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Effective preventive interventions to support parents of young children: Illustrations from the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD)

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Secure attachment relationships are essential for children’s current and later development. From attachment theory and research, it can be derived that sensitive parenting is the key to positive parent-child relationships. Is it possible to design effective interventions to enhance sensitive parenting? In this article, we review elements that are crucial for effective attachment-based interventions, and we proceed with illustrations from the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). We describe how this intervention program was developed, how it has been implemented in practice in different types of families and in daycare settings, and how effective the program is. We conclude that intervention programs like the VIPP-SD could play an important role in the community by serving families in need of parenting support.
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Journal of Prevention & Intervention in the Community
ISSN: 1085-2352 (Print) 1540-7330 (Online) Journal homepage: http://www.tandfonline.com/loi/wpic20
Effective preventive interventions to support
parents of young children: Illustrations from the
Video-feedback Intervention to promote Positive
Parenting and Sensitive Discipline (VIPP-SD)
Femmie Juffer, Estelle Struis, Claudia Werner & Marian J. Bakermans-
Kranenburg
To cite this article: Femmie Juffer, Estelle Struis, Claudia Werner & Marian J. Bakermans-
Kranenburg (2017) Effective preventive interventions to support parents of young children:
Illustrations from the Video-feedback Intervention to promote Positive Parenting and Sensitive
Discipline (VIPP-SD), Journal of Prevention & Intervention in the Community, 45:3, 202-214, DOI:
10.1080/10852352.2016.1198128
To link to this article: https://doi.org/10.1080/10852352.2016.1198128
Published with license by Taylor & Francis©
2017 Femmie Juffer, Estelle Struis, Claudia
Werner, and Marian J. Bakermans-
Kranenburg
Published online: 22 Jun 2017.
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JOURNAL OF PREVENTION & INTERVENTION IN THE COMMUNITY
2017, VOL. 45, NO. 3, 202–214
https://doi.org/10.1080/10852352.2016.1198128
Effective preventive interventions to support parents
of young children: Illustrations from the Video-feedback
Intervention to promote Positive Parenting and Sensitive
Discipline (VIPP-SD)
Femmie Juffer, Estelle Struis, Claudia Werner, and Marian J. Bakermans-
Kranenburg
Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands
ABSTRACT
Secure attachment relationships are essential for children’s
current and later development. From attachment theory and
research, it can be derived that sensitive parenting is the key to
positive parent-child relationships. Is it possible to design effective
interventions to enhance sensitive parenting? In this article, we
review elements that are crucial for effective attachment-based
interventions, and we proceed with illustrations from the
Video-feedback Intervention to promote Positive Parenting and
Sensitive Discipline (VIPP-SD). We describe how this intervention
program was developed, how it has been implemented in
practice in different types of families and in daycare settings, and
how effective the program is. We conclude that intervention
programs like the VIPP-SD could play an important role in the
community by serving families in need of parenting support.
KEYWORDS
Attachment-based
intervention; parent-child
relationships; positive
parenting; sensitive
discipline; sensitive
parenting; video feedback
Secure attachment relationships are essential for children’s current and later
development. From attachment theory and research, it can be derived that
sensitive parenting is the key to positive parent-child relationships. Is it
possible to design effective interventions to enhance sensitive parenting? In
this article, we review elements that are crucial for effective attachment-based
interventions, and we proceed with illustrations from the Video-feedback
Intervention to promote Positive Parenting and Sensitive Discipline
(VIPP-SD). We describe how this intervention program was developed,
how it is implemented in practice, and how effective it is.
The importance of attachment security for children’s development
Young children prototypically use their parent as a secure base: Ideally the
parent provides support and comfort when they are anxious or distressed,
none defined
CONTACT Femmie Juffer juffer@fsw.leidenuniv.nl Centre for Child and Family Studies, Leiden University,
P.O. Box 9555, Leiden 2300 RB, The Netherlands.
