RESUMEN
Psychotherapeutic treatments that focus on improving the relational processes between mothers with postpartum depression (PPD) and their infants, as well as the mother's individual therapeutic needs, have a great potential to positively impact the mother, her infant, and their relationship (K.J. Nylen, T.E. Moran, C.L. Franklin, & M. O'Hara, 2006). Utilizing pilot data from an evaluation of a home-based dyadic therapy for mothers with PPD and their infants, this article reports on a recent academic-community partnership study. The effectiveness of the intervention was examined, specifically regarding changes in mother's mood, parenting experience, and relationship with her infant. In addition, associations were examined among maternal self-report variables measuring change from pre- to posttreatment in PPD, psychological distress, and maternal perceptions of parenting and those variables measuring change in observer ratings of maternal-infant interactions. Results showed improvements in mothers' depression, distress, and perceptions of parenting as well as many ratings of mothers' interactions with their infants. However, only improvements in maternal perceptions of parenting, such as maternal self-esteem and parenting stress, were associated with better mother--infant interactions. Importance of this research for the field of infant mental health as well as clinical implications are discussed.
RESUMEN
In this article, recent research on parenting behaviors associated with infant attachment disorganization is summarized and applied to a parent-infant psychotherapy case. Both hostile/self-referential and helpless-fearful patterns of parentingare described and viewed theoretically as alternate aspects of a single hostile-helpless internal working model of attachment relationships. The case material focuses on the more subtle and harder to identify manifestations of a helpless-fearful parental stance. Some attachment-related treatment guidelines for working with a hostile-helpless parenting stance are suggested, including challenging the hostile-helpless model implicitly in the qualities of the therapist's approach to the parent, explicitly articulating the hostile-helpless bind with the parent, increasing the parent's openness to a wider range of affective experience, differentiating attachment-related needs from other communications of the baby, and developing new skills for balancing the needs of the self and the needs of the other in interaction with the baby.