Minding the Baby: qualitative findings on implementation Summary of findings from an early intervention programme designed to enhance a mother's relationship with her baby

Woman holding a baby looking at a woman and a manMinding the Baby (MTB) is a mentalisation-based preventative parenting programme. Developed in the US, it promotes secure parent-child attachment relationships. It is targeted at disadvantaged families where the mother is under 25 and has additional and complex needs. It is an inter-disciplinary programme which involves visits from a health and social work practitioner. It starts in the third trimester of pregnancy and lasts until the child is two-years-old.

The NSPCC is delivering MTB as a pilot service in three UK sites. This report, by researchers from University College London, summarises qualitative findings from the first pilot cohort. It focuses on practitioners' experiences of using the MTB model and parents' experiences of receiving the service. It is part of our Impact and evidence series.

Authors: Lucy Grayton, Phebe Burns, Nancy Pistrang and Pasco Fearon
Published: May 2017

Parents identified the following positive changes brought about by their involvement in MTB:

  • their parenting skills improved through learning about the baby's development and understanding more about baby's behaviour and how to manage it
  • they felt more confident in caring for their baby
  • they felt their well-being improved and that practitioners helped them to manage their personal difficulties.

Parents identified the following features of the programme which helped them engage and brought about change:

  • it was flexible and tailored to their individual needs
  • it was collaborative – work focused on the mother and baby together rather than just the baby
  • they received good information and guidance
  • they received practical help with caring for baby and sorting out financial and housing difficulties.

Parents also valued the following characteristics and qualities of practitioners delivering the programme:

  • they trusted them and, in turn, were trustworthy
  • they were non-judgemental and supportive
  • they were relaxed and open.

Practitioners identified features of the programme which enabled them to engage parents and work effectively to bring about change:

  • they could build strong relationships with mothers at an early stage – ideally before their baby is born
  • they could give mothers a different, more positive experience of relationships
  • it was helpful to be paired with another professional who acts as a sounding board and offers support
  • they were really able to get to know and understand mothers – their history and attachment style, how they make sense of the world
  • they could tailor the programme to mothers' existing needs and capabilities rather than have any expectations about where they should be at
  • the programme offered supervision which validated practitioners' emotional experiences and, in turn, helped them to understand mothers' emotional experiences.

Practitioners experienced the following challenges engaging families and delivering MTB:

  • many of the mothers in the programme presented with complex needs and difficulties (such as past experience of abuse and neglect) and found it challenging to engage in reflective work
  • family relationships (in particular grandmothers and fathers) could be a source of great support but could also hinder a mother's ability to engage in the programme
  • families struggled to engage when they were facing challenges around finances and housing
  • practitioners' had concerns about getting reflective functioning right and the emotional impact of the work
  • there could be tensions when working with other agencies – particularly with regard to risk assessment and management
  • there were also challenges around building trusting relationships with parents and then potentially having to report a safeguarding concern.
Summary 5
Introduction 7
What is Minding the Baby? An overview of programme elements and theory of change 8
Results of the qualitative evaluation of Minding the Baby 10
Part One: Practitioners 14
Part Two: Parents' perspectives 39
Conclusions 51
References 54

"Just knowing that they are there for you if you need any help, if you have any questions or anything ... they are quite flexible as well, they might just give me a phone if they are sometimes even in the area [and then] they can just pop up or whatever… If I have any questions I need to ask … I can just phone them and ask and they will be there for me."

Please cite as: Grayton, L., Burns, P., Pistrang, N., Fearon, P. (2017) Minding the baby: qualitative findings on implementation from the first UK service. London: NSPCC.

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