Attachment-based Prevention Program Involving Mothers and Fathers: Seven-year Post-Intervention Outcomes of a Randomized Control Trial

Abstract

The effects of a holistic attachment-based primary prevention program (SAFE), which is aimed at fathers and mothers during the transition to parenthood, were assessed over the 7-year post-intervention follow-up of a randomized control trial. A non-clinical German sample was included in the trial (fathers: n = 58, mothers: n = 71; children: n = 72). The children’s mean age was 7.30 years (SD = 0.41) and their attachment representations were assessed using a doll play procedure. Among the group of insecure mothers (n = 58), significantly more children (50%) in the SAFE group displayed a secure attachment representation compared to the control group (25%). No children of mothers with unresolved trauma displayed a disorganized attachment representation. In the parent domain, the increase in couple discord over time perceived by the SAFE mothers was significantly lower than that for the mothers in the control group. Furthermore, mothers in the SAFE group reported significantly higher partnership quality than the control mothers. The perceived benefits of the programs were significantly higher, in multiple domains, among SAFE fathers and mothers compared to control parents. The effect sizes were medium to large. Even after 7 years, program participation continues to have a positive impact on the children, and their fathers and mothers. The most important implication of this study for clinical practice is the need to support mothers with insecure or unresolved trauma in order to promote healthy child development. In addition, we think that it is important to support both parents during the transition to parenthood. TRN: DRKS00017050 (retrospectively registered, March, 28th 2019).