Stolper Hanna, Imandt Lieke, van Doesum Karin, Steketee Majone
Department of Psychology Education and Child Studies, Erasmus University Rotterdam (EUR), Rotterdam, Netherlands.
Jeugd ggz, Dimence Groep, Zwolle, Netherlands.
Front Psychiatry. 2024 Jun 28;15:1377100. doi: 10.3389/fpsyt.2024.1377100. eCollection 2024.
This study investigated changes in the emotional availability of the parent and the child in the dyadic relationship, parental reflective functioning, and parental perception of the relationship with their child following treatment with an integrated family approach in adult and child mental health care services. The aim of the study was to investigate if an integrated family approach in treatment contributes to good practice in mental health care.
Children of parents with a mental disorder are at increased risk for developing mental health problems themselves during lifetime. Infants are extremely vulnerable for environmental influences. Parents with mental disorders are at risk for mis-attuned behavior and non-optimal emotional availability. This increases the risk of adverse cascading effects on the parent-child relationship and child development. A secure parent-child relationship is an important protective factor against the intergenerational transmission of mental disorders. Although treatment of the parental mental disorder is important, it does not automatically change undesirable patterns in the parent-child relationship. Therefore, an integrated family approach to mental health treatment is recommended.
This study involved a mixed methods design using questionnaires, an observation instrument and semi-structured interviews. The variables examined were the quality of the parent-child interaction, the parental perspective on their relationship with the child, their problems with child upbringing, and on their parental reflective functioning. The clinical sample consisted of 50 patients with a variety of mental disorders and their young children.
After finishing the integrated treatment the quality of the parent-child interaction had improved significantly. Likewise, we found a significant improvement in parental perception regarding the relationship with the child and the parental role. The majority of the parents interviewed showed that they were better able to mentalize about themselves, their child and their relationship with the child, but the data from the questionnaire showed mixed results regarding parents' reflective functioning.
Treatment with an integrated family approach to mental health care in which the parental role of the patient, the young child, and the parent-child relationship are integrated in treatment, can be a valuable addition to the current practice of mental health care in which patients are commonly perceived as individuals.
本研究调查了在成人和儿童心理健康服务中采用综合家庭治疗方法后，亲子二元关系中父母和孩子的情感可及性、父母的反思功能以及父母对与孩子关系的认知变化。该研究的目的是调查治疗中的综合家庭治疗方法是否有助于心理健康护理的良好实践。
患有精神障碍的父母的孩子在其一生中自身出现心理健康问题的风险增加。婴儿极易受到环境影响。患有精神障碍的父母存在行为失调和情感可及性不佳的风险。这增加了对亲子关系和儿童发展产生不良连锁反应的风险。安全的亲子关系是预防精神障碍代际传递的重要保护因素。虽然治疗父母的精神障碍很重要，但它不会自动改变亲子关系中不良的模式。因此，建议采用综合家庭治疗方法来治疗心理健康问题。
本研究采用混合方法设计，使用问卷、观察工具和半结构化访谈。所考察的变量包括亲子互动的质量、父母对与孩子关系的看法、他们在养育孩子方面的问题以及他们的父母反思功能。临床样本包括50名患有各种精神障碍的患者及其年幼子女。
完成综合治疗后，亲子互动质量有显著改善。同样，我们发现父母对与孩子关系和父母角色的认知有显著改善。大多数接受访谈的父母表示，他们能够更好地对自己、孩子以及他们与孩子的关系进行心理化思考，但问卷数据显示父母反思功能的结果不一。
在心理健康护理中采用综合家庭治疗方法，将患者的父母角色、幼儿以及亲子关系整合到治疗中，对于当前通常将患者视为个体的心理健康护理实践而言，可能是一个有价值的补充。
