Mom Power Research Articles

Randomized pilot trial of the "Mom Power" trauma- and attachment-informed multi-family group intervention in treating and preventing postpartum symptoms of depression among a health disparity sample.

Perinatal depression, a common complication related to childbearing, impacts mothers, children, and families. Efficacious interventions reduce perinatal depression symptoms; effort is needed to prevent the onset of perinatal depression. To determine feasibility and preliminary efficacy in reducing perinatal depression, we conducted a community-based, randomized parallel open pilot trial of Mom Power, a group-based intervention to improve mental health and parenting in mothers with young children. Mom Power consists of 10 group sessions, focused on parenting, child development and self-care and three individual sessions, to build rapport and provide personalized referrals. Control group participants received psychoeducational mailings. Computer-based urn randomization assigned mothers with experiences of interpersonal violence, depression, or other traumatic experiences to Mom Power (68) or control (54). At 3-months post-treatment, the 31 retained women assigned to Mom Power were half as likely to meet criteria for probable depression (26%) as the 22 women retained in the control group (55%), with treatment predicting lower incidence of probable depression (OR = 0.13, p = 0.015). Moreover, among the 23 women who did not meet criteria for depression diagnosis at baseline, no women in the treatment group developed depression (n = 0, 0%) compared to control group women (n = 3, 30%). Logistic regression controlling for selective attrition confirmed the treatment effect on preventing new onset of depression (OR = 0.029, p = 0.012). These findings support the use of Mom Power for both treatment and prevention of perinatal depression. https://classic.clinicaltrials.gov/ct2/show/NCT01554215, NCT01554215.

Harnessing Virtual Mom Power: Process and Outcomes of a Pilot Telehealth Adaptation of a Multifamily, Attachment-Based Intervention

ABSTRACT The COVID-19 pandemic and mitigation strategies amplified racial and income-based health disparities, profoundly shifted family life, and altered delivery systems for support services. We report pilot data from a telehealth adaptation of Mom Power, an evidence-based, attachment-informed multifamily preventive intervention (clinicaltrials.gov: NCT04241913). We implemented an adaption of Virtual Mom Power (VMP) with a group of economically marginalized, predominantly Black mothers and their young children (n = 9) in New Orleans, an early COVID-19 hotspot with an entrenched history of structural racism and trauma. We outline our approach to adaptation of curriculum and service delivery, using a trauma-informed lens. Maternal reports of maternal and child functioning from pre- to post-intervention were consistent with improvements in maternal depressive and post-traumatic stress symptoms and child competence, comparable to outcomes from in-person trials. Feasibility and acceptability data were strong. Preliminary results and reflections on process suggest that telehealth service delivery of a multifamily preventive intervention, with attention to decreasing barriers to online access and consideration of culture and context, facilitated engagement while maintaining fidelity and effects on intervention targets. Future research using larger samples, randomized controlled design, and multi-method assessment should continue to guide dissemination of reflective, group-based telehealth parenting programs.

Potential Neural Mediators of Mom Power Parenting Intervention Effects on Maternal Intersubjectivity and Stress Resilience.

Stress resilience in parenting depends on the parent's capacity to understand subjective experiences in self and child, namely intersubjectivity, which is intimately related to mimicking other's affective expressions (i. e., mirroring). Stress can worsen parenting by potentiating problems that can impair intersubjectivity, e.g., problems of “over-mentalizing” (misattribution of the child's behaviors) and “under-coupling” (inadequate child-oriented mirroring). Previously we have developed Mom Power (MP) parenting intervention to promote maternal intersubjectivity and reduce parenting stress. This study aimed to elucidate neural mechanisms underlying the effects of MP with a novel Child Face Mirroring Task (CFMT) in functional magnetic-resonance-imaging settings. In CFMT, the participants responded to own and other's child's facial pictures in three task conditions: (1) empathic mirroring (Join), (2) non-mirroring observing (Observe), and (3) voluntary responding (React). In each condition, each child's neutral, ambiguous, distressed, and joyful expressions were repeatedly displayed. We examined the CFMT-related neural responses in a sample of healthy mothers (n = 45) in Study 1, and MP effects on CFMT with a pre-intervention (T1) and post-intervention (T2) design in two groups, MP (n = 19) and Control (n = 17), in Study 2. We found that, from T1 to T2, MP (vs. Control) decreased parenting stress, decreased dorsomedial prefrontal cortex (dmPFC) during own-child-specific voluntary responding (React to Own vs. Other's Child), and increased activity in the frontoparietal cortices, midbrain, nucleus accumbens, and amygdala during own-child-specific empathic mirroring (Join vs. Observe of Own vs. Other's Child). We identified that MP effects on parenting stress were potentially mediated by T1-to-T2 changes in: (1) the left superior-temporal-gyrus differential responses in the contrast of Join vs. Observe of own (vs. other's) child, (2) the dmPFC-PAG (periaqueductal gray) differential functional connectivity in the same contrast, and (3) the left amygdala differential responses in the contrast of Join vs. Observe of own (vs. other's) child's joyful vs. distressed expressions. We discussed these results in support of the notion that MP reduces parenting stress via changing neural activities related to the problems of “over-mentalizing” and “under-coupling.” Additionally, we discussed theoretical relationships between parenting stress and intersubjectivity in a novel dyadic active inference framework in a two-agent system to guide future research.