Published with license by Taylor & Francis © 2017 Femmie Juffer, Estelle Struis, Claudia Werner, and Marian J. Bakermans-Kranenburg
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License
(http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any
medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
and the parent provides encouragement and empathy when they explore and
discover the world. John Bowlby and Mary Ainsworth, the founders of attach-
ment theory (Ainsworth, Blehar, Waters, & Wall, 1978; Bowlby, 1982), found
that children differ in how they trust their parent to serve as a secure base.
Securely attached children expect their parent to respond to their needs
adequately and therefore openly express their feelings and distress. Insecurely
attached children, however, either try to minimize their negative emotions
such as anxiety or sadness (insecure avoidant attachment), or they strongly
focus on these negative emotions (insecure ambivalent attachment).
Insecurely attached children do not seem to be assured of the support of their
parent in situations where they badly need such support. Secure and insecure
avoidant/ambivalent attachment relationships are evaluated as organized
patterns of attachment, and insecure disorganized attachment (Main &
Solomon, 1990) is characterized by fear of the parent (for a more extensive
overview of patterns of attachment, see Van der Voort, Juffer, & Bakermans-
Kranenburg, 2014).
Why are some children securely attached to their parents, whereas in other
cases children develop an insecure relationship with their parent? According
to attachment theory the experiences of secure and insecure children differ:
Secure children usually have sensitive parents, in contrast to insecure children
who tend to have less sensitive parents. Ainsworth defined parental sensitivity
as the ability to accurately perceive and interpret the child’s signals and
respond to these signals in an adequate and prompt way (Ainsworth et al.,
1978). Secure children have experienced that their parents observed and
understood their distress, and their needs were met with adequate solutions
(for example comfort). Insecurely attached children usually have less positive
and satisfying experiences with their parents.
Secure attachment is not only important for the current well-being of
children, but also for their later development. Three recent meta-analyses
confirmed the importance of attachment security for children’s later social
competence (Groh et al., 2014), for externalizing behavior problems (Fearon,
Bakermans-Kranenburg, Van IJzendoorn, Lapsley, & Roisman, 2010), and
internalizing problems (Groh, Roisman, Van IJzendoorn, Bakermans-
Kranenburg, & Fearon, 2012). These outcomes indicate that securely attached
children show more social competence, and fewer externalizing and interna-
lizing behavior problems than insecurely attached children.
Do attachment-based interventions work?
Concluding that secure attachment provides the child with the advantage of a
secure base during childhood, yet it also sets the stage for later positive
child development raises the question whether it is possible to promote sensi-
tive parenting and positive parent-child relationships. In a comprehensive
JOURNAL OF PREVENTION & INTERVENTION IN THE COMMUNITY 203
meta-analysis including 70 attachment-based intervention studies with 88
intervention effects (Bakermans-Kranenburg, Van IJzendoorn, & Juffer,
2003) we found evidence for the parental sensitivity hypothesis formulated
in attachment theory. Attachment-based interventions appeared to be able
to enhance sensitive parenting and children’s attachment security, while the
causal role of sensitivity for attachment was confirmed. More successful inter-
ventions in terms of enhanced parental sensitivity resulted in larger increases
in children’s attachment security (Bakermans-Kranenburg et al., 2003).
The series of meta-analyses also contributed to the knowledge of how we
should deliver an attachment-based intervention. The title of the meta-
analysis, ‘Less is more,’ refers to the meta-analytical outcome that relatively
brief interventions (up to 16 sessions) were more effective than longer inter-
ventions to enhance parental sensitivity. Another meta-analytical outcome
concerned video feedback. Intervenors using video feedback make video
recordings of the parent-child interaction and show them to the parent,
accompanied with comments and feedback. The meta-analysis revealed that
interventions with video feedback were more successful in improving
sensitive parenting than interventions without this method.
