New parenting programme to help children in families with complex psychosocial problems

Families with young children struggling with multiple psychosocial problems are some of the most vulnerable, and some of the hardest to help.

A new pilot project, based at the Department of Psychology, will now test a newly developed intervention for families with children aged 0-5 who are living with toxic stress, such as mental illness, alcohol and drug abuse, crime and poverty.

The project is being carried out in cooperation with the Danish municipalities of Gribskov, Hvidovre and Høje Taastrup, and is supported by the Novo Nordisk Foundation with DKK 5 million. The aim is to strengthen parental resources in vulnerable families and thereby promote children's mental and physical health.

The intervention being evaluated is a parenting program that focuses on parents' ability to reflect on their children's feelings and thoughts.

"By specifically strengthening parents' ability to reflect on and regulate their own and their children's emotions - to 'mentalise' - we are strengthening one of the most fundamental aspects of parenting," says Associate Professor Johanne Smith-Nielsen, who is principal investigator of the project together with Professor Nicole Letourneau from Canada.

"This is crucial if we are to reduce inequalities in children's mental and physical health in families where parents struggle with multiple problems. The good news is that everyone has the potential for mentalising, and we can practice mentalising".

Adaptation to the Danish context

The new project is based on the ATTACH (Attachment & Child Health) intervention developed in Canada, which the researchers will adapt to the Danish municipality family intervention units in collaboration with the Canadian researchers behind the programme.

By specifically strengthening parents' ability to reflect on and regulate their own and their children's emotions - to 'mentalise' - we are strengthening one of the most fundamental aspects of parenting.

Many of the existing parenting programmes in Denmark typically focus on a specific target group, such as parents with addiction or depression. Instead, the ATTACH programme addresses a more fundamental factor in parenting: parents' ability to understand and regulate their own and their children's emotions. This has shown promising results in Canada.

In addition, the programme has the advantage of being able to indicate in a relatively short time whether it is possible to strengthen parental mentalising and the child's home environment sufficiently within a reasonable timeframe.

"Many existing interventions are very long-term, which is often necessary, but for a young child a lot of time for development is lost if you find out after a year, for example, that the intervention has not brought about sufficient change in the family," says Johanne Smith-Nielsen.

The intervention consists of ten weekly sessions in which the therapist works with parents to increase understanding of behaviour in themselves and others, in stressful as well as everyday situations. Small video recordings of parents with their child are also included.

Parents' ability to reflect on their own and their child's thoughts, feelings and needs is also known as 'parental reflective functioning' (PRF) or 'parental mentalisation'. PRF ultimately enables parents to better achieve the overarching aim of the programme: to provide a nurturing environment for the child that promotes wellbeing and development.

Could become widespread

The pilot project in Denmark aims to reach 90 families and involves family counsellors, health professionals and psychologists in the three municipalities. During the project, researchers will evaluate the impact of the intervention, adapted to Danish conditions. Finally, the project will identify any barriers, for example in the municipalities, and examine how counsellors and families experience the intervention.

We hope that with ATTACH we can help to ensure timely and effective interventions for some of Denmark's most vulnerable children.

If the pilot is successful, the daily project manager, postdoctoral researcher Katrine Isabella Wendelboe, hopes that it later can be rolled out on a larger scale in other parts of Denmark.

"The results and experiences from Canada are very encouraging so far, and we hope that with ATTACH we can help to ensure timely and effective interventions for some of Denmark's most vulnerable children and contribute to local capacity building in municipalities," she says.

The project will run from 1 June 2024 to mid-2027.