Mom Power With High-Adversity Mothers and Children

Mom Power With High-Adversity Mothers and Children

5.67 Mom Power©: Promoting Parenting and Maternal Mental Health Among Families With Young Children

Mom Power© is a manualized, 13-session group therapy model for mothers and their children ages 0-6 years. The group is trauma-informed and attachment-based and primarily focused on promoting secure parent-child relationships, a known protective factor for child mental health. This study examined the effectiveness of the Mom Power© program particularly as it relates to parenting.

Screening, Prevention, and Promotion of Resilience: Clinical Interventions for Traumatized Children and Caregivers

The goal of this session is to familiarize attendees with common presenting symptoms, individual and dyadic assessment techniques and screeners, and early intervention strategies used in traumatized children and their caregivers. They will become familiar with child parent psychotherapy (CPP) and Mom Power, evidence-based treatments for trauma in caregivers and young children, as well as Relational Health Screening (RHS), a brief assessment and intervention for high-risk dyads.

Improving Maternal Representations in High-Risk Mothers: A Randomized, Controlled Trial of the Mom Power Parenting Intervention.

A key mechanism of risk transmission between maternal risk and child outcomes are the mother's representations. The current study examined the effects of an attachment-based, trauma-informed parenting intervention, the Mom Power (MP) program, in optimizing maternal representations of high-risk mothers utilizing a randomized, controlled trial design (NCT01554215). High-risk mothers were recruited from low-income community locations and randomized to either the MP Intervention (n = 42) or a control condition (n = 33) in a parallel design. Maternal representations were assessed before and after the intervention using the Working Model of the Child Interview. The proportion of women with balanced (secure) representations increased in the MP group but not in the control group. Parenting Reflectivity for mothers in the treatment group significantly increased, with no change in the control condition. Participation in the MP program was associated with improvements in a key indicator of the security of the parent-child relationship: mothers' representations of their children.

MIXED-METHODS EVALUATION OF PARTICIPANT RECRUITMENT AND RETENTION IN THE MOM POWER PARENTING INTERVENTION PROGRAM.

Parenting group success begins with attendance. Using archival pilot data from 99 mothers who enrolled in the Mom Power (MP) parenting intervention, this study sought to understand the factors that influenced participant engagement and retention. MP is a group-based, early intervention program grounded in attachment theory that utilizes motivational interviewing as a core component to enhance program engagement. Study aims were to qualitatively describe the reasons why mothers were interested in participating in the program, including what they hoped to gain from the experience, and to quantitatively examine the extent to which attendance was associated with demographic, experiential, and psychosocial factors. The qualitative analysis of intake interviews revealed that mothers expected the MP intervention to provide a warm environment for themselves and their children as well as to support and enhance their parenting, and 95% revealed their hopes that the intervention would help them grow and develop as women. Attendance rates were relatively high, with 62% of mothers missing less than one group session. Quantitative analyses using multiple regression to test associations of demographic, experiential, and psychosocial factors with attendance rates were not significant. Results suggest that motivational interviewing may be an important component in promoting participant engagement efforts in parenting interventions.

A community-based randomized controlled trial of Mom Power parenting intervention for mothers with interpersonal trauma histories and their young children.

We conducted a study to evaluate the effectiveness of Mom Power, a multifamily parenting intervention to improve mental health and parenting among high-risk mothers with young children in a community-based randomized controlled trial (CB-RCT)design. Participants (N=122) were high-risk mothers (e.g., interpersonal trauma histories, mental health problems, poverty) and their young children (age <6years), randomized either to Mom Power, a parenting intervention (treatment condition), or weekly mailings of parenting information (control condition). In this study, the 13-session intervention was delivered by community clinicians trained to fidelity. Pre- and post-trial assessments included mothers' mental health symptoms, parenting stress and helplessness, and connection to care. Mom Power was delivered in the community with fidelity and had good uptake (>65%) despite the risk nature of the sample. Overall, we found improvements in mental health and parenting stress for Mom Power participants but not for controls; in contrast, control mothers increased in parent-child role reversal across the trial period. The benefits of Mom Power treatment (vs. control) were accentuated for mothers with interpersonal trauma histories. Results of this CB-RCT confirm the effectiveness of Mom Power for improving mental health and parenting outcomes for high-risk, trauma-exposed women with young children. ClinicalTrials.gov Identifier: NCT01554215.

Parent-child intervention decreases stress and increases maternal brain activity and connectivity during own baby-cry: An exploratory study.