Promoting sensitive parenting and sensitive discipline with VIPP-SD
Our series of meta-analyses described previously resulted in several evidence-
based guidelines for the characteristics of attachment-based interventions.
Positive parent-child relationships can be supported by promoting sensitive
parenting, interventions should be relatively brief, and video feedback is an
effective tool to enhance sensitive parenting. Based on attachment theory
(Bowlby, 1988) and convergent with the meta-analytical outcomes of effective
attachment-based interventions (Bakermans-Kranenburg et al., 2003), we
designed the Video-feedback Intervention to promote Positive Parenting and
Sensitive Discipline (VIPP-SD). Here we describe how we developed this inter-
vention at Leiden University, The Netherlands, and we elaborate on the aims
and themes of the VIPP-SD, and the implementation in various types of
families and daycare settings. For the evaluation of the VIPP-SD, we present
the effectiveness outcomes with respect to sensitive parenting and we discuss
children’s differential susceptibility to improved parenting after an intervention.
Development of the VIPP-SD program
When we started our intervention research in the 1980s, Lambermon and
Van IJzendoorn (1989) found that providing parents with a videotaped role
model—that is, showing videos of an unknown mother interacting in a very
sensitive way with her child—did not work. Apparently, parents have
problems to identify with a parent or child model as portrayed on the video,
204 F. JUFFER ET AL.
and consequently they may not feel encouraged to integrate the modeled
parenting behavior in their own daily life. With the method of video feedback
parents themselves are recorded interacting with their own child and they are
shown these video recordings afterwards. When we started to use video
feedback with parents, as opposed to showing them video-taped models, we
discovered that problems for parents to identify with the videovideotaped
situation did not occur. Video feedback may thus serve as a mirror to see
and reflect on one’s own parenting behavior, supported by an intervenor
who is showing the video to the parent, providing feedback to relevant aspects
of the parent-child interaction.
Video feedback was used in a first version of the VIPP and tested in a
randomized controlled trial (RCT) in a sample of 130 adoptive families with
infants internationally adopted at a very young age (at an average of 10 weeks)
(Juffer, 1993). The intervention was implemented between the child’s age of 9
and 12 months in three home visits, using video feedback to support sensitive
parenting. Compared to the control group, the intervention resulted in
enhanced sensitive parenting in the adoptive mothers while the adopted
children were less likely to be classified as insecure disorganized attached
(Juffer, Bakermans-Kranenburg, & Van IJzendoorn, 2005).
Subsequently, we extended the intervention to other types of families and
settings and to a broader age range of children (currently 0 to 6 years), and
we described the intervention in a protocol with six home visits, standardized
themes and a fixed structure (Juffer, Bakermans-Kranenburg, & Van
IJzendoorn, 2008, 2015). To also accommodate the intervention to the
demands of parenting a child beyond infancy, we extended the VIPP with
an extra module on Sensitive Discipline (resulting in the VIPP-SD inter-
vention) (Juffer et al., 2008; Mesman et al., 2008). Currently, VIPP without
the Sensitive Discipline module can be implemented with parents and infants
before the first birthday, yet VIPP-SD is recommended to be used with
parents and children after the first birthday. The VIPP part in the VIPP-SD
program follows exactly the same protocol as in the VIPP program without
the Sensitive Discipline module. VIPP/VIPP-SD can be used as the only inter-
vention, but it can also be combined with another or longer treatment.
The VIPP-SD is implemented in the home setting, because the intervention
focuses on filming and reinforcing naturally occurring parent-child interac-
tions in daily situations (Juffer et al., 2008). Also, parents may find it easier
to integrate new behaviors in their daily life when these behaviors have
been practiced in the home, and the home setting usually is a safe place to
receive personal feedback. In addition, parents with children in the preschool
age may encounter difficulties in traveling back and forth to health services or
clinics and they may be more likely to cancel visits for these reasons. By
offering the VIPP-SD at home, we increase the chance that parents complete
the entire program. To date, in research and practice dyadic parent-child
JOURNAL OF PREVENTION & INTERVENTION IN THE COMMUNITY 205
interactions - mostly mother-child interactions - have been targeted, although
the first studies on VIPP-SD with fathers (Lawrence, Davies, & Ramchandani,
2013) as well as parent couples are in progress. In the couples study, the
VIPP-SD includes situations of triadic interaction between child and both
parents.
