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Published in: Trials 1/2019

Open Access 01-12-2019 | Study protocol

Video feedback intervention to enhance parental reflective functioning in primary caregivers of inpatient psychiatric children: protocol for a randomized feasibility trial

Authors: Fanny Leyton, Marcia Olhaberry, Rubén Alvarado, Graciela Rojas, Luis Alberto Dueñas, George Downing, Howard Steele

Published in: Trials | Issue 1/2019

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Abstract

Background

Children requiring hospitalization for psychiatric care have serious disorders, high use of psychotropic medication, and frequent readmissions. The development and implementation of therapies focused on incorporating primary caregivers or attachment figures is necessary for working with children with severe psychiatric disorders. Mentalization or parental reflective functioning (PRF) is the ability of parents to understand their children’s behaviors as an expression of internal emotional states and act accordingly to help them regulate their emotions; in this way mentalizing is a key component of sensitive parenting. Video-assisted therapies have proven to be effective in promoting change in parent–child relationships. The majority of studies have been carried out with mothers of pre-school children and in an outpatient setting. Video intervention therapy (VIT) is a flexible manualized therapy, which allows the intervention to be individualized to the context where it is applied, according to the needs and resources of the people who participate in it. The objective of the study is to evaluate the feasibility and acceptability of applying VIT to improve the PRF of the parents as primary carers of children hospitalized in a psychiatric service.

Methods

This is a pilot randomized, single-masked (outcome assessor) study with a qualitative component. It will involve a block randomization procedure to generate a 2:1 allocation (with more people allocated to the intervention arm). The intervention consists of four modules; every module has both one video-recorded play session and one VIT session per week. People assigned to the control group will receive treatment as usual plus weekly play sessions. Feasibility and acceptability of the study will be quantitatively and qualitatively assessed. Evaluation of the caregivers will include assessments of PRF, wellbeing and personality structure; assessments of children will include parent-ratings and clinician-ratings of symptomatology and general functioning. After every video feedback (VF) session, PRF, the caregiver’s wellbeing and children’s general functioning will be reassessed.

Discussion

This study will contribute to the currently scarce evidence on how to provide family attachment-based interventions in a child inpatient psychiatric unit. It will also inform the design and implementation of a future randomized clinical trial.

Trial registration

ClinicalTrials.gov, NCT03374904. Registered on 14 December 2017 (retrospectively registered).
Appendix
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Metadata
Title
Video feedback intervention to enhance parental reflective functioning in primary caregivers of inpatient psychiatric children: protocol for a randomized feasibility trial
Authors
Fanny Leyton
Marcia Olhaberry
Rubén Alvarado
Graciela Rojas
Luis Alberto Dueñas
George Downing
Howard Steele
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3310-y

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