Background:The quality of attachment is greatly influenced by parental sensitivity. Attachment based interventions are designed to promote parental sensitivity, to change parental mental representations and to improve understanding of the developmental needs of the child. Very few studies have investigated the effect of attachment-based interventions on psychiatric symptoms in children. Targeting parental sensitivity and the parent-child interaction might have an important impact on psychiatric symptoms in a clinical sample of children referred to child psychiatric services. Objectives: The primary objective is to investigate whether Circle of Security-Parenting (COS-P) has an effect on parental sensitivity in parents of children referred to child psychiatric services. The secondary objectives are to investigate the effect on children's behavioral and emotional symptoms and the parental stress and reflective functioning after 10 weeks of intervention and at the 24 week follow-up. The study is also exploring the effect of parental attachment style, parental stress and parental psychopathology on the effect of the intervention. Methods: The trial will include 128 families of children (age 3-8 years) who are referred to child psychiatric services in a randomized and controlled design. Included families will be randomized to COS-P+ Treatment as Usual (TAU) or TAU only. Perspectives: Considering the important impact of the quality of the parent-child relationship on the child's well-being, it is essential to target it in interventions and to investigate the relation with psychiatric symptoms. Generally there is a lack of interventions targeting parental sensitivity in psychiatric child populations. Working with the parents on the child-parent relation, might have an important impact on their children's current psychiatric symptoms and could additionally prevent future psychopathology.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
128
COS-P is a brief, behavioral and insight oriented therapeutic group approach for parents with the aim to promote parental sensitivity and attachment and autonomy in the parent-child relationship. The parents will participate in ten weekly 1,5-hour sessions at the clinic conducted by two COS-certified therapists. Groups will include 4-5 families at a time.
TAU consists of clinical assessment and treatment.
Department of Child and Adolescent Mental Health Services
Aabenraa, Denmark
RECRUITINGMaternal sensitivity
Maternal sensitivity is measured by observing a mother-child interaction and is rated using "Coding Interactive Behavior" (CIB)
Time frame: after 10 weeks of intervention
Maternal Intrusiveness
Measured by observing a mother-child interaction and is rated using "Coding Interactive Behavior" (CIB)
Time frame: after 10 weeks of intervention
Maternal Sensitivity
Measured by observing a mother-child interaction and is rated using "Coding Interactive Behavior" (CIB)
Time frame: 24 week follow-up
Maternal Intrusiveness
Measured by observing a mother-child interaction and is rated using "Coding Interactive Behavior" (CIB)
Time frame: 24 week follow-up
Dyadic reciprocity
Measured by observing a mother-child interaction and is rated using "Coding Interactive Behavior" (CIB)
Time frame: after 10 weeks of intervention
Dyadic reciprocity
Measured by observing a mother-child interaction and is rated using "Coding Interactive Behavior" (CIB)
Time frame: 24 week follow-up
Negative states
Measured by observing a mother-child interaction and is rated using "Coding Interactive Behavior" (CIB)
Time frame: after 10 weeks of intervention
Negative states
Measured by observing a mother-child interaction and is rated using "Coding Interactive Behavior" (CIB)
Time frame: 24 week follow-up
Child Behaviour Check List (CBCL)-Total score-parent rated
Parent questionnaire on child symptoms. Score range (0-236). Higher indicates more problems.
Time frame: after 10 weeks of intervention
Child Behaviour Check List (CBCL)-Total score-parent rated
Parent questionnaire on child symptoms. Score range: 0-236. Higher indicates more problems.
Time frame: 24 week follow-up
CBCL-ODD score-parent rated. Score range: 0-26. Higher indicates more problems.
Parent questionnaire on child symptoms
Time frame: after 10 weeks of intervention
CBCL-ODD score-parent rated. Score range: 0-26. Higher indicates more problems.
Parent questionnaire on child symptoms
Time frame: 24 week follow-up
Berkeley Puppet interview
Child interview
Time frame: after 10 weeks of intervention
Berkeley Puppet interview
Child interview
Time frame: 24 week follow-up
Coping with childrens negative emotions scale
Parent questionnaire on their strategies coping with children's negative emotions. Score range 72-504.
Time frame: baseline
Coping with childrens negative emotions scale
Parent questionnaire on their strategies coping with children's negative emotions. Score range 72-504.
Time frame: after 10 weeks of intervention
Coping with childrens negative emotions scale
Parent questionnaire on their strategies coping with children's negative emotions. Score range 72-504.
Time frame: 24 week follow-up
Parental Reflective Functioning Questionnaire
Parent self-report measure that assesses parental reflective functioning or mentalizing. Score range 1-126.
Time frame: baseline
Parental Reflective Functioning Questionnaire
Parent self-report measure that assesses parental reflective functioning or mentalizing. Score range 1-126.
Time frame: after 10 weeks of intervention
Parental Reflective Functioning Questionnaire
Parent self-report measure that assesses parental reflective functioning or mentalizing. Score range 1-126.
Time frame: 24 week follow-up
Eyberg Child Behaviour Inventory (ECBI)
Parent questionnaire on child behavior. Score range 36-252. Higher indicating more problems.
Time frame: after 10 weeks of intervention
Eyberg Child Behaviour Inventory (ECBI)
Parent questionnaire on child behavior. Score range 36-252. Higher indicating more problems.
Time frame: 24 week follow-up
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