Pediatricians, Well-Baby Visits, and Video Intervention Therapy: Feasibility of a Video-Feedback Infant Mental Health Support Intervention in a Pediatric Primary Health Care Setting

Sergio Facchini, Valentina Martin, George Downing, Sergio Facchini, Valentina Martin, George Downing

Abstract

This case series study evaluated the feasibility and acceptability of a behavioral/cognitive psychological intervention in a pediatric primary health care setting during standard well-baby visits. The aim of the intervention was to support caregivers' sensitivity and mentalization in order to promote infant mental health (IMH). Four neonates from birth to 8 months were consecutively enrolled to test a short video-feedback intervention (Primary Care - Video Intervention Therapy, an adaptation of George Downing's Video Intervention Therapy to primary care) conducted by a pediatrician. The 5 min interaction recording and the video-feedback session were performed during the same well-baby visit and in the same pediatrician's office where the physical examination was conducted. During the study period, six video-feedback sessions were performed for each baby at different ages (1, 2, 3, 4, 6, 8 months). A series of different interactional situations were filmed and discussed: touch, cry, affective matching, descriptive language, feeding, separation and autonomy. The intervention was easily accepted and much appreciated by all four families enrolled. This study aimed to answer a dilemma which pediatric providers generally face: if the provider wishes to respond not only to physical but also IMH issues, how on a practical level can this be done? This case series study indicates that Primary Care - Video Intervention Therapy can be a promising new tool for such a purpose.

Keywords: attachment; infant mental health; parenting; pediatrician; prevention; primary care; video-feedback.

References

    1. Ayala G. X., Elder J. P. (2011). Qualitative methods to ensure acceptability of behavioural and social intervention in the target population. J. Public Health Dent. 71 S69–S79. 10.1111/j.1752-7325.2011.00241.x
    1. Bakermans-Kranenburg M. J., van Ijzendoorn M. H., Juffer F. (2003). Less is more: meta-analysis of sensitivity and attachment interventions in early childhood. Psychol. Bull. 129 195–215. 10.1037/0033-2909.129.2.195
    1. Bakermans-Kranenburg M. J., van Ijzendoorn M. H., Juffer F. (2005). Disorganized infant attachment and preventive interventions: a review and meta-analysis. Infant Ment. Health J. 26 191–216. 10.1002/imhj.20046
    1. Barnett M. L., Niec L. N., Acevedo-Polakovich I. D. (2014). Assessing the key to effective coaching in parent-child interaction therapy: the therapist-parent coding system. J. Psychopathol. Behav. Assess. 36 211–223. 10.1007/s10862-013-9396-8
    1. Beebe B. (2003). Brief mother-infant treatment: psychoanalytically informed video feedback. Infant Ment. Health J. 24 24–52. 10.1002/imhj.10042
    1. Beebe B., Steele M. (2013). How does microanalysis of mother-infant communication inform maternal sensitivity and infant attachment? Attach. Hum. Dev. 15 583–602. 10.1080/14616734.2013.841050
    1. Bernard K., Dozier M., Bick J., Lewis-Morrarty E., Lindhiem O., Carlson E. (2012). Enhancing attachment organization among maltreated children: results of a randomized clinical trial. Child Dev. 83 623–636. 10.1111/j.1467-8624.2011.01712.x
    1. Berthelot N., Ensink K., Bernazzani O., Normandin L., Luyten P., Fonagy P. (2015). Intergenerational transmission of attachment in abused and neglected mothers: the role of trauma-specific reflective functioning. Infant Ment. Health J. 36 200–212. 10.1002/imhj.21499
    1. Blount A., Kathol R., Thomas M., Shoenbaum M., Rollman B. L., O’Donohue M., et al. (2007). The economics of behavioral health services in medical settings: a summary of the evidence. Prof. Psychol. 38 290–297. 10.1037/0735-7028.38.3.290
    1. Briggs R. D., Racine A. D., Chinitz S. (2007). Preventive pediatric mental health care: a co-location model. Infant Ment. Health J. 28 481–495. 10.1002/imhj.20149
    1. Buchholz M., Talmi A. (2012). What we talked about at the pediatrician’s office: exploring differences between heathy steps and traditional pediatric primary care visits. Infant Ment. Health J. 33 430–436. 10.1002/imhj.21319
    1. Burtchen N., Alvarez-Segura M., Mendelsohn A. L., Dreyer B. P., Castellanos F. X., Catapano P., et al. (2013). Screening for sustained social withdrawal behaviors in six-months-old infants during pediatric primary care visits: results from an at-risk latino immigrant sample with high rates of maternal major depressive disorder. Infant Ment. Health J. 34 542–552. 10.1002/imhj.21418
    1. Cassidy J., Woodhouse S., Sherman S., Stupica B., Lejuez C. W. (2011). Enhancing infant attachment security; an examination of treatment efficacy and differential susceptibility. Dev. Psychopathol. 23 131–148. 10.1017/S0954579410000696
    1. Committee on Psychosocial Aspects of Child and Family Health and Task Force on Mental Health (2009). Policy statement. (-)The future of pediatrics: mental health competencies for pediatric primary care. Pediatrics 124 410–421. 10.1542/peds.2009-1061
    1. Dollberg D., Feldman R., Keren M., Guedeney A. (2006). Sustained withdrawal behaviour in clinic-referred and nonreferred infants. Infant Ment. Health J. 27 292–309. 10.1002/imhj.20093
    1. Downing G. (2005). “Emotion, body and parent-infant interaction,” in Emotional Development, eds Nadel J., Muir D. (Oxford, NY: Oxford University Press; ), 429–449.
