos résultats montrent que les thérapeutes font l'expérience de défis thérapeutiques spécifiques et de défis éthiques avec un sous-groupe vulnérable de dyades parent-bébé lorsque des problèmes de protection de l'enfant se posent, dans un contexte ou les insécurités des personnes prenant soin de l'enfant enfreignent la relation thérapeutique et où les personnes prenant soin de l'enfant peuvent avoir des problèmes relationnels ou de santé mentale qui n'ont pas été résolus. Le rôle des thérapeutes devient central et exigeant pour ce qui concerne l'alliance, les interventions thérapeutiques et son propre besoin de régulation, de supervision et de structure. Une identification précoce de ces dyades pourrait faciliter une meilleure adaptation de la guidance par vidéo. Nos résultats suggèrent qu'il est nécessaire d'avoir des structures de soutien, une supervision clinique et une formation afin de faire face à ces défis.

Diet and Neurodevelopmental Score in a Sample of One-Year-Old Children-A Cross-Sectional Study.

Environmental factors in the first years of life are crucial for a child's neurodevelopment. Research on the association between breastfeeding and neurodevelopment is inconclusive, while research on the possible association between other dietary factors and neurodevelopment is inadequate in children as young as one year of age. The aim of the present study was to investigate associations between both breastfeeding and other dietary factors and the neurodevelopment of one-year-old children in Norway. METHODS: Participants were recruited from kindergartens in four Norwegian counties in 2017. A questionnaire including questions about dietary factors and breastfeeding, and a standardised age-related questionnaire on neurodevelopment (the Ages and Stages Questionnaire), were completed by parents of one-year-olds. Linear regressions adjusting for relevant covariates were conducted to explore the associations. RESULTS: In our sample of 212 one-year-old children, a longer duration of breastfeeding was associated with higher neurodevelopmental scores. Dietary intake of fish, fruits and vegetables was also strongly associated with higher neurodevelopmental scores, even after adjustment for breastfeeding and maternal education. CONCLUSION: Our results indicate that healthy dietary factors are important for neurodevelopment in young children, with measurable effects already at the age of one year.