Fostering Mothers' Emotionally-Responsive Parenting

描述（由申请人提供）：针对药物滥用母亲的父母培训计划的临床试验表明，在改善亲子关系或儿童的心理社会适应方面取得的成功有限。父母培训计划没有成功的一个原因可能是他们缺乏对亲子关系的情感方面的关注，特别是母亲在发展背景下识别儿童情感需求并以情感上可用的方式回应他们的能力。依恋研究表明，亲子关系的情感质量是孩子适应的一个强有力的预测因素，母亲可以通过学习识别孩子的情感线索和自己在养育角色中的情感反应来改善联系。最近，我们为接受药物治疗的母亲试行了一项干预措施-预防性反应育儿（ERP）。在对43名主要依赖可卡因的母亲进行的预试验研究中，参加ERP的母亲显示：（1）识别情绪状态（自己和孩子的情绪状态）的能力显着提高，（2）比参加TAU的母亲更好的出勤率，保留率和依从性。 在本研究中，我们将（1）完成接近最终版的治疗师手册，（2）开发治疗师培训计划和依从性能力评级量表，（3）对60名2-4岁儿童的母亲进行一项随机的ERP手册试点研究，以评估有效性、可行性和可接受性ERP与家长培训（对照），和（4）检查过程和调节变量对结果的影响，为更大的II期疗效试验做准备。直接针对的结果将是母亲的：（1）认识到儿童的情感需求和能力，（2）监测儿童的思想和感情及其对行为的影响的能力，以及（3）母亲对养育关系的思想和感情。间接针对的结果将是母亲的（1）在育儿互动中的敏感性和情感可用性，（2）精神症状，（3）日常功能，（4）药物和酒精使用，以及（5）儿童的心理社会调整。

DESCRIPTION (provided by applicant): Clinical trials of parent training programs for substance abusing mothers have shown limited success in improving parent-child relationships or children's psychosocial adjustment. One reason parent training programs have not succeeded may be their lack of attention to emotional aspects of the parent-child relationship, especially mothers' capacity to recognize children's emotional needs within a developmental context and respond to them in an emotionally available way. Attachment research has shown that the emotional quality of the parent-child relationship is a strong predictor of child adjustment and mothers can improve bonding by learning to recognize children's emotional cues and their own emotional responses in the parenting role. Recently we piloted an intervention - Emotionally-Responsive Parenting (ERP) -for mothers in drug treatment. In a pre-pilot study with 43 primarily cocaine-dependent mothers, mothers enrolled in ERP showed (1) significant improvement in their capacity to recognize emotional states (their own and their children's, and (2) better attendance, retention, and compliance than mothers enrolled in TAU. In this study we will (1) complete a near-final therapist manual, (2) develop a therapist training program and adherence competence rating scales, (3) conduct a randomized pilot study of the ERP manual with 60 mothers of children ages 2-4 to evaluate the efficacy, feasibility, and acceptability of ERP vs. Parent Training (control), and (4) examine the impact of process and moderator variables on outcome in preparation for a larger, Stage II efficacy trial. Directly targeted outcomes will be mothers': (1) recognition of children's emotional needs and capacities, (2) capacity to monitor children's thoughts and feelings and their influence on behavior, and (3) maternal thoughts and feelings about the parenting relationship. Indirectly targeted outcomes will be mothers' (1) sensitivity and emotional availability during parenting interactions, (2) psychiatric symptoms, (3) daily functioning, (4) drug and alcohol use, and (5) children's psychosocial adjustment.