    1. Downing G. (2008). “A different way to help,” in Human Development in the Twenty-First Century, Visionary Ideas from Systems Scientist, eds Fogel G., King B. J., Shanker S. G. (Cambridge: Cambridge University Press; ), 200–205.
    1. Downing G. (2015). “Work with mentalization in Video Intervention Therapy (VIT): help for children, adolescents, and their parents,” in Strumenti di Valutazione e Interventi di Sostegno Alla Genitorialita, eds Lambruschi F., Lionetti F. (Rome: Carocci; ).
    1. Downing G., Burgin D., Reck C., Ziegenhain U. (2008). Interfaces between intersubjectivity and attachment: three perspectives on a mother-infant inpatient case. Infant Ment. Health J. 29 278–295. 10.1002/imhj.20177
    1. Downing G., Wortmann-Fleischer S., von Einsiedel R., Jordan W., Reck C. (2014). “Video intervention therapy for parents with a psychiatric disturbance,” in Infant and Early Childhood Mental Health. Core Concepts and Clinical Practice, eds Brandt K., Perry B. D., Selingman S., Tronik E. (Washington, DC: American Psychiatric Association; ), 261–279.
    1. Dozier M., Bick J. (2007). Changing caregivers: coping with early adversity. Pediatr. Ann. 36 205–208. 10.3928/0090-4481-20070401-09
    1. Dozier M., Peoloso E., Lindhiem O., Gordon M. K., Manni M., Sepulveda S., et al. (2006). Developing evidence-based interventions for foster children: an example of a randomized clinical trial with infants and toddlers. J. Soc. Issues 62 767–785. 10.1111/j.1540-4560.2006.00486.x
    1. Felitti V. J., Anda R. F., Nordenberg D., Williamson D. F., Spitz A. M., Edwards V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) study. Am. J. Prevent. Med. 14 245–258. 10.1016/S0749-3797(98)00017-8
    1. Fonagy P., Steele M., Steele H., Moran G. S., Higgitt A. C. (1991). The capacity of understanding mental states: the reflective self in parent and child and its significance for security of attachment. Infant Ment. Health J. 12 201–218. 10.1002/1097-0355(199123)12
    1. Fonagy P., Target M. (2005). Bridging the transmission gap: an end to an important mystery of attachment research? Attach. Hum. Dev. 7 333–343. 10.1080/14616730500269278
    1. Freed G. L., Dunham K. M., Lamarand K. E., Loveland-Cherry C., Martyn K. K. (2010). Pediatric nurse practitioners: roles and scope of practice. Pediatrics. 126 846–850. 10.1542/peds.2010-1589
    1. Fukkink R. G. (2008). Video feedback in widescreen: a meta-analysis of family programs. Clin. Psychol. Rev. 28 904–916. 10.1016/j.cpr.2008.01.003
    1. Fukkink R. G., Trienekens N., Kramer L. J. C. (2011). Video feedback in education and training: putting learning in the picture. Educ. Psychol. Rev. 23 45–63. 10.1007/s10648-010-9144-5
    1. Garfield C. F., Isacco A. (2006). Fathers and the well-child visit. Pediatrics 117 637–645. 10.1542/peds.2005-1612
    1. Garner A. S., Shonkoff J. P., Siegel B. S., Dobbins M. J., Earls A. S., Garner A. S., et al. (2012). Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics 129 224–231. 10.1542/peds.2011-2662
    1. Gilbert R., Spatz Widom C., Browne K., Fergusson D., Webb E., Janson S. (2009). Burden and consequences of child maltreatment in high-income countries. Lancet 373 68–81. 10.1016/S0140-6736(08)61706-7
    1. Gorski P. A. (2001). Contemporary pediatric practice: in support of infant mental health (imaging and imagining). Infant Ment. Health J. 22 188–200. 10.1002/1097-0355(200101/04)22
    1. Green J., Charman T., Pickles A., Wan M. W., Elsabbagh M., Slonims V., et al. (2015). Parent-mediated versus no intervention for infants at high risk of autism: a parallel, single-blind, randomised trial. Lancet Psychiatry 2 133–140. 10.1016/S2215-0366(14)00091-1
    1. Guedeney A., Fermanian J. (2001). A validity and reliability study of assessment and screening for sustained withdrawal reaction in infancy: the Alarm Distress Baby Scale. Infant Ment. Health J. 22 559–575. 10.1002/imhj.1018
    1. Guedeney A., Guedeney N. (2010). The era of using video for observation and intervention in infant mental health. Signal 18 1–5.
