Controlled Access. Restriction lift date: 2029-12-31
Designing a mind-mindedness intervention
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Date
2026-04-28
Authors
Clifford, Siobhan
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
Parental mind-mindedness, defined as a caregiver's propensity to represent and treat their child as a psychological agent with independent thoughts, feelings, and intentions, has been associated with positive developmental outcomes and has consequently been proposed as a potential target for clinical intervention. This thesis examines the extent to which the current evidence base substantiates such application, via a critical appraisal of the literature, two empirical studies, and an integrative discussion.
Chapter 1 provides a critical review of the theoretical and empirical foundations of mind-mindedness, including its relationship to parental sensitivity, theory of mind, and conceptually adjacent constructs such as parental reflective functioning and insightfulness. This review indicates that although associations between mind-mindedness and attachment security or theory of mind development are relatively well replicated, they remain correlational in nature, and claims regarding the construct's discriminant validity may be less firmly established than is often assumed.
Study 1 examined these considerations by conducting semi-structured interviews with five internationally recognised mind-mindedness researchers regarding the construct's translation into clinical contexts. Reflective thematic analysis generated four themes, pertaining broadly to the positioning of mind-mindedness within its wider theoretical context, its practical application, considerations of diversity, and the research-practice gap. Participants expressed a relatively high degree of confidence in the construct's clinical readiness; this finding, however, is interpreted cautiously within the thesis, given participants' shared professional investment in the field, and is regarded as indicative of disciplinary conviction rather than independent confirmation of empirical justification. A subsequent reflexive review of the analytic process suggested that an initially deferential interview stance may have contributed to an early overstatement of consensus, a revision consistent with the epistemic caution advocated throughout the thesis.
Study 2 comprised a systematic review of interventions designed to promote parental mind-mindedness, identifying twenty-six eligible interventions across community, clinical, and high-risk populations. Reported intervention techniques were mapped, where feasible, onto the Behaviour Change Wheel framework, with findings suggesting that education, enablement, training, and modelling were among the more frequently employed intervention functions. Results indicate that short-term change in mind-mindedness, particularly reductions in non-attuned parental comments, may be attainable under comparatively low-risk conditions; however, evidence pertaining to the durability of such change, comparative effectiveness, and downstream benefit to children and families remains limited, and the potential influence of publication bias could not be formally evaluated.
Chapter 4 synthesises these findings into a provisional evidence-based roadmap, differentiating between claims that are well supported, plausible but unproven, and presently unknown. On this basis, a preliminary theory of change and accompanying logic model is proposed, intended to function as a heuristic for future research and practice rather than a definitive framework. Collectively, this thesis contributes a more precise and appropriately circumscribed account of what is currently known, plausible, and unresolved regarding parental mind-mindedness and its clinical application, while underscoring the substantial uncertainty that remains prior to the responsible implementation or scaling of such interventions.
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Controlled Access
Keywords
Mind-mindedness , Parental mentalization , Intervention , Systematic review , Clinical translation , Reflexivity
Citation
Clifford, S. 2026. Designing a mind-mindedness intervention. DClinPsych Thesis, University College Cork.