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Randomized control trial report on the effectiveness of Group Attachment-Based Intervention (GABI©): Improvements in the parent–child relationship not seen in the control group

Published online by Cambridge University Press:  13 February 2019

Howard Steele ,
Anne Murphy ,
Karen Bonuck ,
Paul Meissner  and
Miriam Steele
Howard Steele*
Affiliation:
Psychology Department, New School for Social Research
Anne Murphy
Affiliation:
Einstein College of Medicine Montefiore Medical Center
Karen Bonuck
Affiliation:
Einstein College of Medicine Montefiore Medical Center
Paul Meissner
Affiliation:
Montefiore Medical Center
Miriam Steele
Affiliation:
Psychology Department, New School for Social Research
*
Address correspondence and reprint requests to: Howard Steele, New School for Social Research, Psychology Department, NSSR, 80 Fifth Avenue, New York, NY 10011; E-mail: [email protected].
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Abstract

This paper reports on a randomized control trial involving children less than 3 years old and their mothers who were regarded at risk of maltreating their children by referral agencies. Mothers’ risk status derived from a heavy trauma burden (average exposure over the first 18 years of their lives to 10 possible adverse childhood experiences [ACEs] was >5), mental health challenges (15%–28% had experienced a prior psychiatric hospitalization), and prior removal of a child to foster care (20%). Mothers were randomly assigned to either a widely used parenting class known as Systematic Training for Effective Parenting (STEP) or the Group Attachment-Based Intervention (GABI), a multifamily 26-week treatment. The resulting mother–child pairs available for consideration in this baseline versus end-of-treatment report were 35 families in the STEP arm and 43 families in the GABI arm. The focus of this paper is the outcome measure of observed parent–child relationship assessed with the Coding of Interactive Behavior (Feldman, 1998) collected at baseline and end of treatment. In comparison to STEP, results indicated that GABI was linked to significant improvements in maternal supportive presence and dyadic reciprocity, and significant declines in maternal hostility and dyadic constriction (proxies for risk of child maltreatment). These medium-to large-sized effects remained significant even after controlling for mothers’ prior ACEs in analysis of covariance procedures. In addition, two small interaction effects of ACEs by treatment type were found, underlining the need for, and value of, treatments that are sensitive to parents’ traumatic histories.

Keywords

adverse childhood experienceschild maltreatmentCoding Interactive BehaviorGroup Attachment-Based Intervention (GABI)randomized control trialSteps Toward Effective Parenting (STEP)
Type
Special Section Articles
Information
Development and Psychopathology , Volume 31 , Special Issue 1: The effect of maltreatment experiences on maltreating and dysfunctional parenting: A search for mechanisms , February 2019 , pp. 203 - 217
Copyright
Copyright © Cambridge University Press 2019 

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Footnotes

This research is supported by Health Resources and Services Administration Grant R40MC23629.

We want to thank the participating families in the intervention work whose dedication to improving their relationships with their children was essential to the reported work. We also want to thank a great number of gifted MA and PhD students pursuing clinical psychology studies at the New School for Social Research who helped with data collection and coding. Many are now practicing clinicians whose observational skills were honed in part through assistance with the work reported here. They include Jordan Bate, Kelsey Armusewicz, and Jeana DeMairo. In respect of the data reported on in this paper, postdoctoral researcher Vered Bar On (V.B.) and Adella Nikitiades (A.N.) are to be thanked for leading the CIB coding groups. Lead GABI therapists were Anne Murphy and Brooke Allman Bubbico. The original research work included in this paper was part of a presentation made by Howard Steele and Miriam Steele as Reiss-Greenberg 2019 Chairs, an endowed chair of the Reiss-Davis Child Study Center & Institute.

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