    1. Guedeney A., Guedeney N., Tereno S., Dugravier R., Greacen T., Welniarz B., et al. (2011). Infant rhythms versus parental time: promoting parent-infant synchrony. J. Physiol. 105 195–200. 10.1016/j.jphysparis.2011.07.005
    1. Guedeney A., Matthey S., Puura K. (2013). Social withdrawal behavior in infancy: a history of the concept and review of published studies using the Alarm Distress Baby Scale. Infant Ment. Health J. 34 516–531. 10.1002/imhj.21412
    1. Hoivik M. S., Lydersen S., Drugli M. B., Onsoien R., Hansen M. B., Nielsen T. S. (2015). Video feedback compared to treatment as usual in families with parent-child interaction problems: a randomized controlled trial. Child Adolesc. Psychiatr. Ment. Health 9:3 10.1186/s13034-015-0036-9
    1. Hornstein J. (2014). “Brazelton’s neurodevelopmental and relational touchpoints and infant mental health,” in Infant and Early Childhood Mental Health, Core Concepts and Clinical Practice, eds Brandt K., Perry B. D., Selingman S., Tronik E. (Washington, DC: American Psychiatric Association; ), 71–83.
    1. Hunter C. L., Goodie J. L., Oordt M. S., Dobmeyer A. C. (2009). Integrated Behavioural Health in Primary Care: Step-by-Step Guidance for Assessment and Intervention. Washington, DC: American Psychological Association.
    1. Jordan M., Livingstone J. B. (2013). Coaching versus psychotherapy in health and wellness: overlap, dissimilarities and potential collaboration. Glob. Adv. Health Med. 2 44–51. 10.7453/gahmj.2013.036
    1. Juffer F., Bakermans-Kranenburg M. J., van Ijzendoorn M. H. (2008). Promoting Positive Parenting: an Attachment Based Intervention. New York, NY: Psychology Press.
    1. Juffer F., Steele M. (2014). What words cannot say: the telling story of video in attachment-based interventions. Attach. Hum. Dev. 16 307–314. 10.1080/14616734.2014.912484
    1. Kaplan-Sanoff M., Talmi A., Augustyn M. (2012). Infusing mental health services into primary care for very young children and their families. Zero Three 33 73–77.
    1. Knapp M., Barret B., Byford S., Hallam A., Davis H., Tsiantis J., et al. (2005). Primary prevention of child mental health problems using primary health care professionals: cost comparisons. Int. J. Ment. Health Promot. 7 95–102. 10.1080/14623730.2005.9721953
    1. Korfmacher J. (2014). Infant, Toddler, and Early Childhood Mental Health Competencies: a Comparison of Systems. Washington, DC: Zero to Three.
    1. Lake A., Chan M. (2014). Putting science into practice for early child development. Lancet 385 1816–1817. 10.1016/S0140-6736(14)61680-9
    1. Layiou-Lignos E., Tsiantis J., Davis H., Rudic N., Puura K., Paradisiotou A., et al. (2005). Training for primary health care practitioners. Int. J. Ment. Health Promot. 7 41–50. 10.1080/14623730.2005.9721949
    1. Lester B., Sparrow J. D. (eds). (2010). “Nurturing children and families,” in Building on the Legacy of T. Berry Brazelton. Oxford: Wiley-Blackwell Scientific.
