Video feedback parent-infant intervention for mothers experiencing enduring difficulties in managing emotions and relationships: A randomised controlled feasibility trial

Abstract

Objectives Parents experiencing mental health difficulties consistent with “personality disorder”, often related to a history of complex trauma, may face increased challenges in parent–child relationships and child socioemotional development. There are no published randomised controlled trials (RCTs) evaluating perinatal parent–child interventions for this population. We evaluated the feasibility and acceptability of undertaking an RCT of the video feedback intervention for positive parenting adapted for perinatal mental health (VIPP-PMH). Design Feasibility study incorporating a pilot RCT. Methods Mothers with enduring difficulties in managing emotions and relationships, consistent with a “personality disorder”, and their 6- to 36-month old infants were randomly allocated to receive six sessions of VIPP-PMH (n = 20) or usual care alone (n = 14). Results 76% of eligible mothers consented to participate. Intervention uptake and completion rates were 95% (≥1 VIPP-PMH session) and 70% (6 sessions), respectively. Follow-up rates were 85% at month 5 and 65% at month 8 post-baseline. Blinded observer-ratings of maternal sensitivity in parent–child interaction favoured the intervention group at month 5 (RR = 1.94, 95% CI 0.67–5.63) and month 8 (RR = 1.91, 95% CI 0.68–5.33). Small changes over time in self-rated parenting confidence and stress favoured the intervention group. There were no clear intervention effects on maternal non-intrusiveness or mental health, or on child behaviour problems, emotional functioning, or self-regulation. Conclusions An RCT of VIPP-PMH is feasible and acceptable to implement with mothers experiencing difficulties consistent with perinatal “personality disorder”. A fully powered definitive RCT should be undertaken.