Christoph M. Heinicke

Outcome of Child Psychotherapy as a Function of Frequency of Session

Two main questions are addressed: What is the impact of frequency of psychotherapeutic session on the rate of improvement in reading of children referred for a learning disturbance, and do children seen more frequently as opposed to once a week, show a differential development on a number of indices of personality functioning? It was found that children seen more frequently as opposed to once a week, showed a greater rate of improvement in reading in the year after the end of treatment and were in particular characterized by being more flexible in their adaptation and having a greater capacity for relationships at both the end and a year after the end of treatment.

Early intervention in the family system: A framework and review

A framework for understanding the effect of early intervention on family structure and functioning is presented. The framework uses five sets of variables to characterize families: Their ecology; and the values, roles, personalities, and interactions of family members. Twenty research studies that met criteria of having comparison/control groups, beginning intervention either prenatally or during the first 3 months of infancy, and directing intervention to family functioning are abstracted and examined in detail. Successful and unsuccessful studies are compared as to population and nature of intervention. Two criteria of success are used: (1) The commonly used criterion of any positive change; (2) a more rigorous criterion of change in at least three areas of family functioning, based on the assumption that more pervasive change will have more lasting influence on child development. Application of the first criterion found that 75% of early family focused intervention studies showed a successful outcome. Application of the latter criterion found that 50% showed a successful outcome. Further, there were no significant differences between successful and unsuccessful studies as to target group or type of intervention. The review suggests that early intervention targeted at family functioning is effective and that a more pervasive and sustained effect is likely if the intervention includes at least 11 or more contacts over at least a 3-month period.

Stability and change in husband-wife adaptation and the development of the positive parent-child relationship☆

Abstract Previous research has shown considerable stability in the quality of the husband-wife adaptation from prebirth to 2 years of age as well as a consistency in the mutual influence of the positive marital relationship and the positive parent-child relationship. This study examines if within this overall consistency there are different patterns of marital adaptation and interaction with the infant during the first 2 years of life. Using child expectation of being cared for, parent responsiveness to need, child sense of separate self, and parents encouragement of effective autonomy as the indices of the positive parent-child relationship, it was found that by 24 months, three marital patterns were associated with a more positive family development: couples consistently high in their adaptation, those showing an initial decrease followed by an increase, and those showing an increase. It was also found that the optimal patterns of marital adaptation to the firstborn were anticipated by prebirth measures of the mothers capacity for positive relationships and adaptation-competence. The optimal patterns in turn anticipated the positive 48-month development of parent-child mutuality and psychological separateness.

Pre- and postnatal antecedents of a home-visiting intervention and family developmental outcome

This is a study of the pre- and postnatal antecedents of select indices of 6 to 24 months mother-child and child social-emotional development. The following hypotheses guided the study: 1. That a mother who is secure before the birth of her child will be more involved in the work of the home-visiting intervention, and will by child age 24 months be more responsive to the needs of her child, encourage the autonomy of her child, and use verbal and positive forms of control. In this relationship context, the 2 year-olds would expect to be cared for, show more autonomy, and respond positively to the mothers control. 2. That in a regression mode of analysis, the following five antecedents will be additional predictors of the 2 year outcome: (a) the 1-month mother responsiveness and the infant irritability, (b) the 6 month mothers partner and family support, and (c) the mothers involvement in the work of the intervention in the 7-to 12-months period. Repeated measures analysis of variance and stepwise regression analysis showed that the mothers prebirth secure/autonomous state was associated with the outcome in the 6- to 24-month period and her involvement in the work of the intervention, and that the latter was consistently a significant antecedent of the 24-month outcome. The implications of outcome being anticipated by both family characteristics and the mothers involvement in the intervention are discussed.

Pre- and post-birth antecedents of 3- and 4-year-old attention, IQ, verbal expressiveness, task orientation, and capacity for relationships

Abstract The general hypothesis guiding this research is that certain preschool behaviors such as sustained attention are predominantly anticipated by pre-birth parent and early infant characteristics, whereas other behaviors such as positive parent-child mutuality are shaped by both earlier and concurrent influences. It was found that variations in the childs 36-month attention, 36-month verbal expressiveness, and 48-month verbal IQ all correlated significantly with the concurrent parent stimulation of cognitive and verbal experiences, but that when the influence of certain pre-birth and early postnatal variables was allowed in a path analysis, the concurrent correlations were no longer significant. For all three of these preschool behaviors, the mothers pre-birth verbal IQ was a significant influence. By contrast, for the childs 48-month modulation of aggression, the significant correlation with the concurrent parent transaction remained even after the pre-birth and postnatal characteristics had been allowed in the path analysis.

