Exploring the experience and meaning of therapeutic relationships for mothers in a Parent-Infant Mental Health Service with infants who have been at the edge of care: An Interpretative Phenomenological Analysis

The prevalence and consequences of perinatal mental ill health has attracted more attention as a public health issue in recent years. Much attention has focused on the deleterious effects that parental mental health problems can have on parents themselves, as well as on the quality of the parent-infant relationship and their infants’ wellbeing and development. Parental mental ill health can be one of multiple factors that may contribute to the invocation of child protection processes and ultimately, for some families, child removal into the care system. Psychotherapeutic interventions aimed at ameliorating parental mental health or aspects of the parent-infant relationship are significant in the prevention of harm to children and child removals. A systematic literature review of studies investigating parents’ experiences of dyadic parent-infant interventions was conducted, which highlighted the importance of the therapeutic relationship within the work. Research has shown that engaging with families is particularly challenging in edge of care contexts however little is known from the parents’ perspectives about how they experience relationships with mental health professionals. The current research thus explored the experience and meaning of therapeutic relationships of mothers who had accessed a parent-infant mental health service for infants at the edge of care. Semi-structured interviews with four mothers were conducted and analysed using Interpretative Phenomenological Analysis. The analysis revealed the weight of complex relational and social trauma and their sequelae on the mothers. The mothers described the complexities they faced in developing a relationship with their therapist, as a result of these traumas. The results suggest the potential for the therapeutic relationship to be powerfully reparative, leading to positive change in the mothers’ identity and wider relationships. The findings are discussed in relation to extant literature, and recommendations for clinical practice and future research are suggested.