Parent/Infant Psychotherapy is essentially concerned with understanding what may be happening within developing relationships and accordingly is tailored to think about each individual presentation. This flexibility means that it is not a ‘one size fits all’ approach and while some children’s difficulties may require a brief intervention, others may require more over a longer period.
Interventions that draw upon an approach developed by the Tavistock Clinic Under-5’s Service in London typically involve the baby or infant as a crucial partner in the therapeutic work and all parental figures or carers are encouraged to attend sessions whenever possible. As fostered and adopted children have had to contend with a lot in their short lives and accordingly can present particular challenges, this approach may be adapted to begin with an initial meeting for adults in which participants will be encouraged to talk about and explore their concerns.
The role of the Therapist at this stage is to gain insight and learn about what is happening in the child’s relationship with their parental figures, and where applicable within the supporting professional network. At the end of this meeting another appointment may be offered to include the child or it might be decided that further thinking with the adults involved in their care would be most helpful. Sometimes a single meeting may allow the adults concerned to feel they understand more about what may be happening to manage their situation differently.
What kind of changes do you aim to achieve with Parent/Infant Psychotherapy for adopted and fostered children?
To answer this question it is important to appreciate how the child’s past strongly influences what may be a struggle for them in the ‘here and now’, so what may need to change will be individual to them and their particular experience.
Very young children are naturally highly dependent upon the adults who care for them to help them make sense of what is happening inside and around them, but when a child has not been able to rely upon consistent parental care it may be hard for them to accept and make use of new relationships and all they might offer. Where siblings have been through a lot together they may also need to ‘disentangle’ in their relationship to become less reliant upon one another.
Children who have had to wait a long time for their circumstances to be recognised and changed may be so deeply affected their emotional development may be delayed. It can then be hard for those caring for them to reconcile what may be ordinarily expected of them, at their ‘age and stage‘, with what they seem capable of managing; and Caregivers can in turn become confused and troubled by what to do for the best and what may be expected of them in their role.
Parent/Infant Psychotherapy seeks to help parental figures, and where appropriate professionals supporting them, appreciate what their child may be presenting in behaviour that may range in quality and intensity from angry and tyrannical to overly compliant and emotionally cut off, with all sorts of combinations in between.
How does Parent/Infant Psychotherapy work for adopted and fostered children?
In essence Parent/Infant Psychotherapy offers insight and encourages understanding that in turn enables parental figures to respond in a more informed way to the demands being made upon them in their relationship with their child. A different experience of a dialogue may gradually emerge through a better quality of contact in which a parent or carer and their child are more in touch or ‘attuned’ to one another, growing towards a more secure attachment relationship. Fostered and adopted children can be said not have had a very successful earlier experience of emotional relationships and consequently will have had much to learn about themselves and their impact upon the world. Progress is more likely to be measured in incremental steps as change may come through the repeated negotiation of ordinary day to day tasks and routines, but in some relationships improvement may be more rapid, it will depend upon individual circumstances.
Who does Parent/Infant Psychotherapy?/What kind of training do practitioners have?
NICE Guidance outlines how infant mental health clinicians should:
- have a good understanding of the emotional, physical and developmental needs of babies and young children, including those with complex needs;
- have a high level of understanding of attachment theory, and the impact of trauma and loss on child development and the forming of attachments;
- be skilled in observing and understanding the behaviour of babies and young children, and parent-child interactions.
- Parent/Infant Psychotherapy may be provided by a range of experienced professionals from different disciplines who are either qualified Child and/or Perinatal Psychotherapists [Mother & Baby Specialists employed within adult mental health services], or are qualified in a child mental health related discipline (Child Psychiatry, Clinical Psychology, Psychiatric Nursing, Social Work, Occupational Therapy and Art Therapy to name but a few) and have undertaken additional training in a particular approach.
Why are you passionate about Parent/Infant Psychotherapy for fostered and adopted children?
In a career that now spans 30 years I have had the privilege of meeting a number of children and young people who have been challenged by adversity. My initial training and experience as a Social Worker in Child & Adolescent Mental Health provided insight into the lives of children who were often deeply affected by the developmental experience of their parents in the way they were looked after.
My subsequent training as a Child & Adolescent Psychotherapist allowed much more detailed insight into early emotional development and the potency of early intervention. As a discipline Child Psychotherapy remains unique in its degree of focus upon early emotional development within an extensive and rigorous training. I have since been committed to promoting greater awareness of infant mental health and the impact of developmental trauma, while being rewarded by the experience of applying an approach that has so much to offer.
I would like to commend the website of the UK Branch of the World Association for Infant Mental Health (AIMH[UK]) and The Association of Psychotherapists as useful sources of further information on infant mental health and psychotherapy.