What Works for Whom? Moderators in Mentalization-Based Intervention

• In Event: Making room for mentalization in everyday parenting: from research to practice

Abstract

Parental reflective functioning (PRF) is a parent’s ability to understand and interpret his/her child’s behavior in terms of mental states: feelings, thoughts, motivations, and beliefs of the child and himself/herself. Empirical studies have shown the effectiveness of PRF-based interventions for the parents, the children, and the parent-child relationship. However, because parents and children vary in the extent of their improvement, our study aimed to better understand “what works for whom” in PRF-based interventions. Identifying and understanding these specific and salient characteristics is crucial for the development of tailored parenting interventions, thereby improving the efficacy of treatment.
We examined the role of baseline capacities (PRF, parental sense of control and competence, parent-child interactions, and child outcomes), as well as parental distress (parental depression, parental stress, and emotion regulation) and family-environment distress (marital dissatisfaction and home chaos) as moderators when looking at the improvement in PRF and parental sense of control and competence, parent-child interactions, and child outcomes following the DUET intervention program. DUET is a 12-session group intervention aiming to enhance PRF. We examined: a) Do baseline capacities predict change? b) Do different subgroups (classes) exist based on individual parental characteristics (depression, anxiety, stress, emotion regulation) and family environment (marital dissatisfaction, home chaos); c) Do these classes differ in the extent of change in the outcome measures.
One hundred forty-two parents (native Israelis; mean age = 34.84 years) of preschool children (n = 107; mean child age = 4.3 years; 53% female) were assessed before, after, and six months following the intervention. Latent class analysis (LGA) was used to identify latent classes of parents with comparable patterns of observed individual characteristics and family environment. Figure 1 presents the standardized scores for the two classes. The first class comprised 73.4% of the LCA sample (80 parents; 23 fathers, 57 mothers) and represented low levels of self-reported difficulties across all domains (i.e., “Low Distress” class). The second class comprised 25.7% of the LCA sample (28 parents; 8 fathers, 20 mothers) and represented high levels of self-reported difficulties across all domains (i.e., “High Distress” class). Independent sample t-tests indicated that compared to parents in the low-distress class, parents in the high-distress class had significantly higher scores on all measures (ps > .001). Furthermore, results indicated significant associations between lower levels at baseline and greater improvement in PRF, child self-regulation, and child self-distraction strategies. Furthermore, for each outcome variable, a conditional LGM was run separately, regressing probability of membership in the High Distress class on slope. For most outcome variables, LCA class membership was unrelated to slope, suggesting that both classes of participants benefitted from the intervention. Nevertheless, for “Child Behavioral and Emotional Problems,” both classes experienced significant change, although the greater change was observed for the High Distress class (Figure 2a). For “Parental Locus of Control,” significant change was specific to individuals in the Low Distress class (Figure 2b), whereas for “Parental Sensitivity,” significant change was unique to individuals in the High Distress class (Figure 2c). Clinical and future directions are discussed.

Authors

• Naama Atzaba-Poria, Ben-Gurion University of the Negev
  Presenting Author

• Atara Menashe-Grinberg

• Sofie Rousseau