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Video feedback intervention to enhance parental reflective functioning in primary caregivers of inpatient psychiatric
Fanny Leyton1,2, Marcia Olhaberry3, Rubén Alvarado4,5
1School of Psychology, Pontificia Universidad Católica, Av. Vicuña Mackenna 4860, Macul, Santiago, Chile. foleyton@uc.cl.
Insights
This study explores video intervention therapy (VIT) to enhance parental reflective functioning (PRF) in caregivers of children in psychiatric hospitals. Findings will inform future attachment-based interventions for improved child mental health outcomes.
Area of Science:
- Child and Adolescent Psychiatry
- Clinical Psychology
- Family Therapy
Background:
- Hospitalized children with psychiatric disorders often have severe conditions, high medication use, and frequent readmissions.
- Parental reflective functioning (PRF) is crucial for sensitive parenting, enabling caregivers to understand children's behavior as expressions of internal emotional states.
- Video-assisted therapies, like Video Intervention Therapy (VIT), show promise in improving parent-child relationships, particularly in outpatient settings.
Purpose of the Study:
- To evaluate the feasibility and acceptability of applying Video Intervention Therapy (VIT) to enhance parental reflective functioning (PRF) in primary caregivers of children in psychiatric inpatient units.
- To assess the impact of VIT on caregiver wellbeing and personality structure.
- To examine the effects of VIT on children's symptomatology and general functioning.
Main Methods:
- A pilot randomized, single-masked study with a qualitative component, using block randomization for a 2:1 allocation ratio (intervention:control).
- The intervention group received four weekly modules of video-recorded play sessions and VIT sessions; the control group received treatment as usual plus weekly play sessions.
- Feasibility and acceptability were assessed quantitatively and qualitatively. Caregiver PRF, wellbeing, and personality, along with child symptomatology and functioning, were evaluated.
Main Results:
- This section is not available in the provided abstract.
Conclusions:
- This study will contribute to the limited evidence on family attachment-based interventions within child inpatient psychiatric settings.
- Findings will guide the design and implementation of future randomized clinical trials focused on improving PRF in caregivers of hospitalized children.
- The study highlights the potential of flexible, manualized therapies like VIT for individualized application in psychiatric care settings.
Background:
Children requiring hospitalization for psychiatric care have serious disorders, high use of psychotropic medication, and frequent readmissions. The development and implementation of therapies focused on incorporating primary caregivers or attachment figures is necessary for working with children with severe psychiatric disorders. Mentalization or parental reflective functioning (PRF) is the ability of parents to understand their children's behaviors as an expression of internal emotional states and act accordingly to help them regulate their emotions; in this way mentalizing is a key component of sensitive parenting. Video-assisted therapies have proven to be effective in promoting change in parent-child relationships. The majority of studies have been carried out with mothers of pre-school children and in an outpatient setting. Video intervention therapy (VIT) is a flexible manualized therapy, which allows the intervention to be individualized to the context where it is applied, according to the needs and resources of the people who participate in it. The objective of the study is to evaluate the feasibility and acceptability of applying VIT to improve the PRF of the parents as primary carers of children hospitalized in a psychiatric service.
Methods:
This is a pilot randomized, single-masked (outcome assessor) study with a qualitative component. It will involve a block randomization procedure to generate a 2:1 allocation (with more people allocated to the intervention arm). The intervention consists of four modules; every module has both one video-recorded play session and one VIT session per week. People assigned to the control group will receive treatment as usual plus weekly play sessions. Feasibility and acceptability of the study will be quantitatively and qualitatively assessed. Evaluation of the caregivers will include assessments of PRF, wellbeing and personality structure; assessments of children will include parent-ratings and clinician-ratings of symptomatology and general functioning. After every video feedback (VF) session, PRF, the caregiver's wellbeing and children's general functioning will be reassessed.
Discussion:
This study will contribute to the currently scarce evidence on how to provide family attachment-based interventions in a child inpatient psychiatric unit. It will also inform the design and implementation of a future randomized clinical trial.
Trial Registration:
ClinicalTrials.gov, NCT03374904 . Registered on 14 December 2017 (retrospectively registered).
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