Aims and theoretical background of the VIPP-SD
In the VIPP-SD we aim at enhancing positive parenting—particularly sensi-
tive parenting—to promote positive parent-child-relationships, and sensitive
discipline to reduce children’s behavior problems. For the component of
sensitive parenting the intervention is based on attachment theory (Bowlby,
1982, 1988), and the structure of the intervention is a direct translation of
Ainsworth’s definition of parental sensitivity (Ainsworth et al., 1978). In the
first intervention sessions, the focus is on the first part of the definition—
accurately observing the child’s behavior and interpreting child signals in a
correct way—by encouraging and supporting the parent to observe the child’s
behavior and expressions. In the following intervention sessions, the interve-
nors also work on the second part of the sensitivity definition—adequately
responding to the child’s needs, for example comforting a crying child—by
reinforcing moments of sensitive parenting and explaining the relevance of
such moments.
The component of sensitive discipline in the VIPP-SD is based on the work
of Gerald Patterson (1982) on coercive cycles in families. Beyond infancy,
parents not only should respond sensitively to their children’s needs but also
teach their children rules and limits in an effective way. Coercive cycles in
families are characterized by noncompliant child behavior, followed by inef-
fective parental discipline, and resulting in escalating conflicts with the parent
ultimately giving in to the child (to stop the child’s increasing protest and
resistance). Patterson (1982) observed that in such cases the child ‘trains’
the parent to give in, and the child will challenge the parent’s rules again in
the future. To stop this coercive cycle Patterson (1982) suggested several ways
to promote effective discipline in parents and compliance in children: reinfor-
cing positive child behavior (for example by giving compliments or attention)
while ignoring negative child behavior (e.g., with a time-out). We integrated
Patterson’s ideas of parental discipline in the VIPP-SD and extended
this component with constructs from Hoffman’s (2000) work on inductive
discipline and empathy. Hoffman (2000) argued that children learn more
from inductive discipline than from authoritarian discipline styles.
Using inductive discipline, parents not only tell their children that they are
not allowed to do something but also why they should not do so. Also, in their
explanation of a command, prohibition or refusal the parents pay attention to
the perspective and feelings of the person who may be harmed by the child’s
206 F. JUFFER ET AL.
behavior. For example, the parent should not say “No, don’t hit!” but rather
something like: “No, do not hit because you will hurt him and he will be in
pain.” By paying attention to the emotions of other people, parents teach their
child empathy, that is, understanding and identifying with the perspective of
the other person (Hoffman, 2000).
Themes in the VIPP-SD program
Based on attachment theory (Bowlby, 1988) themes for sensitive parenting
were developed, and based on coercion theory (Patterson, 1982) and
Hoffman’s work themes for sensitive discipline were formulated (see
Table 1). As noted above, for sensitive parenting the structure follows
Ainsworth’s definition of sensitivity and in the first and second home visit
parents are supported to better observe their child’s behavior. By explaining
and showing on the video recordings the difference between exploration
and attachment behavior (Session 1), parents learn to understand when and
how their child needs them: being a secure base when the child needs support
and providing the child with opportunities to discover the world through
playing and learning.
