MTB Training & Consultation

This session will serve to introduce an MTB approach to working with parents, beginning with the idea that mentalizing and reflective functioning emerge against the backdrop of the relational foundations of reflection (RFR). This is true for both clinicians and parents. Both safety and regulation serve as the foundation for connection and the development of trust. Many families come to intervention threatened and dysregulated, and with a deep distrust of others, including clinicians. In order for trust to emerge, at least some degree of safety and regulation must be achieved. This allows clinician and parent to begin to know and trust each other. Deepening trust then supports the development of reflection, meaning making, exploration, and play.

This session is geared toward providing practitioners who work with young children and/or parents an introduction to the core principles of attachment theory, and to the primary ways that this theory can be used to understand families in all their complexity. Both the identification of attachment types and strategies for working with attachment processes will be discussed.

This session is geared toward providing practitioners who work with young children and/or parents an introduction to the concept of disorganized attachment, as well as other manifestations of disrupted attachment. Some of the proposed etiologies of this form of attachment will be discussed, and its long-term sequelae considered. The relevance of this construct clinically will also be addressed.

In this session, the basic components of reflective parenting – embodied mentalizing (or sensitive responsiveness) and parental reflective functioning (PRF) – will be described. Both are evidence of the parents’ capacity to mentalize or imagine what the child is thinking and feeling, and respond accordingly, particularly in moments of high intensity arousal (both positive and negative). Breakdowns or deficits in parents’ capacity to ‘read’ the child, manifest in both anomalous parental behavior and impaired PRF or prementalizing, will also be discussed.

Working in the Infant and Early Childhood Mental Health (IECHM) field can be challenging and make one question their own parenting experiences, values, and beliefs about how infants and caregivers “should be” in relationship, while also feeling burnt out, triggered, angry, frustrated, unsupported, and uncertain about their role as IECMH practitioners or supervisors. This introductory training will enable participants to define what makes Reflective Supervision different from other types of supervision and what the benefits are. The essential elements that are the hallmarks of Reflective Supervision will be reviewed, including parallel process and how to intentionally impact relationships. How Reflective Supervision is trauma and diversity informed will also be explored, along with how this supervisory relationship may affect understanding of and the trajectory for the infant/child caregiver relationship.

The more a parent feels threatened – by the ghosts of their own relational trauma and unmet attachment needs, by the child and their needs, and/or by real, external threats to their own agency and survival – the more likely they are to struggle as a parent. This session will focus both on internal threats to safety, specifically the psychological sequelae of childhood relational trauma, and external threats to safety, toxic stressors (Shonkoff et al., 2012) such as chronic poverty, other forms of socioeconomic risk, and racism (Shonkoff et al., 2020), cultural oppression and historical trauma. Some of the issues involved in working with parents who have trauma histories will also be discussed.

In this two-part series, clinical approaches to enhancing reflective parenting will be addressed. Part one will consider the ways that clinicians can establish the relational foundations of reflection by promoting safety, regulation, and an openness to relationship in both themselves and parents. Clinical approaches will be described to help move parents out of “fight or flight” and into the meaningful, trusting relationships that make it possible for them to discover themselves and their child. Part two will consider how to work with parents once they are open to reflection. A series of stages will be described, moving from observing and mirroring to hypothesizing. Part one is a prerequisite for part two.

Many adults who participate in parent or child interventions have mental health issues (anxiety, depression, complex trauma disorders, PTSD, etc.) of their own that can greatly challenge clinicians who may have little training in evaluating or treating adult mental health difficulties. In such circumstances, clinicians can become overwhelmed, and parents left without the resources and help they need. In this session, some of the skills that all practitioners can bring to addressing mental health problems will be discussed, along with some basic frameworks for approaching diagnostic and treatment questions outside of the context of formal mental health training.

Around the globe, nurses – public health nurses, hospital-based nurses, nurse midwives, and nurse practitioners – provide the lion’s share of care to pregnant women, young children, and their parents. In this session the focus is specifically on what is known as reflective nursing. The simplest way to describe reflective nursing is that nurses approach their clinical goals through the lens of reflective practice. While reflective practice comes naturally to nurses, the pace and demands of nursing practice often make this difficult. In this session, the ways in which the basic principles of MTB-P can expand and enrich nursing practice will be addressed, particularly within the framework of home visiting.

In this session, a brief description will first be provided of the Pregnancy Interview (PI) and the Parent Development Interview (PDI), both of which invite parents to talk about their emotional experiences of parenthood. The coding system used to score the PI and PDI will then be described, along with how these measures can be used as tools in both quantitative and qualitative research. Extant research using these instruments will be reviewed, and future directions for measuring and assessing PRF in parents will be considered. Transcripts of both instruments will be used to anchor the discussion.

The Pregnancy and Parent Development Interviews have been used widely in research. This session focuses on how these interviews can be used to understand parents and their experiences more deeply. To what extent are they able to envision their child’s thoughts and feelings, how are unresolved issues from their own childhood’s playing out in the relationship with the child, what is the quality of their representations of the child and themselves as parent, and, finally, are they able to see themselves as a safe and secure base? The session will be organized around discussion of PI and PDI transcripts and relevant clinical material.