1st Edition

Enhancing Attachment and Reflective Parenting in Clinical Practice A Minding the Baby Approach

By Arietta Slade Copyright 2023

    How can clinicians help vulnerable young families overcome barriers to secure, reciprocal, and joyful parent–infant relationships? This book provides a flexible framework for promoting reflective parenting "from the ground up." Described are effective ways to support safety and self-regulation in parents with histories of trauma and adversity, giving them a stronger foundation for seeing, hearing, and connecting to their children. The book distills principles of the influential Minding the Baby (MTB) home visiting program, as well as contemporary attachment and mentalization research. Vivid case material illustrates therapeutic strategies that can be used with parents and children in any clinical context. End-of-chapter "Questions for Clinicians" help readers apply the concepts discussed, with special attention to developing their own reflective capacities.

    Glossary of Acronyms and Abbreviations
    1. Minding the Baby™ and Reflective Parenting: An Introduction
    I. Theoretical and Scientific Bases for Minding the Baby Parenting
    2. The Foundations of Attachment Theory and Research
    3. Pathways to Secure Attachment: Caregiver Sensitivity
    4. Pathways to Secure Attachment: Parental Mentalizing
    5. Impaired Mentalizing and Trauma
    6. Adversity, Toxic Stress, and Resilience
    II. Establishing the Relational Foundations of Reflection
    7. The Relational Foundations of Reflection
    8. The Relational Foundations of Reflection in the Clinician
    9. The Relational Foundations of Reflection in Parents and Children
    III. Building Reflective Capacities
    10. Enhancing Parental Reflective Functioning: General Considerations
    11. Reflective Nursing
    12. Parental Mental Health
    13. Clinical Applications of the Pregnancy and Parent Development Interviews
    IV. Clinical Applications of Minding the Baby Parenting
    14. Brenda, Aidan, and Allie
    15. Yolanda, Manny, and Mildred
    16. Genevieve, Jared, and Jimmy
    17. Embracing Complexity
    Appendix I. The Pregnancy Interview, Arietta Slade
    Appendix II. The Parent Development Interview--Short Version (2004), Arietta Slade, J. Lawrence Aber, Brenda Berger, Ivan Bresgi, and Merryle Kaplan


    Arietta Slade, PhD, is a clinical psychologist and Professor of Clinical Child Psychology at the Yale Child Study Center. She is Co-Founder and Co-Director of Minding the Baby™ (MTB), an evidence-based, interdisciplinary, reflective home visiting program for high-risk mothers, infants, and their families at the Yale Child Study Center and Yale School of Nursing. She came to MTB, where she oversaw model development, training, and consultation, with a background as a theoretician, clinician, teacher, and researcher. Dr. Slade has written widely on reflective parenting, relationship-based infant mental health practice, and the implications of attachment and mentalization theory for child and parent psychotherapy. She is coauthor of Attachment in Therapeutic Practice and coeditor of the six-volume set Attachment Theory (both with Jeremy Holmes). Dr. Slade is a recipient of the Bowlby–Ainsworth Award from the New York Attachment Consortium.

    Lois S. Sadler, PhD, RN, FAAN, is a pediatric nurse practitioner and Professor at the Yale School of Nursing and Yale Child Study Center. She is Co-Founder and Co-Director of the Minding the Baby™ (MTB) home visiting program and has led MTB clinical trials and program implementation nationally and internationally. She came to MTB having taught at the graduate level for many years, and with extensive clinical and research experience working with teen parents and young families in diverse community settings. Dr. Sadler has published widely in the areas of the transition to parenthood among adolescent parents and their families, adolescent pregnancy prevention, evaluation of specialized support programs for young parents and their children, and pediatric sleep. She has won numerous awards for her teaching and research and is a Fellow of the American Academy of Nursing.

    Tanika Eaves, PhD, LCSW, IMH-E®, is a clinical social worker, Assistant Professor of Social Work at the Egan School of Nursing and Health Studies at Fairfield University, and an endorsed Infant Mental Health Specialist. Dr. Eaves joined the Minding the Baby™ team in 2009, where she worked with sites in the United States and Western Europe as both a clinician and training specialist. She helped develop an introductory training course on clinical approaches to enhancing reflective parenting that drew participants from around the world. She has published in the areas of reflective supervision and workforce well-being, culturally responsive parent–infant psychotherapeutic interventions, and equity in maternal–infant health and mental health outcomes. She has also worked to expand social work education competencies in infant/early childhood mental health and in promoting diversity, equity, and inclusion.

    Denise L. Webb, MSN, APRN, PNP, IMH-E®, is a pediatric nurse practitioner and endorsed Infant Mental Health Mentor. She joined the Minding the Baby™ team at its inception, first as a clinician and later as a training specialist working with teams in the United States and Western Europe. She coined the term Reflective Nursing to describe the application of mentalization theory to nursing practice and played a pivotal role in developing an introductory training course on clinical approaches to enhancing reflective parenting that drew participants from around the world. Before completing her training as a nurse practitioner, Ms. Webb worked as an early childhood educator for many years.

    "This outstanding, beautifully written book gives clinicians an understanding of how to apply Minding the Baby principles with parents of infants and young children. It is by far the very best description of applied attachment theory and the concept of mentalizing available for a clinical audience. Practitioners are guided to improve parents’ experiences and practices, with the ultimate aim of improving young children's lives. The authors do not shy away from challenging questions about the universal applicability of attachment theory--instead, they address them head-on, emphasizing the importance of race, poverty, and other societal factors in the lives of families. I would use this book for my elective clinical practice class entitled Stress and Trauma in the Early Years."--Ruth Paris, PhD, School of Social Work, Boston University

    "An exceptionally helpful and practical guide, written by one of the world’s best experts in this field. Slade and her colleagues provide a crystal-clear description of clinical strategies based on one of the most influential evidence-based interventions for vulnerable parents and children. The book shows how to understand and address tough parenting challenges that can gravely undermine children's development and well-being. Practitioners will treasure this superb work."--Peter Fonagy, OBE, FMedSci, FBA, FAcSS, Head, Division of Psychology and Language Sciences, University College London, United Kingdom; Chief Executive, Anna Freud Centre

    "This much-needed book fills an important gap in the literature on parenting interventions. It will serve as a go-to resource for mental health providers from a range of disciplines, including nursing, psychology, and social work, because it models a clinical attitude and describes therapeutic techniques in a clear, approachable style. The clinical examples--of both effective interventions and interventions that 'miss the mark'--help the reader appreciate the central role of mentalization in promoting emotional growth. The numerous figures depicting the relationships between concepts are a useful tool for better understanding. The Clinician Mentalizing Self-Assessment feature is simply brilliant."--Alicia F. Lieberman, PhD, Irving B. Harris Endowed Chair in Infant Mental Health and Professor, Department of Psychiatry ​and Behavioral Sciences, University of California, San Francisco

    "In this book, you will find a therapeutic recipe crafted by people who are caring for parents and children. This is an intervention that carries the souls and hearts of the families and professionals who have helped to create it. Surrounding this is the science that provides support for the intervention--both the data and the theory. What you will feel most strongly as you take in the principles and ideas of this program are the arms holding you up until you are ready to hold up others."--Jessica Borelli, PhD, Department of Psychological Science, University of California, Irvine-