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This chapter examines public policy, public health and clinical initiatives that can support new parents, including fertility education, supportive interventions, family-friendly policies, and workplaces and childcare. There is an emphasis on father-inclusive policy and interventions that respect the diversity of contemporary families.
The chapter examines the role of parents in the welfare and upbringing of children, including parents’ own history and mental health and how and when psychologists might be asked to prepare a report on parenting and parent capacity. The chapter describes the changing demands as the baby grows and eventually becomes an adolescent, along with possible interventions at various ages, with attachment as a helpful overarching theory, both in the parent’s history and the current environment of the child. The importance of cultural expectations, genetics and environment are examined. Materials and measures are suggested as helpful in the reliable and valid assessment of parenting and a framework for the preparation of a report on parenting is described.
Project Support is a theory-driven, empirically based parenting intervention that reduces conduct problems of school-aged children exposed to frequent and severe family violence. It also increases the quality of the parent-child relationship by improving caregivers’ parenting skills. In addition to general clinical skills, such as effectively establishing and maintaining the therapeutic alliance, several specific competencies are required to administer Project Support. Clinicians need to understand theory and research on how exposure to violence can impact parenting and child behaviour, as well as the proposed mechanisms and theory behind behavioural interventions. This background knowledge helps inform specific competencies for Project Support, such as how to tailor the program to individual families and how to teach and execute the parenting skills properly. Clinicians also need to flexibly respond to changing family circumstances and address challenges to optimal treatment such as emerging crises, significant parental psychopathology or potential ongoing contact with a violent partner. This chapter summarizes the core competencies necessary for delivering Project Support and provides an illustrative case example.
Postpartum depression is common in the perinatal period and poses a risk for the development of the infant and the mother–infant relationship. Infancy is a critical developmental period of life and supportive parenting is crucial for healthy development, however, the effects of interventions aimed at improving parenting among mothers with depression are uncertain.
Aims
To assess the effects of parenting interventions on parent–child relationship and child development among mothers with depressive symptoms with 0–12-month-old infants.
Method
We conducted a systematic review with the inclusion criteria: (a) randomised controlled trials of structured psychosocial parenting interventions for women with depressive symptoms and a child aged 0–12 months in Western Organisation for Economic Co-operation and Development countries, (b) minimum three sessions with at least half of these delivered postnatally and (c) outcomes relating to the parent–child-relationship and/or child development. Publications were extracted from 10 databases in September 2018 and supplemented with grey search and hand search. We assessed risk of bias, calculated effect sizes and conducted meta-analysis.
Results
Eight papers representing seven trials were included. We conducted meta-analysis on the post-intervention parent–child relationship. The analysis included six studies and showed no significant effect. For individual study outcomes, no significant effects on the majority of both the parent–child relationship and child development outcomes were reported.
Conclusions
No evidence of the effect of parenting interventions for mothers with depressive symptoms was found on the parent–child relationship and child development. Larger studies with follow-up assessments are needed, and future reviews should examine the effects in non-Western countries.
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