Intervention with infants, preschoolers, and their families requires that the child and adolescent psychiatrist shift perspective from a one-person psychology to a multiperson or Brelational[ psychology. Assessment and intervention with children younger than 5 years therefore necessitate that the clinician pay close attention to the unique characteristics of the parentYchild relationship. These characteristics include adaptation to each other’s temperaments, developmental capacities, and biological and psychological needs and desires, and to the demands of the particular environment with which the parentYchild relationship contends. Central to this work is the observation of parentY child interactionVholding, communicating, feeding, grooming/diapering, dressing, and, of course, playing. For those who practice in clinics or private offices, these observations occur during free and unstructured interactions in an environment where age-appropriate toys are available for the child. The content of the child’s spontaneous play; the parent’s affective, behavioral, and verbal responses to the child and their play; the child’s response during play while the parent speaks with the therapist; and the child’s direct response to the parentVall are key sources of information regarding the nature of the interaction. The child and adolescent psychiatrist alternately considers the child’s and parent’s perspectives, while also stepping outside of both individual perspectives to view the childYparent relationship. Thus, in addition to developmental and psychiatric vantage points, a relational vantage point is adopted. In an effort to maximize the potential for adaptive socialYemotional functioning of parent and child, particular attention is paid to both protective and risk factors within the relationship. One such factor, the presence of which is considered a protective element and the absence of which implies risk, is that of Bmentalization.[ Mentalization is the capacity to reflect on, and hold in mind, the mental states (i.e., feelings, thoughts, beliefs) of oneself and others. Empirical research suggests that this capacity is a parental trait that forms in the first years of life within the context of the attachment relationship with the parent’s own caregivers. The parent’s mentalization capacity affects the parent’s caregiving behavior with her own child and, in turn, the child’s attachment behavior with the parent. The processes involved in mentalization have been operationalized as a range of Bself-reflective functioning[ or BRF.[ Reflective functioning was originally developed as a codification of verbal examples of mentalization ranging from examples of low RF to high RF. It was used to code narrative content from the Adult Attachment Interview (C. George et al., unpublished, 1984). High RF was found to correlate significantly with secure adult attachment and subsequently with the Assistant Editors

When Parenting Becomes Unthinkable: Intervening with Traumatized Parents and Their Toddlers

The Caregiver Evaluation in the Infant &amp; Early Childhood Assessment

Understanding the caregiver’s view of their child is central to working with very young children. This chapter will describe the tools used to explore the caregiver’s internal working model, their perceptions of the child, and the child’s world. It will also examine how a caregiver may place unconscious projections onto their child, which are influenced by cultural values, the caregiver’s own history of being parented, caregiver traumas, and the caregiver’s ghosts and angels in their nursery. Interviews like the Working Model of the Child Interview, the Adult Attachment Interview, the Angels in the Nursery Interview and the Circle of Security Interview (COSI) which help the clinician understand these complex factors that influence a caregiver’s perception of their child will be discussed.

Caregiver Perceptions of the Young Child: Assessment and Treatment Implications

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Caregiver Perceptions of the Young Child: Assessment and Treatment Implications