Dr Chantal Cyr – Keynote: The use of attachment-based video feedback as an assessment and intervention used with vulnerable families. Madeleine Mackinnon.

The use of attachment-based video feedback as an assessment and intervention used with vulnerable families: A summary of a piece of research presented as a Keynote at the Association of Video Interaction Guidance UK (AVIGUK) International Conference in Glasgow ‘Video Interaction Guidance – Closing the Gap’ May 2017 by Dr. Chantal Cyr, a professor of Developmental Psychology, Canada Research Chair in Child Attachment and Development, and Child and Family Psychologist at the University of Quebec at Montreal (UQAM).

Report by Madeleine Mackinnon.

Introduction

The current paper provides a summary of a piece of research which was presented at the 7th AVIG UK International Conference held in Glasgow, Scotland, titled ‘Video Interaction Guidance- Closing the Gap’. Key speakers and workshops involved the sharing of stimulating and inspiring ways in which to apply video feedback to create positive change, particularly for vulnerable children, young people, and families. More specifically, Dr Chantal Cyr’s work provided insights about the use and efficacy of video feedback as assessment information which can be used as a predictor of future outcomes in relation to child welfare cases.

Dr Cyr is involved in teaching child developmental psychopathology and conducts state-of-the-art research in which she tests interventions with children and families within an attachment-based framework. The work of Dr Cyr involves working closely with the child protective services in Montreal, recently involving a piece of research which focused on attachment-based assessment and intervention with the use of video-feedback, and this has been used with vulnerable children and families, including children within care arrangements and those who have suffered maltreatment and still live with their biological parents.

Video feedback interventions aim to enhance sensitivity and communication in interactions to improve attachment relationships (Fukkink, Trienekens, & Kramer, 2011). They achieve this through microanalysis of video footage by providing a focus on moments of quality positive interactions within the context of everyday, natural situations. This process, through which new and more positive parent-child interactive experiences are made possible, empowers parents to achieve change in their caregiving behaviour.

The research presented was titled ‘A Video feedback attachment-based protocol as a valid assessment of parenting capacity in child welfare cases’ (Cyr & Alink, 2007; Cyr et al., 2012 for more information). It outlined a study where video feedback was used as a way of assessing parenting capacity within the context of child welfare cases. The assessment information, gathered through a comprehensive evaluation of the parent, included the application of attachment-based video feedback to assess parents’ capacity to change. It was used to inform placement decisions and plan appropriate interventions with parents and children.

The positive benefits of attachment-based video feedback interventions used with vulnerable families in order to promote positive interactions have been widely documented (Beebe, 2003; Cassibba, Castoro, Costantino, Sette & Van IJzendoorn, 2015; Moss, Dubois-Comtois, Cyr, Tarabulsy, St-Laurent, Bernier, 2011). They aim to assess parenting capacity through gaining the parents’ perspective of their ability to apply parenting skills, while practitioners aim to build upon promoting positive behaviours in parenting (Poslawsky, Naber, Bakermans-Kranenburg, Van Daalen, Van Engeland & Van IJzendoorn, 2015). Underpinned by attachment theory, short-term intervention-based interventions focus on enhancing parental sensitivity, security of attachment and child social competence, as well as on decreasing internalised and externalised or dysregulated behaviours (Yagmur, Mesman, Malda, Bakermans-Kranenburg & Ekmekci, 2014; Juffer & Steele, 2014).

Research Objectives

The aim of the presented research was to apply video-feedback to assess parental capacity to change in order to predict future outcomes of children within the child welfare system, in particular the frequency of child recurrence of maltreatment during the year following the intervention. As a first objective, this randomised control-trial design was used to evaluate whether the Attachment Video-Feedback Intervention (AVI), as part of a broader ‘parenting capacity assessment’ used in the short-term with parents who were identified as a risk to their children by the child welfare system, would be shown to be effective in promoting positive outcomes in relation to promoting increased parent to child interaction, levels of child attachment security and a decrease in child externalising behaviours.

Also, the study sought to examine the key research questions of whether or not the use of an attachment-based intervention within a parenting capacity assessment framework could be shown to provide clear assessment information regarding placement decisions. This approach focuses on whether assessment information gathered from the use of video-feedback better supports practitioners having to inform the court and social workers about parents’ capacity to provide minimal adequate child care. Therefore, as a second objective, the study asked whether practitioners assessing parental capacity with the use of an attachment-based intervention provide a reliable prediction of whether or not child maltreatment is likely to reoccur during the year following the intervention.

Method

A sample of participants who had been reported for child maltreatment were included in the study. All families were identified as having a low socio economic background and several psycho-social risk factors. The design involved pre and post tests which were administered to three groups. Group one included the Attachment Video-feedback Intervention, group two a psychoeducational intervention and group three posed as a control group. No socio-economic differences were found between the groups at pre test.

