New Beginnings for mothers and babies in prison: A cluster randomized controlled trial

Michelle Sleed,Tessa Baradon,Peter Fonagy

doi:10.1080/14616734.2013.782651

Michelle Sleed, Tessa Baradon + Show 1 more

Open Access

https://doi.org/10.1080/14616734.2013.782651

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Abstract

Mothers in prison represent a high-risk parenting population. New Beginnings is an attachment-based group intervention designed specifically for mothers and babies in prison. This cluster randomized trial examined the outcomes for 88 mothers and babies participating in the New Beginnings program and 75 dyads residing in prisons where the intervention did not take place. Outcomes were measured in terms of parental reflective functioning, the quality of parent–infant interaction, maternal depression, and maternal representations. Mothers in the control group deteriorated in their level of reflective functioning and behavioral interaction with their babies over time, whereas the mothers in the intervention group did not. There were no significant group effects on levels of maternal depression or mothers’ self-reported representations of their babies over time. An attachment-based intervention may mitigate some of the risks to the quality of the parent–infant relationship for these dyads.

Highlights

The number of women serving prison sentences has increased dramatically worldwide over the last decade (Walmsley, 2012) resulting in increasing numbers of young children who are affected by maternal incarceration
The results indicate that the rating of Reflective Functioning (RF) assessed at follow-up increased significantly for the treatment group relative to the controls, expβk = 0.91; 95% CI: 0.3, 1.5; p = 0.002
Mothers tended to have very low levels of reflective functioning when talking about their relationship with their babies which were comparable to levels seen in other high-risk samples (Schechter et al, 2008; Suchman et al, 2010)

Summary

Introduction

The number of women serving prison sentences has increased dramatically worldwide over the last decade (Walmsley, 2012) resulting in increasing numbers of young children who are affected by maternal incarceration. Many women in prison have been exposed to or are currently experiencing a number of difficulties which may impinge on their children’s social and emotional development directly or indirectly. These include poor education, homelessness, and domestic violence (Prison Reform Trust, 2012), mental health problems (Birmingham, Coulson, Mullee, Kamal, & Gregoire, 2006; Gregoire, Dolan, Birmingham, Mullee, & Coulson, 2010), and drug and alcohol misuse (Singleton, Farrell, & Meltzer, 1997). Mentalizing, the capacity to understand behavior in terms of underlying mental states, is thought to be pivotal to the intergenerational transmission of attachment patterns (Fonagy & Target, 2005; Slade, Grienenberger, Bernbach, Levy, & Locker, 2005) and the breakdown of this process in the parent has been implicated in a poor outcomes for the child (Sharp & Fonagy, 2008)

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