Attachment based early interventions: an examination of the impact on the attachment related behaviour of parents and caregivers

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O'Byrne, Emma
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University College Cork
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There were two research articles included in this thesis with two separate abstracts. Systematic Review: “Attachment and Biobehavioural Catch-Up” (ABC) is a 10 session home visiting programme, grounded in attachment theory. It aims to improve child emotion regulation, attachment and behavioural outcomes through changing caregivers’ attachment related behaviours. There is increasing evidence with respect to the efficacy of ABC, but the interventions direct effect on parent behaviour remains unclear. This review examined ABC’s association with parent behaviour (the putative mechanism of change). The PubMed, EMBASE, PyscINFO and SCOPUS databases were searched for relevant studies in August 2021, and again in April 2022. The eligibility criteria for included studies were (1) infants aged 0-27 months at time of the ABC intervention, (2) “at-risk” parents, (3) controlled trials published in peer-reviewed journals, and (4) measure of attachment related parent behaviour included. Eleven eligible studies were included, nine of which were rated as having good methodological quality. The findings showed ABC had a significant small to medium effect on a variety of attachment-related parent behaviours amongst parents’ with multiple psychosocial risk factors. “Sensitivity” was measured most frequently, with small to medium main effect sizes recorded at follow-up compared to controls. Implications for the clinical effectiveness of the ABC programme in community settings are discussed. Future research should clarify whom ABC is most effective for, and how it compares to similar attachment based interventions. Major Research Project: Infant massage has been shown to positively influence maternal wellbeing and the mother-child attachment in clinical samples and up to a 1 year follow-up period. The present study examined, in a longitudinal randomised controlled trial (RCT), whether such benefits may be accrued in non-clinical, community samples and across a 4 year period. Participants were recruited from a maternity hospital in Ireland. They were mostly educated to third level (93%), in employment (88%) and identified as Irish (88%). At baseline participants were randomised to an infant massage or control condition (N=269). Qualitatively mothers from the intervention group recalled their experience of infant massage from almost 4 years earlier in surprising detail. Four main themes emerged describing the infant massage experience as a positive opportunity for bonding and relaxing with a newborn. Quantitative data pertaining to maternal wellbeing and dyads attachment were collected at baseline, 4-months, 18-months and 48-months post-intervention. Overall, analyses showed no significant difference between groups with respect to maternal mental health or parent-child relationship factors at 4, 18 or 48-months. We concluded that, in a non-clinical sample, infant massage is (a) subjectively experienced in a positive way with personal and infant relationship benefits, yet (b) this did not translate into objective benefits on clinical scales related to maternal or relational outcomes in the short or long-term. Clinical implications and suggestions for research adaptations in this area are outlined.
Attachment , Early intervention , Parenting , Infant mental health
O'Byrne, E. 2022. Attachment based early interventions: an examination of the impact on the attachment related behaviour of parents and caregivers. DClinPsych Thesis, University College Cork.