A review of the evidence
Toddler-Parent Psychotherapy to Reorganize Attachment in the Young Children of Depressed Mothers
Toth SL, Rogosch FA, Manly JT, Cicchetti D.
The Issue
When a mother becomes depressed after giving birth, she may not be able to provide the loving and consistent care that her infant needs. When someone is depressed, they may be very tired or irritable. Exhaustion and low mood can mean that a mother is not available to her child either emotionally or physically. Her behavior towards the infant may be negative or sometimes even hostile. She may use ineffective or harsh discipline with the child as it gets older. One consequence of this unfortunate situation is that the baby may not develop a secure attachment to his/her mother. Insecurely attached infants may make them more likely to become depressed or anxious or have behavior problems as they become preschoolers. Preventing attachment difficulties could prevent these problems from developing.
The Research
The participants were 130 mothers of toddlers who had been depressed at some point since their child’s birth, and 68 mothers who had no history of depression or any other mental health problem. As poverty and lower social class increase risks to children, the women were not from low income families. Mothers filled out questionnaires that are used to detect symptoms of depression. The mothers and their toddlers were later observed during the Strange Situation, which is used to identify attachment problems in toddlers. Three groups were formed: depressed mothers who were given the therapy, depressed mothers who did not get the therapy, and non-depressed mothers. The intervention used was Toddler-Parent Psychotherapy, a therapy that helps mothers alter they way they see their child and themselves. It is intended to reduce misinterpretations and negative reactions to the child. The mothers are also helped to better understand themselves. These are key factors that help produce healthy child development. Most of the participants took part in 45 sessions for about one year. The children were assessed again at age 3 to determine whether or not they were securely attached.
The Outcome
Compared to non-depressed mothers, more depressed mothers had insecurely attached toddlers at the beginning of the study. By the end of the study period, there was a significant drop in the number of insecurely attached children whose depressed mothers had been given the intervention compared to the control group of depressed mothers.
Conclusions
An intervention that helped mothers change their attitudes and behaviours towards their toddlers was successful in changing their child’s attachment classification from insecure to secure. This study shows that insecure attachment can be changed through an intervention for depressed mothers.
The preceding is a summary of:
Toth SL, Rogosch FA, Manly JT, Cicchetti D. The efficacy of toddler-parent psychotherapy to reorganize attachment in the young offspring of mothers with major depressive disorder: A randomized preventive trial. Journal of Consulting and Clinical Psychology. 2006; 74: 1006-1016.
^top
