Effect of Attachment and Child Health (ATTACHTM) Parenting Program on Parent-Infant Attachment, Parental Reflective Function, and Parental Depression

Lubna Anis, Kharah Ross, Henry Ntanda, Martha Hart, Nicole Letourneau, Lubna Anis, Kharah Ross, Henry Ntanda, Martha Hart, Nicole Letourneau

Abstract

High-risk families exposed to toxic stressors such as family violence, depression, addiction, and poverty, have shown greater difficulty in parenting young children. In this study, we examined the effectiveness of ATTACHTM, a 10−12 session manualized one-on-one parental Reflective Function (RF)-based parenting program designed for high-risk families. Outcomes of parent-child attachment and parental RF were assessed via the Strange Situation Procedure (SSP) and Reflective Function Scale (RFS), respectively. The protective role of ATTACHTM on parental depression was also assessed. Data were available from caregivers and their children < 6 years of age who participated in five pilot randomized control trials (RCTs) and quasi-experimental studies (QES; n = 40). Compared with the control group, caregivers who received the ATTACHTM-program demonstrated a greater likelihood of secure attachment with their children (p = 0.004) and higher parental RF [self (p = 0.004), child (p = 0.001), overall (p = 0.002)] in RCTs. A significant improvement in parental RF (p = 0.000) was also observed in the QES within ATTACHTM group analysis. As attachment security increased, receiving the ATTACHTM program may be protective for depressed caregivers. Results demonstrated the promise of ATTACHTM for high-risk parents and their young children.

Keywords: ATTACHTM; parent-child attachment; parental reflective function; parenting intervention; post-natal depression.

Conflict of interest statement

The authors declare the following financial interests which may be considered as potential competing interests: Drs. Nicole Letourneau and Martha Hart are co-owners of the not-for-profit company called ATTACH and Child Health Foundation, established to support community delivery of ATTACH™. All other authors have no competing financial interests.

Figures

Figure 1
Figure 1
Schematic of data collection. Both intervention and wait-list control groups completed a baseline measurement (Wave 1). The intervention group completed the ATTACH™ Intervention between Wave 1 and Wave 2. Both the intervention and wait-list control groups completed an assessment after the intervention group completed the program (Wave 2). The wait-list control group then completed the ATTACH™ Intervention between Wave 2 and Wave 3. The wait-list control group completed another wave of assessment after the intervention was completed (Wave 3). The blue box indicates data points that were included in between-person analyses (intervention vs. control group, RCT). The red boxes indicate data points that were included in within-person analyses. (pre-to-post intervention change; QES).

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