WEBVTT

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In this section
we're going to be

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thinking about
methods of working

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during the postnatal period.

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As with the antenatal period,
the key approaches to working

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during the postnatal period
are delivered by three main

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methods, media-based methods,
group-based programmes

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and dyadic interventions that
are delivered to individual

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parent-infant dyads.

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Media-based methods
include apps and websites

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that provide
information and support

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to parents of new babies.

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One such website and app,
called Getting to Know Your Baby

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provides information
and videos that

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address some of the
material that we

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have covered in this course.

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A link to this website is
available at the bottom

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of this page.

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Other media-based tools
include Baby Express,

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which is an eight-page
newsletter sent monthly

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to parents of infants until
the child is one year of age,

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after which it's sent once every
two months for the next four

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years.

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The newsletter's written by
a local health journalist,

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and provides information
on emotional development,

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parent-child
interaction, and play.

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This intervention aims to
enhance maternal well-being

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and positively influence
parenting style.

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There are also a number of
group-based methods of working

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with parents postnatally.

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Possibly one of the
most popular methods

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is infant massage classes.

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This involves groups of
around six to eight mothers

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and babies that are facilitated
by a trained infant massage

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teacher.

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The facilitator teaches the
massage strokes on a doll

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and encourages attending
parents to sit on the floor with

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their babies and
practise the strokes.

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Facilitators also teach about
infant cues, the use of songs

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and music and
provides opportunities

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for social interaction
between the participating

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mother-infant dyads.

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The research shows
that infant massage

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can improve the interaction
of depressed mothers.

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A second type of intervention
is group-based parenting

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programmes.

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Some of these programmes are
provided on a universal basis

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to all parents of new babies,
but some of them target parents

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who are experiencing
particular problems,

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such as being socioeconomically
deprived or having postnatal

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depression.

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So for example, Mellow Babies
is a group-based programme

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targeting women experiencing
depression and is underpinned

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by cognitive behavioural theory.

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The intervention is
delivered over 14 weeks,

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during which time
mothers and infants can

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attend the group for a
whole day on a weekly basis.

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Babies are cared for in
the creche in the morning,

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providing the mothers
with an opportunity

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to reflect on their own
lives, to draw links

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between their past and present
feelings and relationships

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and to consider ways of
managing depression using

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broadly cognitive
behavioural approaches.

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In the afternoon, participants
engage in play time,

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involving interaction
coaching, baby massage,

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looking at picture books,
lap games and nursery rhymes

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to promote sensitive
interaction and attunement.

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The babies are then
returned to the creche

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and the afternoon
sessions involve

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the use of videos of mothers
interacting with their baby

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to demonstrate
sensitive interaction.

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The results of a small
study involving 20 mothers

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found significant improvements
in maternal depression

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and in parent-infant
interaction.

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A third group of
interventions are

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provided to parent-infant dyads
but not in group settings.

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And video feedback is
possibly one of the best known

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of these dyadic interventions.

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Video feedback involves
the use of observations

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from brief periods of videotaped
interaction between the parent

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and the infant being
fed back to the parent.

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Practitioners help parents
to improve their confidence

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and their sensitivity
to infant cues

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by identifying moments
of sensitive interaction

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on the videotape
and giving feedback

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about these to the parents.

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Parents are encouraged to
think about the interaction

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and what is happening
for the baby, which

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can help to increase their
reflective functioning.

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In terms of women
who are experiencing

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significant problems such
as domestic abuse, substance

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dependency, or severe
mental illness,

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methods such as
video feedback are

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being used as part of
broader care pathways.

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This means that
video feedback is

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being used as part of
the delivery of a wider

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set of services
that might include

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the involvement of Child
Protection and the courts

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in the case of women
experiencing domestic abuse

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or substance dependency, or
the delivery of other services

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in specialist inpatient
perinatal mother and baby

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units for women
experiencing conditions

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such as postnatal psychosis.

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Watch my interview
with Hilary Kennedy,

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who is a leading
developer and trainer

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of video interaction
guidance in the UK,

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and who describes the use of
this approach in more detail.

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Parent-infant psychotherapy
is another example

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of a dyadic intervention
that involves

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a parent-infant psychotherapist
working directly

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with individual parent-infant
dyads in the home, clinic

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or hospital setting.

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This technique
addresses a wide range

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of problems that can arise
during the antenatal and

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postnatal periods.

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Parent-infant
psychotherapy comprises

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a theoretically-guided
dyadic intervention

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that is delivered concurrently
to the parent and the infant

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and that focuses on improving
infant attachment security

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by targeting parental
internal working models.

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The approach is
essentially psychodynamic,

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in that it involves identifying
unconscious pounds of relating

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and using the parent-infant
relationship itself

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as the focus of
the intervention.

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The duration of delivery of
parent-infant psychotherapy

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depends on the
presenting problems,

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but typically ranges from 5
to 20 weeks, usually involving

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weekly sessions.

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Parents may be
referred to the service

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by a primary care
clinician, such as a doctor,

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or may self-refer to
privately-run services.

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Parent-infant psychotherapy
services typically

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target infants less
than two years of age

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at time of referral.

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This reflects the importance
of the first two years of life

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in terms of children's
later development.

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A number of studies
have shown that

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parent-infant psychotherapy
is effective in increasing

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the number of children
who are securely attached.

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If you would like to know
more about other types

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of intervention
that can be provided

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during the postnatal period,
please read the article

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that we have provided.

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In the next two videos,
I talk to Tessa Baradon,

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who is clinical lead at
The Anna Freud Centre,

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and who tells us a bit
more about this approach.

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