Dear Björn (and others)
I just wanted to let you know that the Cochrane Collaboration have just published this meta-analytic review of parent-infant psychotherapy, by a team (which I was part of) led by Prof. Jane Barlow -
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010534.pub2/abstract
It is available as a free download.
Although the findings are mixed, one of the strongest conclusions is the urgent need for further, good quality studies - so your proposal (building on work that I know you have already done!) is certainly much needed. One of the issues for the Cochrane review is the lack of agreement on key measures, so it would also be good for you to take a look and see if it is possible for you to use some of the measures that have been used in previous studies, to make findings more comparable... Almost no previous studies have looked in detail at change mechanisms, so if you are able to do that, it would be fantastic!
Best wishes,
Nick
From: list-manager@psychotherapyresearch.org [mailto:list-manager@psychotherapyresearch.org] On Behalf Of Björn Salomonsson
Sent: 14 January 2015 07:05
To: caftr@psychotherapyresearch.org
Subject: SV: CaFTR two questions on a project evaluating analytic interventions in Child Health Centers
Dear Karen,
Thanks for taking time and effort to answer my queries. I agree that measuring interaction, mentalization, and trauma is essential. The problem is the usual one; time and resources. Given the fact that quite a few parent-infant therapy studies did yield results at least on maternal depression, would you think our study is redundant or incomplete? My idea was to correlate the EPDS and the ASQ:SE with an alliance measure (WAI-SR) and extensive background data from the analysts. The aim was not only to investigate therapeutic effects but also therapeutic specificity; I think more research is needed on that topic. What do you say?
Best regards,
Björn
Björn Salomonsson
Gaveliusgatan 11
116 41 Stockholm
08 21 81 96
070 585 49 29
Off: 08 642 99 98
Från: list-manager@psychotherapyresearch.org [mailto:list-manager@psychotherapyresearch.org] För Karin Ensink
Skickat: den 10 januari 2015 13:56
Till: caftr@psychotherapyresearch.org
Ämne: Re: CaFTR two questions on a project evaluating analytic interventions in Child Health Centers
Dear Björn
I would strongly recommend considering inclusion of a measure of parental mentalization/representation such as the PDI regarding self and the baby, as well as an interactional measure. This will enable you to see whether the intervention produces changes at the level of understanding or representing self or the baby, and ideally at the level of interaction with the baby. Nancy Suchman’s has been able to show changes with a mentalization intervention, and it may be worth looking at her measures.
My second recommendation is to include something on personality and trauma in addition to the EPDS, as in my experience and from looking at for example Karlen Lyons-Ruth’s work, the mums that health workers flag and are concerned about, often have personality/trauma issues that are not captured by a scale that focus on the internalizing dimension.
Warm regards
Karin
De : Björn Salomonsson <bjorn.salomonsson@comhem.se>
Répondre à : "caftr@psychotherapyresearch.org" <caftr@psychotherapyresearch.org>
Date : samedi 10 janvier 2015 05:26
À : "caftr@psychotherapyresearch.org" <caftr@psychotherapyresearch.org>
Objet : CaFTR two questions on a project evaluating analytic interventions in Child Health Centers
Dear colleagues,
I’m asking for points of view from anyone interested in the following questions: I’m planning a research project in Child Health Centers (CHC) in Stockholm. Parents visit the CHC for regular controls, and sometimes the health visitor detects “baby worries”, that is, emotional troubles in the parent(s) and/or in the baby. We’ve got funding for analysts to be placed at various CHCs. They receive parents, with or without the baby, and provide consultations with a mean of four sessions per family. The setting varies; mother-infant interventions, couple and individual therapy – or a combination. Thus we do not evaluate one specific treatment. A manual will be written that accounts for the common psychoanalytic perspective and its various forms of implementation in the cases.
Question 1 concerns the relevance of a study with such a varied treatment modality. My argument has been to perform a naturalistic study evaluating a clinical project. Outcome measures are the Edinburgh Postnatal Depression Scale (EPDS) on parental depression, and the Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) on child functioning. They will be related to parental ratings of therapeutic alliance (WAI-SR) and the analysts’ evaluations of background factors (medical/psychiatric care, social situation, etc.). Is such a research question too “woolly”?
An RCT is impossible, for several reasons. Instead, we’re into a naturalistic non-equivalent group design (NEGD) with three measurement points; pre-treatment and 3 + 9 months later. The index group consists of families in which the health visitor suspects emotional trouble and suggests to the parent that they see the analyst. The control group should consist of either the every next family coming to the health visitor, or families matched on child age and gender. For the EPDS, we know that scores normally decline as the baby grows older and the parents adapt to the new situation. The non-clinical families’ scores would be compared with the clinical families in an ANCOVA or a change score analysis.
Question 2: how does one calculate power in a NEGD?
Best regards,
Björn Salomonsson
Unit of Reproductive Health
Department of Women’s and Children’s Health
Karolinska Institutet, Stockholm