A Trial and Qualitative Review of an Attachment-Based Online Parenting Program

Mary Gregory

doi:10.25907/00057

The bond that develops between an infant and their caregiver, often their mother, shapes their developing brains and provides the internal working models through which they understand themselves, others, and the world. Attachment theory provides a structure in which to understand this unique and important relationship. A number of attachment-based interventions have been developed, which have shown positive effects for both parents and children. However, these interventions are intensive in terms of time and resources. As these interventions have demonstrated positive effects there is a need to ensure they are easily accessible for parents. This thesis used a randomised control trial to evaluate the effectiveness of putting an attachment-based intervention online. Using an internet-based format provided an easily accessible and cost-effective way to provide information and activities to parents and caregivers. Participants were recruited from Child and Youth Mental Health Service (CYMHS), Playgroup Queensland, a Child Health Service as well as parents and caregivers from the Department of Child Safety, Youth and Woman (DCSYW). However, the primary participant pool came from the general population through social media recruitment. Pre-intervention and post-intervention psychometric measures were used to assess the effectiveness of this internet-based intervention. Thirty-four participants completed the pre and post measures. There was also a follow-up measure sent out three months after completion of the intervention, however this data was not considered due to a low response rate (n = 7). The pre and post measures examined self-reported parental stress, acceptance, rejection, and reflective functioning as well as perceived child strengths and difficulties. For the quantitative analyses, due to the low power from high participant attrition t-tests were used to analyse the results. The analyses found that parental stress as measured by the Parental Stress Scale significantly decreased in both the control and treatment groups. The warmth and affection scale and the hostility and aggression scales were examined from the Parental Acceptance and Rejection Questionnaire. They showed that warmth and affection and hostility and aggression decreased in both the treatment and control groups but not in a statistically significant way. The Strengths and Difficulties Questionnaire was unable to be analysed due to the low Cronbach’s alpha. Finally, reflective functioning (certainty and uncertainty) as measured by the Reflective Functioning Questionnaire remained in the normal range for the control and treatment groups. A qualitative analysis was also conducted on the feedback the participants provided. The feedback was examined in terms of the delivery and content of the program. Participants particularly identified audio options, handouts, having activities, and time pressures as important with regard to the delivery. Overall the participants were positive in terms of the content of the intervention with themes identified including the importance of reflection and learning, a desire to change intergenerational patterns, and the usefulness of mindfulness/meditation. The themes identified in relation to the content pointed towards the intervention helping the participants to reflect and potentially change their internal working models. Participant attrition was identified as a significant challenge for this research and the level of attrition which occurred as part of this research is examined and compared to other research. The researchers concluded that there are a lot of opportunities in the online parenting intervention space, with participants particularly positive regarding the attachment-based content, however participant attrition is a major challenge and needs to be further examined particularly in terms of vulnerable populations.

A Trial and Qualitative Review of an Attachment-Based Online Parenting Program

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