Through ‘Speaking for the child’ (Carter, Osofsky, & Hann, 1991) the
parent is invited to verbalize the child’s behavior on the video recordings
(Session 2), thus practicing observational skills. In Session 3 sensitivity chains
are used to describe moments of positive interactions on the video recordings,
that is: a signal of the child (e.g., reaching for a toy), followed by a sensitive,
adequate response of the parent (giving the toy to the child), and the child’s
reaction (a happy smile to the parent). The intervenor explains that such
interactions are important for children because they will trust their parents
to attend to their needs and help them if necessary. In Session 4 moments
of shared emotions are highlighted, for example comforting a sad child. When
parents share their child’s positive and negative emotions, children learn that
they are allowed to show such feelings. During the last two booster sessions,
all sensitive parenting themes are repeated and integrated. Moreover, in these
booster sessions newly acquired parenting behaviors can be reinforced and
changes consolidated, while there is room to address possible concerns or
questions of the parent.
Table 1. Themes used in the VIPP-SD sessions.
Session Sensitive parenting Sensitive discipline
1. Exploration versus attachment behavior Inductive discipline and distraction
2. ‘Speaking for the child’ Positive reinforcement
3. Sensitivity chain Sensitive time-out
4. Sharing emotions Empathy for the child
5. Booster session Booster session
6. Booster session Booster session
JOURNAL OF PREVENTION & INTERVENTION IN THE COMMUNITY 207
For sensitive discipline, relevant themes are highlighted during the inter-
vention sessions. Parents learn to use more positive reinforcement (for
example by giving compliments for compliant child behavior) and ignore
challenging child behaviors. They are also encouraged to show and teach
the child empathy (for example by inductive discipline, see before).
Testing the VIPP-SD in various types of families and daycare settings
The VIPP/VIPP-SD program has been implemented and tested in various
types of (clinical) families and in daycare settings. The VIPP program, without
the Sensitive Discipline module, has been used with families adopting a baby
(see before), and in an RCT of 81 mothers screened on showing an insecure
adult attachment representation, often a result of difficult or cold childhood
experiences. To support sensitive parenting, mothers in the intervention
group received the VIPP program when their babies were between 6 and 9
months old. Compared to the control group, the mothers’ sensitive parenting
increased and the children showed fewer externalizing problems in the clinical
range at preschool age (Klein Velderman, Bakermans-Kranenburg, Juffer, &
Van IJzendoorn, 2006; Klein Velderman et al., 2006).
Whereas VIPP is used in families of infants (to the first birthday), VIPP
with the Sensitive Discipline module has been implemented in families with
children of one-year-old to currently 6 years of age. For example, VIPP-SD
was used in an RCT of 237 families of 1- to 3-year olds, screened on showing
elevated rates of externalizing behavior problems (such as aggression).
Compared to the control group, the mothers showed higher rates of sensitive
discipline after the intervention and the children showed less overactive beha-
vior (Van Zeijl et al., 2006). Overactive behavior refers to the narrowband
scale Overactive from the broadband syndrome Externalizing behaviors in
the Child Behavior Checklist (Achenbach & Rescorla, 2000). This scale
includes items indicating the child’s inclination for disruptive behavior
(e.g., cannot sit still, quickly shifts activity) (Van Zeijl et al., 2006).
VIPP/VIPP-SD has been tested in various clinical and at risk groups, such
as mothers with eating disorders (Stein et al., 2006), mothers screened for
insensitive parenting behavior (Kalinauskiene et al., 2009), parents of children
with autism (Poslawsky, Naber, Bakermans-Kranenburg, De Jonge et al., 2014;
Poslawsky, Naber, Bakermans-Kranenburg, Van Daalen et al., 2014), families
with poverty problems (Negrao, Pereira, Soares, & Mesman, 2014), and ethnic
minority families (Yagmur, Mesman, Malda, Bakermans-Kranenburg, &
Ekmekci, 2014).
VIPP-SD has also been adapted to be used in family childcare and daycare
centers (Groeneveld, Vermeer, Van IJzendoorn, & Linting, 2011; Werner,
Vermeer, Linting, & Van IJzendoorn, 2016). In this adaptation, the video
feedback intervention does not focus on one caregiver and one child but on
208 F. JUFFER ET AL.
one caregiver interacting with several children. Therefore, the method of
‘Speaking for the child’ was adapted to ‘Speaking for the children.’