    1. Lyons-Ruth K., Yellin C., Melnick S., Atwood G. (2005). Expanding the concept of unresolved mental states: hostile/Helpless states of mind on the Adult Attachment Interview are associated with disrupted mother-infant communication and infant disorganization. Dev. Psychopathol. 17 1–23. 10.1017/S0954579405050017
    1. MacMillan H. L., Wathen C. N., Barlow J., Fergusson D. M., Lebenthal J. M., Taussig H. N. (2009). Interventions to prevent child maltreatment and associated impairment. Lancet 373 250–266. 10.1016/S0140-6736(08)61708-0
    1. Marvin R., Cooper G., Hoffman K., Powell B. (2002). The circle of security project: attachment-based intervention with caregiver-pre-school child dyads. Attach. Hum. Dev. 4 107–124. 10.1080/14616730252982491
    1. Matthey S., Crncec R., Hales A., Guedeney A. (2013). A description of the modified Alarm Distress Baby Scale (m-ADBB): an instrument to assess for infant social withdrawal. Infant Ment. Health J. 34 602–609. 10.1002/imhj.21407
    1. Meade E. B., Dozier M., Bernerd K. (2014). Using videofeedback as a tool in training parent coaches: promising results from a single-subject design. Attach. Hum. Dev. 14 356–370. 10.1080/14616734.2014.912488
    1. Mendelsohn A. L., Dreyer B. P., Brockmeyer C. A., Berkule-Silberman S. B., Huberman H. S., Tomopoulos S. (2011a). Randomized controlled trial of primary care pediatric parenting programs: effect on reduced media exposure in infants, mediated through enhanced parent-child interaction. Arch. Pediatr. Adolesc. Med. 165 42–48. 10.1001/archpediatrics.2010.266
    1. Mendelsohn A. L., Huberman H. S., Berkule S. B., Brockmeyer C. A., Morrow L. M., Dreyer B. P. (2011b). Primary care strategies for promoting parent-child interaction and school readiness in at-risk families: the Bellevue Project for early language, literacy, and education success. Arch. Pediatr. Adolesc. Med. 165 33–41. 10.1001/archpediatrics.2010.254
    1. Mendelsohn A. L., Valdez P. T., Flynn V., Foley G. M., Berkule S. B., Tomopoulos S., et al. (2007). Use of videotaped interaction during pediatric well-child care: impact at 33 months on parenting and on child development. J. Dev. Behav. Pediatr. 28 206–212. 10.1097/DBP.0b013e3180324d87
    1. Murphy A., Steele M., Dube S. R., Bate J., Bonuck K., Meissner P., et al. (2014). Adverse childhood experiences (ACEs) questionnaire and adult attachment interview (AAI): implications for parent child relationships. Child Abuse Neglect 38 224–233. 10.1016/j.chiabu.2013.09.004
    1. Olds D. L., Sadler L., Kitzman H. (2007). Programs for parents of infants and toddlers: recent evidence from randomized trials. J. Child Psychol. Psychiatry 48 355–391. 10.1111/j.1469-7610.2006.01702.x
    1. Olson L. M., Inkelas M., Halfon N., Schuster M. A., O’Connor K. G., Mistry R. (2004). Overview of the content of health supervision for young children: reports from parents and pediatricians. Pediatrics 113 1907–1916.
    1. Ordway M. R., Webb D., Sadler L. S., Slade A. (2015). Parental reflective functioning: an approach to enhancing parent-child relationships in pediatric primary care. J. Pediatr. Health Care 29 325–334. 10.1016/j.pedhc.2014.12.002
    1. Papousek M. (2011). Resilence, strenghts, and regulatory capacities: hidden resources in developmental disorders of infant mental health. Infant Ment. Health 32 29–46. 10.1002/imhj.20282
    1. Papousek M., Schieche M., Wurmser H. (2004). Disorders of Behavioural and Emotional Regulation in the First Year of Life. Washington, DC: Zero to Three.
    1. Powell B., Cooper G., Hoffman K., Marvin B. (2013). The Circle of Security Intervention. New York, NY: Guildford Press.
    1. Puura K., Mantymaa M., Luoma I., Kaukonen P., Guedeney A., Salmelin R., et al. (2010). Infants’ social withdrawal symptoms assessed with a direct infant observation method in primary health care. Infant Behav. Dev. 33 579–588. 10.1016/j.infbeh.2010.07.009
    1. Reck C., Hunt A., Fuchs T., Weiss R., Noon A., Moehler E., et al. (2004). Interactive regulation of affect in postpartum depressed mothers and their infants: an overview. Psychopathology 37 272–280. 10.1159/000081983
    1. Riva Crugnola C., Ierardi E., Albizzati A., Downing G. (2015). “Promoting responsiveness, emotion regulation and attachment in young mothers and infants (PRERAYMI): an implementation of Video Intervention Therapy and psychological support,” in Handbook of Attachment-Based Interventions, eds Steele H., Steele M. (New York, NY: Guilford; ).