Parental responses to their children are crucially influenced by stress. However, brain-based mechanistic understanding of the adverse effects of parenting stress and benefits of therapeutic interventions is lacking. We studied maternal brain responses to salient child signals as a function of Mom Power (MP), an attachment-based parenting intervention established to decrease maternal distress. Twenty-nine mothers underwent two functional magnetic resonance imaging brain scans during a baby-cry task designed to solicit maternal responses to child's or self's distress signals. Between scans, mothers were pseudorandomly assigned to either MP (n = 14) or control (n = 15) with groups balanced for depression. Compared to control, MP decreased parenting stress and increased child-focused responses in social brain areas highlighted by the precuneus and its functional connectivity with subgenual anterior cingulate cortex, which are key components of reflective self-awareness and decision-making neurocircuitry. Furthermore, over 13 weeks, reduction in parenting stress was related to increasing child- versus self-focused baby-cry responses in amygdala-temporal pole functional connectivity, which may mediate maternal ability to take her child's perspective. Although replication in larger samples is needed, the results of this first parental-brain intervention study demonstrate robust stress-related brain circuits for maternal care that can be modulated by psychotherapy.

39.4 EMOTION PROCESSING AND PSYCHOPATHOLOGICAL RISK IN THE PARENTAL BRAIN: PSYCHOSOCIAL INTERVENTION INCREASES ACTIVITY AND DECREASES STRESS

The mother-child relationship, central to social-emotional development, is impaired by trauma exposure and mental illness. Affected mothers are at risk for diminished parenting skills and sensitivity, placing children at risk for negative psychosocial outcomes. Certain neurological functioning, known to support parenting, is also defective with mental illness (including “perception and understanding of others/empathy” and “approach motivation”) and may be treatable. Mom Power is an attachment-based intervention that improves parental reflective functioning and emotion regulation toward reducing depression, posttraumatic stress, and caregiving helplessness. This study contributes to mechanistic understandings of parental brain function in mental health, illness, and intervention.

A Mental Health and Parenting Intervention for Adolescent and Young Adult Mothers and their Infants

Purpose: Adolescent girls with mental illness are at heightened risk for unplanned pregnancies, which often disrupts typical psychological development, relationship formation, access to support systems, and school performance. Thus, adolescent mothers face many challenges while parenting in addition to coping with mental health concerns. Without interventions, adolescent mothers may put themselves and their children at risk and face further challenges than their non-parent or older counterparts. Method: The Mom Power program (MP) is a treatment engagement intervention for young mothers and their children, developed through a University-Community Partnership in Michigan. The program is designed to engage young mothers in mental health services, provide developmental and parenting guidance, teach self-care skills, increase social support, and provide hands-on parenting practice. Results: Preliminary feasibility data support MP as an effective intervention for adolescent mothers by reducing selfreported symptoms of Major Depressive Disorder (MDD) and Post Traumatic Stress Disorder (PTSD). MP is effective at increasing parenting competence, social support and connection to care in a high-risk population of young mothers compared to a demographically similar group of young mothers that did not complete the intervention. Conclusion: Mom Power is a short-term attachment-based psycho-educational parenting and self-care skills group for adolescent mothers. Comprehensive models like the MP Program are vital in reaching out to the needs of young mothers and their babies in an effort to decrease mental health symptoms and increase positive parenting skills

Mom Power: preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers.

Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child's early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age <6years old), focused on enhancing mothers' mental health, parenting competence, and engagement in treatment. Mothers were referred from community health providers for a phase 1 trial to assess feasibility, acceptability, and pilot outcomes. At baseline, many reported several identified risk factors, including trauma exposure, psychopathology, poverty, and single parenthood. Ninety-nine mother-child pairs were initially recruited into the MP program with 68 women completing and providing pre- and post-self-report measures assessing demographics and trauma history (pre-assessment only), maternal mental health (depression and post-traumatic stress disorder (PTSD)), parenting, and intervention satisfaction. Results indicate that MP participation was associated with reduction in depression, PTSD, and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70% of the 10 groups (completers; N = 68) improved on parenting and mental health outcomes, in contrast to non-completers (N = 12). Effects were most pronounced for women with a mental health diagnosis at baseline. The intervention was perceived as helpful and user-friendly. Results indicate that MP is feasible, acceptable, and holds promise for improving maternal mental health and parenting competence among high-risk dyads. Further research is warranted to evaluate the efficacy of MP using randomized controlled designs.

Predictors of Treatment Engagement to the Parenting Intervention Mom Power Among Caucasian and African American Mothers

ABSTRACT. It has been well documented that early-intervention programs focused on young children hold the greatest promise to mediating mental, emotional, and behavioral disorders. Parenting programs with young children have yielded favorable outcomes; however, engaging and retaining participants has typically been a challenge. Predictors of treatment engagement, or factors influencing participants’ attendance rates and/or retention in a program, have been routinely studied with outcomes yielding differing results. The present study aims to extend this research by presenting engagement data on 150 mothers and their young children (ages 0–6 years old) in an attachment-based parenting and self-care skills intervention called Mom Power (MP). This study examines the impact of sociodemographic data, and mental and physical health factors on attendance rates of the entire mother–child sample and also compares rates for Caucasian and African American mothers separately. Results show that employment status and physical health impacted attendance for the entire sample and continued to be main predictors among African American mothers. This study has implications for future research specifically pertaining to ethnic and physical health predictors of participants’ retention in intervention programs. Recommendations for engagement and retention strategies are discussed, as are considerations for next steps to test the MP model in a real-world effectiveness trial.