Dear Björn,

 

In the event that you did not receive the email I sent to you a few weeks ago, I am resending it. I hope that you receive/received it.

 

I would be grateful to audit or enter your discussions about measuring the effects/improvements/outcomes of infant-parent relationships.

 

Yours sincerely,

 

Don Hughston

 

 

 

From: Don Hughston [mailto:dhsage1@aol.com]
Sent: Wednesday, February 11, 2015 11:00 AM
To: 'Björn Salomonsson'; 'Harriet Calvert'
Cc: 'Stella Acquarone'
Subject: RE: SV: CaFTR RE: parent-infant psychotherapy

 

Dear Björn,

 

Harriet Calvert forwarded the email chain below to Stella Acquarone, PhD the founder and Director of the Parent-Infant Centre (www.infantmentalhealth.com) who forwarded it to me for response. Harriet and Stella had a meeting here at the Centre last night and reminded me how important it was that I reach out to you let you know of the research, clinical methodology and the measurement tools we’ve developed to build an empirical body of evidence of the efficacy (or not) of psychodynamic (psychoanalytically-based) psychotherapy. The Parent Infant Centre offers inter-complementary services in parent-infant psychotherapy: the Parent Infant Clinic, the School of Infant Mental Health, Child Focus Consultancy, and a charity called ipAn to research, raise awareness and help fund treatments for an intensive early intervention programme for pre-Autistics called the Re:Start programme). We are also supporting the development of a professional membership society of parent-infant psychotherapists called PIPA. In short, we offer turn-key parent-infant services.

 

The core of our research, training and clinical work is to use relationships to change the course of development in at-risk populations. We have developed a well-deserved reputation for working with babies who show the early signs of autism.

 

I have read carefully the emails below and was pleased to see that we both face similar next-steps. (By the way, I’ve tried several times to visit your website but was always greeted by an “Internal Server Error” message...thought you would want to know). Below, you say, “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?” Earlier, you ask: “Question 1 concerns the relevance of a study with such a varied treatment modality. And, “Question 2: how does one calculate power in a NEGD?”

 

These are extremely interesting and important questions. In fact, just last night, Harriet, Stella and I were discussing the need and search here in the UK for techniques, instruments and measurement tools to help in the UK effort to intervene early. We all are involved at Parliament level with promoting the policy and use of early intervention. It is not my purpose here to explain the detail or the reasonings why our early intervention measure scale and graphs may be of relevance in answering your questions. I just want you to know that we exist and have long been sorting through similiar minefields.

 

Faced with the similar need to measure the effects of our approach and treatment outcomes, years ago, Stella set out to develop her own scales and analytics. We have been working on these Scales and Graphs for quite a number of years. For the past 14 months, several of the staff and I have made a big effort to consolidate all of the various versions of the Scales that evolved over the years. Stella also worked with several top researchers to figure out the best way to display the summary charts…for example, how best to display summary improvement (or not) before and after treatment. Finally, there was much discussion on how to chart the age-summary babies (e.g., all 0-1 year olds, all 1-2 year olds, etc.).

 

The focus of the process and measurements is on the quality of the infant-parent relationship. I have attached samples of the SCALES, GRAPHS, and SUMMARIES (by age). These materials – 4 cases and summaries of 16 cases – were prepared for a book Stella wrote about the Re:Start programme, now at the publisher. As you will see, we observe, mark and measure elements (29 elements in babies and 15 elements in mothers) in four areas: Interpersonal, Sensorial, Motor, and Affect. We are currently entering into a project with the University of Bedfordshire to validate the SCALES. And with are seeking funding for a research project to supplement our observational analysis with physiological markers of anxiety dysfunctions.

 

If you are interested, I would be happy to correspond further about our observational and physiological work and rationales.

 

Yours sincerely,

 

Don Hughston

Administration and Development

Parent Infant Centre

London, UK

 

 

 

From: Stella Acquarone [mailto:acquarone@aol.com]
Sent: Wednesday, February 04, 2015 6:47 PM
To: dhsage1@aol.com
Subject: Fwd: SV: CaFTR RE: parent-infant psychotherapy

 

Dear Don,

 

Can you please send my results to Björn Salomonsson <bjorn.salomonsson@comhem.se>;

 

Dr Stella Acquarone
Child and Adult Psychotherapist
Principal
Parent Infant Clinic
27 Frognal, London, NW3 6AR
020 74333112
www.infantmentalhealth.com

Support the charity ipAn - the charity to prevent autism for free when shopping online with over two thousand retailers including Argos, Next, M&S, John Lewis, Debenhams, HMB, Vodafone, DEL, The Body Shop, Play.com, Interflora, and many more.
http://www.easyfundraising.org.uk/causes/ipan

 

 

-----Original Message-----
From: Harriet Calvert <harrietcalvert@aol.com>
To: acquarone <acquarone@aol.com>
Sent: Wed, 4 Feb 2015 17:57
Subject: Fwd: SV: CaFTR RE: parent-infant psychotherapy

for info

 

 Dr.Harriet Calvert, PhD, Psychoanalyst and Child Psychotherapist
harrietcalvert@aol.com

 

 

-----Original Message-----
From: Barlow, Jane <Jane.Barlow@warwick.ac.uk>
To: Björn Salomonsson <bjorn.salomonsson@comhem.se>; caftr <caftr@psychotherapyresearch.org>
Sent: Mon, 19 Jan 2015 12:48
Subject: Re: SV: CaFTR RE: parent-infant psychotherapy

That is lovely feedback Bjorn…thank you so much.  There are a number of ongoing studies that we will be able to add in at the next update.  

 

Very curious findings thought.  Clear impact on attachment but no impact on any of the mechanisms that would explain such an outcome.  Maybe this is just a measurement issue, or the fact that we still have too few studies.  So a bit disappointing in terms of maternal mental health and sensitivity etc. 

 

Any thoughts would be much appreciated. 

 

BW Jane

 

From: Björn Salomonsson <bjorn.salomonsson@comhem.se>
Date: Friday, 16 January 2015 16:19
To: "caftr@psychotherapyresearch.org" <caftr@psychotherapyresearch.org>
Cc: Jane Barlow <Jane.Barlow@warwick.ac.uk>
Subject: SV: CaFTR RE: parent-infant psychotherapy

 

Dear Nick and Jane,

I’ve just had time to browse through your review, but let me just say: A super-job! Congrats! This should encourage and inspire future researchers to refine research methodology in the quite complex clinical field of parent-infant psychotherapy.

As for your advice about tracking change mechanisms, we’re planning to include interviews with a number of therapists and parents. This will be done on a qualitative basis. Did you have anything quantitative in mind, Nick?

Best,

Björn

PS Why not post this Cochrane to the SPR listserve as well?

 

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 Nick Midgley
Skickat: den 16 januari 2015 09:31
Till: caftr@psychotherapyresearch.org
Ämne: CaFTR RE: parent-infant psychotherapy

 

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 -

 

 

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