Changes in Maternal Insightfulness and Dyadic Emotional Availability Following an Attachment-Based Intervention Program

• In Event: 3-223 - Interventions in Early Childhood: The Central Role of the Parent-Child Relationship

Integrative Statement

The presentation will report findings from two studies conducted at the Lourie Center for Children's Social and Emotional Wellness, a community-based early intervention center theoretically informed by attachment theory. The center operates a number of programs serving children from birth to eleven with complex social, emotional, and developmental difficulties through several intervention programs at home, school, and clinic. The center's vision is that interventions with families and children at-risk is best shaped and delivered through an integrated approach of research and practice. Thus, the efficacy of the different programs practiced at the center is continuously studied.
Study 1 was conducted at the center's Parent-Child Clinical Services, a community-based outpatient mental health clinic serving families who are referred from social services, courts, pediatricians, and early intervention providers. Utilizing a developmental-relational approach that focuses on the dyad, treatment in this program is aimed at regulating affective states of mind through safety, containment, modeling, recognition, reflection and interpretation, in order to help the dyad to develop a more organized and rewarding relationship. In the study, we assessed changes in parental insightfulness and dyadic emotional availability in 32 mother-child dyads from pre- to post-intervention. At both data points, caregivers were interviewed with the Insightfulness Assessment (IA; Oppenheim & Koren-Karie, 2002) and the caregiver-child dyad was observed in play sessions coded with the Emotional Availability Scales (EAS; Biringen, 2008). Findings revealed a strong association between maternal insightfulness and dyadic emotional availability, both before and after treatment. In terms of intervention efficacy, positive gains were observed in both insightfulness and dyadic emotional availability from pre- to post-intervention. Mothers who changed their classifications from non-insightful to insightful following the intervention showed the greatest gains in emotional availability (Table 1).
Study 2 was conducted in the center's Therapeutic Nursery Program (TNP), a relationship-centered, family-focused preventive-intervention program. Children (ages 3-5) are referred to the TNP to address a range of challenges that have made it impossible for them to function in a typical preschool setting (e.g., aggression, excessive tantrums, refusal behavior, clinically significant anxiety and depressive symptoms). The TNP's intervention model combines safety and predictable structure with warmth and emotional attunement. An essential part of the intervention model is the provision of support to caregivers in securing their relationship with the child. The same measures as in study 1 were used as well as a host of other individual assessments used to evaluate children's development during their stay in the TNP. Here as well, more insightful caregivers showed higher levels of emotional availability. In addition, children with more emotionally available caregivers showed more competent social information processing patterns and social behavior. Finally, strong associations were found between caregivers' exposure to Adverse Childhood Experiences (ACEs) and their emotional availability and insightfulness (Table 2) as well as for their ability to change following the intervention.
These findings have important implications for the type of interventions and service delivery model that could work in real world clinical and educational settings.

Authors

• Kristen L. Capps Umphlet, the Lourie Center for Children's Social and Emotional Wellness
  Presenting Author

• Stephanie Olarte, he Lourie Center for Children's Social and Emotional Wellness
  Non-Presenting Author

• Jimmy Venza, the Lourie Center for Children's Social and Emotional Wellness
  Non-Presenting Author

• Inbar Sofri, University of Haifa, Dept. of Counseling and Human Development
  Non-Presenting Author

• Yair Ziv, University of Haifa
  Non-Presenting Author