The parenting capacity assessments, involving an average of seven sessions of video-feedback lasting between about three hours each were administered over the course of two months. This involved parents and children being filmed whilst engaging in a ten-minute activity. The activities and instructions were bespoke to the identified attachment style and needs of the parent and child.

The most commonly used protocol involved the assessor encouraging parents to follow the child’s lead, to describe the intentions and actions of the child whilst engaging in the activity. Video-feedback was provided immediately after filming the parents and children and involved the reinforcement of behaviours which demonstrated the parents’ ability to accurately identify the needs of their child, and to promote the parents’ understanding of the importance of their own positive behaviour. In particular, this involved the ways in which parental behaviour has a positive affect on the behaviour of the child. During video-feedback, parents were also asked to describe the interaction, reflect on what their child was doing and trying to communicate, and to reflect on what their child may be thinking and feeling. In addition, where inappropriate behaviours occurred between the parent and child, techniques were reinforced by practitioners in order to promote positive behaviours and reparation.

During the session the parents were also involved in a discussion which involved reflecting on the interaction which involved focusing on their child’s motives underlying behaviour and as well as what their child may be attempting to communicate to them.

Information which was used to assess levels of parents’ and children’s functioning included measuring quality of parent to child interaction, child attachment and child behaviour problem, as well as the collation of child welfare reports which detailed child placement history and risks posed to the child by the parent, including historical maltreatment.

Results

The information gained from attachment-based video feedback has shown to be valued by those (social workers, family judges) involved in making decisions around placements. The current study found assessment information drawn from the attachment video feedback intervention to better support practitioners having to provide a report on the parents’ capacity to child care. Precisely, conclusions of reports of those practitioners, as to whether or not the parent is capable of providing minimal and adequate child care, were found to be predictive of child recurrence of maltreatment in the year following post assessment. Implementation factors which contributed to the success of attachment video feedback intervention in predicting outcomes for children, young people, and families included the level of training and supervision of practitioners completing assessments, the level of observational skills applied and undertaking regular supervision.

The current study highlights the positive use of video-feedback in order to reinforce positive behaviour and support interaction and repair in the relationships between the parents and children identified in the current study.

Positive outcomes included enhanced relationships between parents and children, greater child attachment organisation, fewer child behaviour problems, as well as parents becoming more forthcoming with services including increased levels of receptiveness to social services and a higher uptake of suggested interventions.

Dr Cyr concluded the current research by highlighting the use of video-feedback as a successful way to promote relationships between parents and children and to orient placement decisions.

The current study highlighted the way in which video-feedback can be applied within a multi-professional framework in order to predict future outcomes.

References

Cassibba, R., Castoro, G., Costantino, E., Sette, G., & Van Ijzendoorn, M. H. (2015). Enhancing maternal sensitivity and infant attachment security with video feedback: An exploratory study in Italy. Infant mental health journal, 36(1), 53-61.

Cyr, C. & Alink, A. (2017). Child maltreatment : Causes, Consequences, and the assessment and promotion of parenting capacities. Current Opinion in Psychology, 15, 81-86. http://dx.doi.org/10.1016/j.copsyc.2017.02.002

Cyr, C., Dubois-Comtois, K., Michel, G., Poulin, C., Pascuzzo, K., Losier V., Dumais, M., St-Laurent, D., & Moss, E. (2012). Attachment Theory in the Assessment and Promotion of Parental Competency in Child Protection Cases. In A. Muela (Ed.) Child Abuse and Neglect – A Multidimensional Approach, (pp. 63–86). InTech Open, Available from: doi.org/10.5772/48771

Fukkink, R. G., Trienekens, N., & Kramer, L. J. (2011). Video feedback in education and training: Putting learning in the picture. Educational Psychology Review, 23(1), 45-63.

Juffer, F., & Steele, M. (2014). What words cannot say: the telling story of video in attachment-based interventions. Attachment & human development, 16(4), 307-314.

Moss, E., Dubois-Comtois, K., Cyr, C., Tarabulsy, G., St-Laurent, D., & Bernier, A. (2011). Efficacy of a home-visiting intervention aimed at improving maternal sensitivity, child attachment, and behavioral outcomes for maltreated children: A randomized control trial. Development & Psychopathology, 23, 195-210.

Poslawsky, I. E., Naber, F. B., Bakermans-Kranenburg, M. J., van Daalen, E., van Engeland, H., & van IJzendoorn, M. H. (2015). Video-feedback Intervention to promote Positive Parenting adapted to Autism (VIPP-AUTI): A randomized controlled trial. Autism, 19(5), 588-603.

Yagmur, S., Mesman, J., Malda, M., Bakermans-Kranenburg, M. J., & Ekmekci, H. (2014). Video-feedback intervention increases sensitive parenting in ethnic minority mothers: a randomized control trial. Attachment & human development, 16(4), 371-386.

Madeleine Mackinnon, Trainee Educational Psychologist.

madeleine.mackinnon.2015@uni.strath.ac.uk

 

 

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