Efficacy of Group Attachment Based Intervention for Vulnerable Families

Birth to Three: A Pragmatic Clinical Trial for Child Maltreatment Prevention

The study examines the effectiveness of parent-child Group Attachment Based Intervention (GABI) in reducing risk of maltreatment in infants and toddlers compared with parenting skills classes. GABI directly addresses the needs of isolated, marginalized families, with the goals of of enhancing parent coping and resilience, and improving parent-child attachment relationships.

We hypothesize that compared to usual care, GABI will be associated with improved child, parent and parent-child outcomes.

Child abuse and neglect ("maltreatment") pose enormous short- and long-term risks to children. Yet despite the critical importance of the U.S. Department of Health and Human Services, Maternal and Child Health Bureau's goal "to reduce fatal and non-fatal child maltreatment," non-empirically supported parenting skills classes remain child welfare agencies' standard approach to meeting this goal.

The study examines the effectiveness of parent-child Group Attachment Based Intervention (GABI) in reducing risk of maltreatment in infants and toddlers compared with parenting skills classes. GABI directly addresses the needs of isolated, marginalized families, with the goals of of enhancing parent coping and resilience, and improving parent-child attachment relationships.

Seventy families with children aged 2-36 months who are referred for parenting help will be randomly assigned to either GABI or "treatment as usual" that consists of parents-only parenting skills classes. Treatment will be offered for up to 6 months. Both groups will be assessed at baseline, end of treatment and at 6 months follow up.

Inclusion Criteria:

• Parents with children age 0-36 months
• Parent(s) is/are biological parent of child (mother or father)
• Parent(s) has/have custody of their child even if he/she/they have lost custody of previous children
• Risk of maltreatment from referral source or intake interview, including parent's own childhood adversity, parent's current exposure to relationship violence, history of parental substance abuse or history of parental incarceration
• If history of substance abuse, enrolled in treatment program
• Willing to sign informed consent

Exclusion Criteria:

• Parent is unable to provide informed consent due to cognitive impairment
• Parent not fluent in English
• Child has diagnosis of an autistic spectrum disorder or severe cognitive delay