RESUMO
Family members mentalize when they try to understand each other's behavior on the basis of intentional mental states. This article aims to introduce and briefly describe how the concept of mentalization can provide a useful framework for clinicians to understand psychopathology of children, youths, and families. The authors further outline how mentalization-based techniques and interventions can be applied to build epistemic trust and to reestablish mentalizing in families by presenting clinical vignettes of initial sessions from various clinical settings in the United Kingdom and Germany. The article concludes with a brief summary about the current evidence for mentalization-based interventions with children, adolescents, and families and provides an outlook for future clinical and research work.
Assuntos
Mentalização , Adolescente , Criança , Humanos , Pais , Confiança , Reino UnidoRESUMO
Strengthening Attachment Competencies in Parents with Mental Illness: Adaptation and Pilot Testing of the Mentalization-Based Lighthouse Parenting Program Mentalizing describes the imaginative ability to understand human behaviour in terms of mental states. Parents with mental illnesses and experiences of early maltreatment frequently show impairments in mentalizing, which negatively impact their caregiving competences for the child. A number of mentalization-based programs to strengthen parental competences have been developed and most of them have been positively evaluated with regard to their efficacy. However, approaches which specifically aim to reach highly impaired families with children from different age groups and which can be implemented in psychiatric settings are currently lacking. The newly adapted mentalization-based Lighthouse-Parenting Program aims to fill this gap and strengthen competences of parents with a mental illness. The specific MBT-based stance, the structure and content of this new program are outlined and first results of a pilot test are presented. The program is a promising approach, which can easily be trained and implemented in existing mental health care systems. The Lighthouse-Parenting Program aims to improve the relationship between parent and child, to reduce parental stress and in the long-term to promote the child's development. A randomized controlled trial to evaluate the program's effectiveness is currently being planned.
Assuntos
Filho de Pais com Deficiência/psicologia , Mentalização , Relações Pais-Filho , Poder Familiar/psicologia , Pais/educação , Pais/psicologia , Criança , Desenvolvimento Infantil , Humanos , Projetos Piloto , Estresse Psicológico/prevenção & controleRESUMO
The aim of this study was to assess the 12-week group version of the mentalization-based Lighthouse Parenting Program for child maltreatment prevention. Parents who might be facing mentalizing difficulties due to challenges in the parent-child relationship were invited to participate in the program. The aim of the program was to promote mentalizing-to encourage parents' curiosity about their children's minds and their willingness to reflect on their own feelings, thoughts, and behaviors. Study participants were 101 parents (82 mothers, 19 fathers). Parenting practices and parental and family adjustment were assessed using the Parent and Family Adjustment Scale and mentalization was measured using Mentalization Scale at pre- and post-intervention assessments. Parents' feedback on the program was gathered after the program. Results revealed that mentalization, parental adjustment, and family functioning improved while coercive parenting practices decreased after the intervention. Study results provide preliminary indications of the benefits of the 12-week Lighthouse Parenting Program for parents referred or self-referred for mental health services due to their own or their child's difficulties.
RESUMO
This article introduces an innovative mentalization-based treatment (MBT) parenting intervention for families where children are at risk of maltreatment. The Lighthouse MBT Parenting Programme aims to prevent child maltreatment by promoting sensitive caregiving in parents. The programme is designed to enhance parents' capacity for curiosity about their child's inner world, to help parents 'see' (understand) their children clearly, to make sense of misunderstandings in their relationship with their child and to help parents inhibit harmful responses in those moments of misunderstanding and to repair the relationship when harmed. The programme is an adaptation of MBT for borderline and antisocial personality disorders, with a particular focus on attachment and child development. Its strength is in engaging hard to reach parents, who typically do not benefit from parenting programmes. The findings of the pilot evaluation suggest that the programme may be effective in improving parenting confidence and sensitivity and that parents valued the programme and the changes it had helped them to bring about.
Assuntos
Maus-Tratos Infantis/prevenção & controle , Desenvolvimento Infantil , Mentalização , Apego ao Objeto , Relações Pais-Filho , Poder Familiar/psicologia , Psicoterapia/métodos , Adulto , Criança , Humanos , Projetos Piloto , Desenvolvimento de Programas , Avaliação de Programas e Projetos de SaúdeRESUMO
PURPOSE OF REVIEW: This review summarizes advances in our understanding of child maltreatment and the implications thereof for physical, psychological and social development, with special emphasis on mental health aspects. RECENT FINDINGS: Methodological problems persist. These may be related in part to an over-emphasis on type of maltreatment, to the detriment of consideration of degree and extent of maltreatment. They may also be related to inadequate application of a comprehensive model of maltreatment and its consequences. Recent studies underline the inter-relatedness and cross-over between different types of child maltreatment and family violence. Research also underlines the extent to which child maltreatment is a major public health crisis internationally. Effects are seen on physical health and development as well as mental health, and it is becoming increasingly evident that these outcomes are inextricably linked to one another. There are encouraging signs that certain interventions are effective. SUMMARY: There is a need for a more sophisticated model of child maltreatment that includes not only degree but also the extent to which basic developmental needs are overridden when children are maltreated, and that includes children's responses to maltreatment as a mediating influence. More studies are needed of samples of children who have been maltreated in order to gain a better understanding of how maltreatment distorts the trajectory of normal development. Crucially, we need more research on intervention, including both case management and psychological treatment approaches.