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Teams supporting and strengthening relationships between babies and their carers

What are specialised parent-infant relationship teams?

Specialised parent-infant relationship teams are multi-disciplinary teams with expertise in supporting and strengthening the important relationships between babies and their parents or carers.

Teams work with babies and their primary caregivers, including parents, foster carers, grandparents or others who may be playing this role. In our work, when we refer to parents, it is shorthand for this wider group.

Parent-infant relationship teams:

  • Can help parents to overcome difficulties
  • Build on existing parenting strengths
  • Develop new capacities to provide the sensitive, responsive and appropriate care that their babies need to thrive

Parent-infant teams generally work at two levels:

  • They are expert advisors and champions for parent-infant relationships. They use their expertise to help the local workforce to understand and support parent-infant relationships, to identify issues where they occur and take the appropriate action. This happens through offering training, consultation and/or supervision to other professionals and advice to system leaders and commissioners.
  • They offer direct support to families. This includes targeted work with families experiencing early difficulties, and specialist therapeutic work with families experiencing severe, complex and/or enduring difficulties in their early relationships, where babies’ emotional wellbeing and development is particularly at risk.

These two tiers of activity mean that, when specialised parent-infant relationship teams are functioning effectively, and embedded within their local system, they can help to promote healthy relationships for all babies in their locality through working with other services, and offer early and effective intervention to those most at risk.

How do you define a specialised parent-infant relationship team?

There are currently 29 specialised parent-infant relationship teams in the UK, which collectively form the Parent-Infant Network.

There is local variation in:

  • How teams are constituted and commissioned
  • Which interventions they offer
  • Whether they work with particular needs or populations.

All teams include at least one and often several highly-experienced psychologists or psychotherapists with specific expertise in parent-infant relationships. There are a number of characteristics that all teams have in common:

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They are ideally multidisciplinary teams, which include highly skilled mental health professionals such as clinical psychologists and child psychotherapists, with expertise in infant and parent mental health and in supporting and strengthening the important relationships between babies and their parents or carers

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They are experts and champions. They use their expertise to help the local workforce to understand and support all parent-infant relationships, to identify issues where they occur and take the appropriate action. This happens through offering training, consultation and/or supervision to other professionals and advice to system leaders and commissioners.

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They offer direct support for families who need specialised help. This includes targeted work with families experiencing early difficulties whose needs cannot be met by universal services alone, and specialist therapeutic work with families experiencing severe, complex and/or enduring difficulties in their early relationships, where babies’ emotional wellbeing and development is particularly at risk.

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They assess families and offer individualised programmes of support to meet their needs drawing on a toolkit of both professional practice and evidence-based programmes.

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Their focus is on the parent-infant relationship. They do not work only with an individual child or parent(s) but with the dyad or triad (although there may be particular sessions in which parents see a therapist on their own).

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There is a clear referral pathway to enable families who need support to access the service. Families are referred because of concerns about difficulties in their early relationships, which is putting or could put babies’ emotional wellbeing and development at risk. Unlike other mental health services there does not need to be a clinical diagnosis in the adult or child for families to be eligible for the service.

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They accept referrals for children aged two and under and their parent(s). Some work from conception, others from birth. (Some services see older children too, and some are currently expanding to reach other preschool children, up to the age of four).

What makes specialised parent-infant teams different from other services?

Anyone who works with families during the first 1001 days can help to protect and promote babies’ emotional wellbeing, and to support early relationships.

Many professionals in the public, private and voluntary sector have developed a specialist expertise in babies’ emotional wellbeing and offer interventions, including evidence-based programmes, to support parent-infant relationships.

For example:

  • Health visitors can play a particularly important role as they work with every family during this important period. Some health visiting services have specialist infant mental health visitors who offer interventions to support families who need additional help.
  • Some CAMHS services have time dedicated to working with children under two, although not all of these focus on the parent-infant relationship.
  • Other services may have professionals who have the expertise but not the time or mandate to offer families’ therapeutic support.

These are all important parts of the ecosystem that supports babies’ emotional wellbeing but they are insufficient on their own to provide the same therapeutic intensity of specialised, multi-disciplinary teams and often don’t have capacity to support system-wide change.

Why do we need specialised parent-infant relationship teams?

The first 1001 days of life, from conception to age two, is a time of unique opportunity and vulnerability. It is a period of particularly rapid growth, when the foundations for later development are laid.

During this time, babies’ brains are shaped by the interactions they have with their parents. The evidence is clear: at least one secure, responsive relationship with a consistent adult is a vital ingredient in babies’ healthy brain development.

Persistent difficulties in early relationships can have pervasive effects on many aspects of child development, with long term costs to individuals, families, communities and society.

During this period, babies are unable to talk about their feelings and needs, but communicate these in different ways. They are completely dependent on adults to survive. Therefore, work with babies is in the 1001 days is different from work with older children and requires a specific set of competencies:  practitioners must have a deep understanding of child development and have the ability to read babies’ pre-verbal cues.

They need the ability to work with parents, babies and their relationships. This is skilled work that requires specialist expertise. It is also true preventative work: acting early to prevent potential harm to babies’ emotional wellbeing and later mental health.

The unique opportunities and challenges during the first 1001 days, and the need for practitioners to have specific expertise to work effectively with families during this period, create a strong case for the existence of specialised parent-infant relationship teams.

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