An intensive perinatal mentalisation-based intervention for women at risk of child removal and the role of restorative relationships

Abstract

Pregnant women with a history of child removal are at greater risk of being found unsuitable to care for their new babies. Neglect, showing a lack of capacity to provide for the child's physical and/or emotional needs, is the most frequent reason why infants are removed from their parents' care. Parents with a history of child removal have often been themselves subject to maltreatment as children and suffer the sequelae of relational trauma which then becomes a barrier to establishing nurturing relationships with their own children. Attachment, and particularly mentalisation-based, parenting interventions focus on restoring relationships by developing parents' capacity to reflect upon their own internal mental experiences as well as those of the child, helping them to better understand themselves and their children. The DAISY programme is an intensive perinatal attachment and mentalisation-based intervention for pregnant women with a history of child removal, aiming to improve mothers' mentalising capacities and care proceeding outcomes. This article uses a case study to describe the programme's model and mechanisms of change. Additionally, we present preliminary observations about the programme's delivery and impact from the perspective of one of its practitioners.