This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
Note: Interaction Guidance (IG) was not responsive to the CEBC's request for information about their program. The following information was obtained from publicly available sources (websites, articles, etc.).
Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Relevance to Child Welfare Rating:
2
Medium
See scale of 1-3
Child Welfare Outcomes: Permanency
Brief Description:
Interaction Guidance (IG) has been rated by the CEBC in the area of Infant and Toddler Mental Health (0-3). IG treats infants with a variety of early regulation disorders including feeding, sleeping, and excessive crying. The program was developed for families who have been difficult to engage in treatment due to risk factors such as poverty, substance abuse, mental illness, or other family stressors. IG uses observation of interactions between the baby and caregiver as representations of family structure. Therapeutic techniques include reviewing videotaped interactions to reinforce positive aspects and enhance caregivers' understanding of infant behavior and development.
Manual and Training section:
The publicly available information indicates that there is a manual and training available for Interaction Guidance (IG). Contact Dr. Susan McDonough at the University of Michigan's Comprehensive Center for Depression, phone: 734-936-4400.
Relevant Published, Peer-Reviewed Research:
Interaction Guidance is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. For more information on the rating of a "3 - Promising Research Evidence," please see the please see the Scientific Rating Scale.
Robert-Tissot, C., Cramer, B., Stern, D. N., Serpa, S. R., Bachmann, J. P., Palacio-Espasa, F., & Mendiguren, G. (1996). Outcome evaluation in brief mother-infant psychotherapies: Report on 75 cases. Infant Mental Health Journal, 17(2), 97-114.
Type of Study: Randomized controlled trial
Number of participants: 75 mother-infant pairs
Population:
Location/Institution: Child Guidance Clinic, Geneva, Switzerland.
Summary: (To include comparison groups, outcomes, measures, notable limitations) Mother-child pairs referred for treatment were randomly assigned to receive either Interaction Guidance (IG) or Psychodynamic Mother-Infant Psychotherapy (PD). Problem symptoms were assessed at baseline, 1 month, and 6 months post-treatment using the Symptom Check-List. Each mother was also interviewed to assess her representations of herself, her child, her role, and the child's father. Structured mother-infant interactions were videotaped and coded for quality, sensitivity, and child emotions. Both treatments showed improvements in symptoms, particularly for sleep problems which were the most common reason for referral. Behavior problems were more resistant to treatment and tended to increase with age, although those who were referred specifically for behavior problems did show improvements. Mother-child interactions and maternal self-esteem also improved. This study was limited by lack of an untreated comparison group. The authors also note that large developmental differences in the youngest versus the oldest children could have influenced results.
Length of post-intervention follow-up: 6 months.
Benoit, D., Madigan, S., Lecce, S., Shea, B., & Goldberg, S. (2001). Atypical maternal behavior toward feeding-disordered infants before and after intervention. Infant Mental Health Journal, 22(6), 611-626.
Type of Study: Non-randomized matched comparison group.
Number of participants: 28 mother-infant pairs
Population:
Location/Institution: Infant psychiatry clinic in a tertiary care pediatric hospital, Toronto, Ontario, Canada
Summary: (To include comparison groups, outcomes, measures, notable limitations) Mother-infant pairs received either 5 weeks of the Interaction Guidance (IG) intervention or 7 weeks of the feeding-focused intervention. Measures included the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE), a coding protocol that assesses mother-infant interaction on the dimensions of affective communication errors, role/boundary confusion, frightened/disoriented behavior, intrusiveness/negativity, and withdrawal. Results showed improvement in AMBIANCE scores for the IG (play-focused) group, but not for the feeding-focused group. This study is limited by a small sample size and lack of a randomized design.
Length of post-intervention follow-up: None for IG group, 14 weeks for feeding-focused group.
Madigan, S., Hawkins, E., Goldberg, S., & Benoit, D. (2006). Reduction of disrupted caregiver behavior using modified interaction guidance. Infant Mental Health Journal, 27(5), 509-527.
Type of Study: Pretest/posttest
Number of participants: 11 caregiver-infant pairs
Population:
Location/Institution: Infant psychiatry clinic in a tertiary care pediatric hospital, Toronto, Ontario, Canada
Summary: (To include comparison groups, outcomes, measures, notable limitations) Note: This analysis uses a subgroup of the sample used in Benoit et al., 2001. Mother-infant pairs were assessed at baseline and at a final feedback session. They received either 3, 4, or 5 Interaction Guidance (IG) treatment sessions depending on need and availability. Interactions were assessed using the AMBIANCE protocol. The current analysis focused on disrupted caregiver behavior, which consists of frightened or frightening behaviors on the caregiver's part during interactions with her infant. Result showed that mothers who underwent treatment with IG showed a reduction in disrupted behavior.
Length of post-intervention follow-up: None.
References:
McDonough, S. C. (2000). Interaction Guidance: An approach for difficult-to-engage families. In C. H. Zeanah, Jr. (Ed.) Handbook of infant mental health (2nd ed.) (pp. 485-493). New York, NY: Guilford Press.
McDonough, S. C. (2004). Interaction Guidance: Promoting and nurturing the caregiving relationship. In A. Sameroff, S. C. McDonough, & K. L. Rosenblum, (Eds.) Treating parent-infant relationship problems: Strategies for intervention (pp. 79-96). New York, NY: Guilford Press.
McDonough, S. C. (1993). Interaction Guidance: Understanding and treating early infant-caregiver relationship disturbances. In C.H. Zeanah, Jr. (Ed.) Handbook of infant mental health (pp. 414-426). New York, NY: Guilford Press.
Contact Information
Name: Dr. Susan McDonough
Affiliation/Agency: University of Michigan Comprehensive Depression Center
E-mail: scmcdono@med.umich.edu
Phone: 734-936-4400
Date review compiled: December 2009