Marital adaptation, divorce, and parent–infant development: A prospective study

In this prospective study of divorce in the first 4 years of life we have shown that previous marital patterns anticipate the occurrence of divorce and influence the response to that event. Most of the divorces occurred in marriages that were consistently low in satisfaction or decreased in satisfaction from birth on. The family response to the event differed. The continuing effort at conflict resolution and the fact that differing levels of adjustment are reached at different time points are suggested by these reactions. For couples with an unsatisfactory marriage from late pregnancy through the first 2 years (consistently low), the immediate and sustained impact of divorce was to enhance the parents responsiveness to the needs of their infant and the infants expectation of being cared for. This was not true for couples decreasing from high to lower satisfaction in their adaptation. However, by child age 4, when all families had been divorced for 1 year, divorce versus no divorce was associated with a differential positive effect on teacher Q-sort ratings of the children for both marital patterns. Children who were from families where the parents were in conflict but did not divorce were more likely to externalize control, were more often uncontrolled, and were more anti- as opposed to prosocial. The implication of these findings are discussed.

Prebirth Prediction of the Quality of the Mother-Infant Interaction The First Year of Life

A predictive method involving the assessment of prebirth functioning and the anticipated quality of parenting is described and developed in order to facilitate identification of families at risk for future parenting. The association between these predictions and selected outcome criteria was studied in a representative sample of 46 families. Both the quantitative and qualitative results support the hypothesis that those families where mother and father were both characterized during the prebirth assessments as above average on adaptation-competence, capacity for relationships, and their positive view of their marriage, and who were expected to provide an optimal parent care environment, did in fact enhance a mother-infant relationship characterized by positive mutuality and responsiveness. It is assumed that the prebirth assessments and predictions, even though global in nature, effectively reflect a profile of family system and individual characteristics that are likely to enhance the development of positive mother-infant mutuality. We stress “enhance” because the characteristics of the infant, such as his or her irritability, are also going to influence the quality of the emerging transaction (Heinicke et al., 1985; Matheny, Riese, and Wilson, 1985).

Maternal style of emotional expression

Abstract This research describes the development of a semantic differential technique for rating nonverbal style of expressiveness in a population of expectant mothers. Nonverbal features (facial expression, gesture, voice quality) were emphasized as uniquely valid indices of emotional reactions towards parenthood and as the principal forms of interpersonal stimulation to which preverbal infants would be exposed. In the final trimester of pregnancy 46 primiparous mothers, representing a range of age, ethnic, and social-class backgrounds, were interviewed on videotape discussing childhood, marital adjustment, and expectations about parenthood. Interview selections were then presented to judges under three stimulus conditions: total videotape, videotrack, or audiotrack. Each mothers expressive style was rated on 12 bipolar adjective scales pertaining to affective tone, energy level, and involvement. Analyses demonstrated significant associations between nonverbal expressive style variables and measures of parent and child functioning over the first 2 years of life.

Continuity and Discontinuity of Task Orientation

Abstract Preschool task orientation and certain parent-child variables assessed during infancy predict school-age task orientation and academic achievement. There is, however, limited evidence of direct association between task-orientation variables in infancy and those assessed later. Research on attachment suggests one possible explanation of the link between variations in early parent-child interaction and later task orientation. Thus, a certain profile of mother-infant interaction is associated with the childs secure attachment to the mother in infancy and his or her ego resiliency, task orientation, and capacity for peer relations from 2 to 5 1/2.

The role of pre-birth parent characteristics in early family development☆

In designing early intervention studies, it is important to consider how the nature of pre-birth parent personality and marital characteristics influence family and child development. Descriptions of the development of three families show the specific impact of these pre-birth characteristics on the quality of the parent-infant transaction of infant soothability-responsiveness to need. Further focus is provided by linking the parents responsiveness to the infants need to the emergence and resolution of ambivalent feelings about caring for the infant. The variations in the resolution of ambivalent feelings and the parental personality and marital context of that resolution are explored. Three such configurations are illustrated: a competent mother whose ambivalence appeared in the context of difficulty with intimacy; a mother who struggled with intensely loving and hostile feelings generally; and the description of the emergence of maternal ambivalence in the context of difficulty in achieving psychological separation from her child. Finally, quantitative indices are used to compare these three instances of difficulty in resolving ambivalence with two families whose resolution of the ambivalence was optimal.