Home-Visiting Intervention for Depressed Mothers and Their Infants

 

 

OVERVIEW

 

The home-visiting intervention program is aimed to develop better relationships between depressed mothers and their infant. The study focus on the quality of mother-child interaction, children socioemotional function and infant-mother security attachment. This home visiting intervention is found to have positive impacts on the quality of mother-infant interaction, child competence, and child attachment security, but no impact on mother's depression level.

 

DESCRIPTION OF PROGRAM

 

Target population: Depressed mothers and their 1 to 12 months old babies.

 

The program is designed to enhance the quality of mother-child interaction, infant-mother attachment security, and children's socioemotional functioning. The

Home-visiting intervention consists of 8 to 10 bi-weekly home visits, lasting from 60 to 90 minutes during the span of 3 to 4 months.  Graduate or postgraduate students of psychology or social psychiatry in training for prevention or health education are responsible for video recording and advising depressed mothers after the first home visit. All home visitors are given a manual, a videotape, and are trained by the first author and child therapist to prepare them before they visit participant's home.

 

 During each home-visit, the home visitor video records mother-child interactions, such as bathing or feeding the baby. Assessment on the quality of mother-infant interaction, child attachment security, and infant socioemotional functioning is done through a multidisciplinary team of specialist in infant mental health care and adult psychopathology. Home visitors are responsible for discussing the interaction between mother-child and encouraging them to learn appropriate communicative behavior. One to four additional techniques were also taught to mothers (e.g. modeling, cognitive restructuring, practical pedagogical support, and baby massage) to aid them with their children interaction.

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EVALUATION(S) OF PROGRAM

 

Evaluated population: 60 depressed mothers of Dutch descent with 11 mothers from other from different ethnic backgrounds ( Turkish, Moroccan, Surinamese, Portuguese, and Australian) with infants were all required to a) have a child under 12 months old, b) be currently receiving outpatient treatment for their depression, and c) be sufficiently fluent in Dutch.

 

Approach: Participants were gathered from local therapist's referral or through the national newspapers, women's magazine, or websites. The Beck Depression Inventory and International Neuropsychiatric Interview were used to evaluate mother's depressive symptoms. Mothers were randomly assigned to receive either the home-visiting intervention or the telephone support control group.

 

The control group received 3 phone calls, each lasted up to 15 minutes for 3 consecutive months, by one of the eight child therapist. The phone calls were directed towards practical parenting only, and do not focus on mother-child interaction with the parents.

 

Trained graduate and postgraduate home-visitors videotaped mother-child interaction for about 15-20 minutes during each visit. Each video tape was evaluated through four trained observers who were unaware of the group assignment. Methods to enhance mother's sensitivity to child's signals and needs are analyzed by a team of specialist. Home visitors delivered these methods to the parent(s) while they watched the recorded video together, and revised it according to the mother's need.

 

Data were collected on a) maternal sensitivity and related behaviors, such as nonhostility and nonintrusiveness, b) stressfull life events and chronic difficulties, c) child internalizing and externalizing symptoms, d) infant socioemotional functioning, and e) child attachment security. A posttest was completed two weeks after the last intervention, and a follow-up was conducted after six months.

 

 

Results: Infant in the experimental group had significantly higher scores for attachment security and competence in the follow-up assessment when compared to infants in the control group. Also, maternal sensitivity only increased in the intervention and not the control group. The program did not impact maternal depression, as depression level for both groups decreased over time as they continued to receive treatment from their therapist. Impacts were not found for infant internalizing, externalizing, or dysregulation. Although this intervention showed positive differences in the attachment security, it remains unclear if the program also helped prevent attachment disorganization.

 

 

SOURCES FOR MORE INFORMATION

 

Karin T.M. van Doesum, Prevention Research Centre, Department of Clinical Psychology, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegan, the Netherlands.

 

Email: k.vandoesum@riagg.ijsselland.nl

 

References

 

Doesum, K. T., Hosman, C. M., Riksen-Walraven, J.M., & Hoefnagels, C. (2008). A randomized controlled trial of a home-visiting intervention aimed at preventing relationship problems in depressed mothers and their infants. Child Development, 79(3), 547 - 561.

 

SUMMARY & CATERGORIZATION

 

Program categorized in this guide according to the following:

 

Evaluated participants ages: 0-1

 

Program components: Home-visiting

 

Measured outcomes: social and emotional health and development, life skills, mental health.

 

KEYWORDS: Early Childhood (0-5), Infants, White or Caucasion, Home-visiting, Depression, Mental Health, Parent-child Interaction, Attachment Security, Socio Emotional Functioning, Mothers

 

Program information last updated on 2/27/09

 

		© Child Trends 2003