Thanks to a generous grant from Sue Fairbanks, TXICFW will be conducting a Randomized Control Trial of “Family Minds” this year. Research Associate Tina Adkins developed the intervention as her Ph.D. thesis after years out in the field working with parents involved with the foster care system. We sat down with Tina to learn more about her project and why reflective parenting is important to parents of foster and adopted children.
What is Family Minds?
Family Minds is a short 3 session psycho-educational training program for foster and adoptive parents. It focuses on teaching parents about mentalization (also known as “reflective parenting”) and how to use this skill to be more therapeutic with their children, to help manage their children’s emotions and behaviors better and to help increase secure attachment with their foster or adoptive children.
So what is mentalization?
Mentalization involves the ability to look inside the mind of another (while simultaneously looking inside your own mind) and understanding behavior in relation to mental states such as thoughts, feelings, desires etc. It is the skill of being able to see yourself from the outside and your children from the inside, and is an essential component of being a sensitive, therapeutic foster or adoptive parent. Mentalization allows a parent to see the deeper meaning behind a child’s behavior, which then positively influences the way a parent then responds that child, increasing the likelihood that the parent will ultimately meet that child’s deeper emotional need which can both reduce the behavior problem and increase attachment.
How or why did you develop this intervention? Was there a specific experience or trend you found in your work?
I had been training foster parents for years and one of the first things I noticed, was that the quality of the training materials was mediocre and not evidenced based. Additionally, parents were eager for concrete ways to help their foster and adopted children heal from trauma. Often these trainings simply imparted knowledge or “the what”…and what parents both want and need is “the how”. I was working on my PhD in London, where they have quite advanced with regards to interventions and trainings for foster and adoptive parents, and I was learning about Mentalization-Based Therapy for Families (MBT-F). I discovered that mentalizing therapies had been quite successful for families and part of these therapies involved some psychoeducation around mentalizing skills. I thought how useful those skills would be for foster and adoptive parents, and I set about creating a training for parents in Texas. I spent a lot of time creating content from evidenced based materials and programs and designing hands-on exercises for parents and their children. I piloted the Family Minds program during my dissertation work and parents absolutely loved the training and felt it helped them deepen their relationship to their children and both understand and manage their behaviors better.
Near the end of one training, a foster mother told me a story about how she was near the end of her rope with a 17 year old teenager she was fostering that we will call “Tanya”. Tanya had been suspended from school yet again and this foster mother was ready to make her leave her home. Then, she thought about what she had learned in Family Minds and instead of being mad and yelling at Tanya, she became really concerned instead….really curious what was going on inside Tanya’s mind. She conveyed this to Tanya and the teen revealed to her for the first time that she was very sad and had a plan to kill herself. This foster mother felt she would have never discovered this about Tanya if she hadn’t seen and talked to this child in a different way, a way she learned about during the Family Minds training. As a result, she did not make Tanya leave her home.
Tell us a little bit more about the research behind it. What’s the most important thing someone should know about this?
One factor not given much consideration when recruiting or training foster parents in the U.S. is their mentalizing/reflective parenting skills. Studies have shown that parents who are poor mentalizers and are more likely to be triggered negatively by their children’s attachment needs and behaviors. As a result, this will likely activate childhood anxieties, traumas and defenses of these parents. Unfortunately, this prevents them from being able to successfully attune to their child and challenges their sensitivity. Maltreated children who are placed with such foster/adoptive parents have an increased risk of placement breakdown. Ensuring parents have such skills is especially relevant given that maltreated children who have been removed from their homes display higher rates of insecure attachment, emotional and behavioral challenges, relationship problems and poor social skills. Having a parent who is good at mentalizing helps prevent such issues in children and is thought to be a protective factor.
What will you be doing in the next year for the grant?
We found in previous research that this intervention increased parents’ mentalizing skills and lowered parenting stress. In 2017, I plan to replicate the study I have already done evaluating my intervention, except this time we will use a rigorous study design which will include randomization and a control group so that we can see if my intervention is what is actually helping parents build these skills. We will also follow the foster parents for a period of months post intervention to see if these changes and skills hold, and to see if behavior problems in their children reduced and placements stayed intact.
What are the desired outcomes? And what is the ultimate goal of the intervention?
Ultimately, I am hoping this intervention will give parents the reflective/relational skills necessary to help children heal from trauma. In the short-term, this means children would display a reduction in behavior problems and parents will feel more satisfaction and bonding in their relationship, resulting in fewer placement breakdowns. Long-term, I hope this intervention impacts foster and adopted children’s well-being and as they age, they have better outcomes such as improved mental health and more high school and college graduations. Having a successful and healthy long-term relationship with a caregiver is essential for children to build resilience and overcome adversity. Improving parents’ mentalizing skills has the potential to positively influence this relationship and build better outcomes for these vulnerable children.