Watch, Wait and Wonder DownUnder

Research

 

The evaluation compared the Watch, Wait and Wonder Intervention with psychodynamic Parent-Infant Psychotherapy [PPT], with a random allocation of families to the two treatments.  67 dyads aged from 10-30 months were involved in the first study [pre and post treatment evaluation], and 58 of these dyads were re-evaluated 6 months after treatment ended. WWW  improved infant developmental functioning, emotion regulation, and attachment security; and enhanced parental sensitive responsiveness, confidence and feelings of efficacy.

 

Post-Treatment both treatments resulted in a reduction in the presenting problems of the  infants, increased maternal confidence in their capacity to manage parenting problems and decreased stress associated with parenting. Mothers were less intrusive and there was less conflict in the infant-mother play interactions.

There was a significant shift toward a more organised or secure attachment relationship[Strange Situation Procedure SSP] in the infants receiving the Watch, Wait and Wonder intervention. This group also showed significant improvements in cognitive development and increased capacity to become engaged in cognitive tasks. Their parents were significantly less depressed and reported more satisfaction and effectiveness in their parenting than mothers receiving the PPT.

Cohen N., Muir E., Lojkasek M., Muir R., Parker C., Barwick M. and Brown M. [1999]       Watch, Wait, and Wonder: Testing the effectiveness of a new approach to mother-infant psychotherapy Infant Mental Health Journal; 20, 429-451

Six Month Follow-up results indicated that the positive effects observed from the beginning to the end of treatment in both treatment groups in infant symptoms, parenting stress, and mother–infant interaction were maintained or improved further. Interestingly, between the post-treatment to follow-up period the PPT group also showed gains with decreased maternal depression, gains in infant cognitive development and emotion regulation, and improved infant–mother attachment.

Thus, for these variables it would be more accurate to say that the outcomes were similar for the two treatment groups but change emerged at a different pace.

Nevertheless, an advantage persisted in the Watch, Wait and Wonder intervention group in relation to mothers’ comfort dealing with infant behaviours and their ratings of parenting stress which improved more in this group from the end of treatment to follow-up.

Thus, “all roads lead to Rome” [Stern, 1995] but taking some roads takes less time than others [N Cohen, M Lojkasek and E Muir; 1996].

Cohen N., Muir E., Lojkasek M., Muir R. and Parker C. [2002] Six-month follow-up of two mother-infant psychotherapies: Convergence of therapeutic outcomes. Infant Mental Health Journal; 23, 4, 361-380

There is a need for further research into the Watch, Wait and Wonder Intervention and considerable interest in this. One of the steps towards further research is the comprehensive training of clinicians so that there is workforce capacity for implementing the intervention with fidelity and reliability.