A Cohort Study on the Effect of Parental Mind-Mindedness in Parent-Child Interaction Therapy.

ABSTRACT

Parent-child interaction therapy (PCIT) is a short-term, evidence-based intervention for caregivers with children aged between 2 and 7 who exhibit behavioral problems. PCIT is effective, but has a high attrition rate ranging from 27% to 69%. We hypothesize that a low level of parental mind-mindedness-the parent's propensity to treat the child as an intentional agent with its own thoughts and emotions-might contribute to premature attrition or cause families to profit less from treatment. To test these hypotheses, we performed a retrospective cohort study in a time-limited, home-based PCIT sample (n = 19) and in a clinic-based PCIT sample (n = 25), to investigate whether parents with a medium-high level of mind-mindedness differ from parents with a medium-low level of mind-mindedness in the outcome measures of PCIT (child's behavioral problems, parenting skills and stress and mothers' anxious and depressed symptoms). Furthermore, we examined if mind-mindedness was related to attrition and (for clinic-based PCIT only) number of sessions. Repeated measures ANOVA showed that mothers with a medium-high level of mind-mindedness displayed more improvement in two parenting skills benefiting a positive parent-child interaction. Furthermore, we found a group effect of mind-mindedness in the PCIT-home sample, with mothers with a medium-high level of mind-mindedness showing better results on most outcome measures. Our findings suggest that adding a mind-mindedness improving intervention prior to or during PCIT could benefit mothers with a medium to low level of mind-mindedness.