    1. Robling R., Bekkers M.-J., Bell K., Butler C. C., Cannings-John R., Channon S., et al. (2016). Effectiveness of a nurse-led intensive home-visitation programme for first-time teenage mothers (Building Blocks): a pragmatic randomized controlled trial. Lancet 387 146–155. 10.1016/S0140-6736(15)00392-X
    1. Rusconi-Serpa S., Rossignol A. S., McDonough S. (2009). Video feedback in parent-infant treatment. Child Adolesc. Psychiatr. Clin. North Am. 18 735–751. 10.1016/j.chc.2009.02.009
    1. Salder L. S., Slade A., Mayes L. C. (2008). “Working with parents in child psychotherapy: engaging in reflective functioning,” in Handbook of Mentalization-Based Treatment, eds Allen J. G., Fonagy P. (London: Wiley; ), 271–288.
    1. Schechter D. S., Myers M. M., Brunelli S. A., Coates S. W., Zeneah C. H., Davies M., et al. (2006). Traumatized mothers can change their minds about their toddlers: understanding how a novel use of videofeedback supports positive change of maternal attributions. Infant Ment. Health J. 27 429–447. 10.1002/imhj.20101
    1. Scourfield J., Cheung A. Y., Macdonald G. (2014). Working with fathers to improve children’s well-being: results of a survey exploring service provision and intervention approach in the UK. Child. Youth Ser. Rev. 43 40–50. 10.1016/j.childyouth.2014.04.009
    1. Shonkoff J. P. (2003). From neurons to neighborhoods: old and new challenges for developmental and behavioral pediatrics. Dev. Behav. Pediatr. 24 70–76. 10.1097/00004703-200302000-00014
    1. Shonkoff J. P., Boyce W. T., McEwen B. S. (2009). Neuroscience, molecular biology, and the childhood roots of health disparities. Building a new framework for health promotion and disease prevention. J. Am. Med. Assoc. 301 2252–2259. 10.1001/jama.2009.754
    1. Shonkoff J. P., Garner S. (2012). The life long effects of early childhood adversity and toxic stress. Pediatrics 129 e232–e246. 10.1542/peds.2011-2663
    1. Slade A. (2005a). “Minding the baby. Enhancing parental reflective functioning in a nursing/mental health home visiting program,” in Enhancing Early Attachments: Theory, Research, Intervention, and Policy, eds Berlin L. J., Ziv Y., Amaya-Jackson L. M., Greenberg M. T. (New York, NY: Guilford Press; ), 152–177.
    1. Slade A. (2005b). Parental reflective functioning: an introduction. Attach. Hum. Dev. 7 269–281. 10.1080/14616730500245906
    1. Steele H., Steele M. (2008). “Ten clinical uses of the adult attachment interview,” in Clinical Applications of the Adult Attachment Interview, eds Steele H., Steele M. (New York, NY: Guildford Press; ).
    1. Steele M., Steele H., Bate J., Knafo H., Kinsey M., Bonuck K., et al. (2014). Looking from the outside in: the use of video in attachment-based interventions. Attach. Hum. Dev. 14 402–415. 10.1080/14616734.2014.912491
    1. Talmi A., Stafford B., Buchholz M. (2009). Providing perinatal mental health services in pediatric primary care. Zero Three 5 10–16.
    1. Tiffany F. (1982). Interaction coaching for high-risk infants and their parents. Prevent. Hum. Serv. 1 5–24. 10.1300/J293v01n04_02
    1. Tronik E. (2007). The Neuro Behavioural and Social-Emotional Development of Infants and Children. New York, NY: W.W. Norton.
    1. Weitzman C., Wegner L. (2015). Promoting optimal development: screening for behavioral and emotional problems. Pediatrics 135 384–395. 10.1542/peds.2014-3716
    1. Whittaker K. A., Cox P., Thomas N., Cocker K. (2014). A qualitative study of parents’ experience using family support services: applying the concept of surface and depth. Health Care Soc. Care Commun. 22 479–487. 10.1111/hsc.12101
    1. World Health Organization [WHO] (2013). Meeting Report. Nurturing Human Capital Along the Life Course: Investing in Early Child Development. Geneva: World Health Organization.
    1. Zeneah P. D., Gleason M. M. (2009). “Infant mental health in primary health care,” in Handbook of Infant Mental Health, ed. Zeneah C. H. (New York, NY: Guilford Press; ), 549–563.
    1. Zuckerman B. (2009). Promoting early literacy in pediatric practice: twenty years of Reach Out and Read. Pediatrics 124 1660–1665. 10.1542/peds.2009-1207

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