Training opportunities to become a VIPP-SD intervenor are available in
English, Dutch, Spanish, and Italian, with manuals in the same language.
During the training, future intervenors learn how to record pertinent episodes
of parent-child interaction, how to prepare the video feedback by writing a
“script” with the comments to be made during the intervention visit, and
how to deliver the intervention in the home (or daycare center). Building a
supportive relationship with the parent (or caregiver) is considered one of
the crucial ingredients of the VIPP-SD program. In one of the VIPP-SD
studies we found that the alliance between the mother and intervenor indeed
predicted change in sensitive parenting (Stolk et al., 2008).
Effectiveness of the VIPP-SD program
Including 12 samples with 1,116 parents or caregivers in a meta-analysis of
VIPP/VIPP-SD studies (all RCTs), we computed an overall effect size of
Cohen’s d = 0.47, indicating that the VIPP/VIPP-SD program substantially
affected sensitive parenting in a positive way (see Juffer, Bakermans-
Kranenburg, & Van IJzendoorn, 2014, 2017). Recent outcomes have
confirmed the positive effect of the VIPP-SD on sensitive parenting (Green
et al., 2015; Negrao et al., 2014; Poslawsky, Naber, Bakermans-Kranenburg,
Van Daalen et al., 2014; Yagmur et al., 2014) and on sensitive caregiving in
daycare (Werner et al., 2016). There are also several VIPP-SD studies in
progress, for example with fathers (Lawrence et al., 2013), and with parents
with intellectual disabilities (Hodes, Meppelder, Schuengel, & Kef, 2014).
Interestingly, we also found intervention effects of the VIPP-SD at a
neurobiological level. In families with children screened for elevated rates
of externalizing behavior the intervention proved to be effective in decreasing
daily cortisol production in children with the DRD4 7-repeat allele (a variant
of the dopamine receptor gene that is associated with motivational and reward
mechanisms and ADHD in children), but not in children without the DRD4
7-repeat allele (Bakermans-Kranenburg, Van IJzendoorn, Mesman, Alink, &
Juffer, 2008). Moreover, VIPP-SD proved to be effective in decreasing exter-
nalizing behavior in the children with the DRD4 7-repeat allele. Focusing on
the parents who showed the largest increase in sensitive discipline after the
intervention, the decrease in externalizing behavior was strongest in children
with the DRD4 7-repeat allele, showing that they were indeed the most
susceptible to the change in their caregiving environment (Bakermans-
Kranenburg, Van IJzendoorn, Pijlman, Mesman, & Juffer, 2008).
Why would children with the DRD4 7-repeat allele profit more from the
VIPP-SD intervention than children without the DRD4 7-repeat allele?
Children with the DRD4 7-repeat may be more open to the rewards of their
JOURNAL OF PREVENTION & INTERVENTION IN THE COMMUNITY 209
parents’ positive discipline behaviors (e.g., receiving compliments). And
because these children need this emphasis on the reward value of parental
responses most, they may be the ones who gain most by enhanced sensitive
parenting. In the VIPP-SD parents learn to read their child’s signals promptly
and accurately, and are encouraged to extend their repertoire of behaviors.
Dopamine-related genes may be associated with differential intervention
effects because of the increased susceptibility of carriers of the DRD4 7-repeat
allele to changes in the environment for the better (Bakermans-Kranenburg &
Van IJzendoorn, 2011, 2015).
This first experimental test of (measured) gene by (observed) environment
interaction indicates that children may be differentially susceptible to
intervention efforts depending on their genetic make-up. According to the
evolutionary-based differential susceptibility hypothesis children vary in their
susceptibility to parental rearing, for better—when receiving sensitive care, or
improved sensitive parenting after a successful intervention—and for worse—
when receiving less optimal care (Belsky, Bakermans-Kranenburg, & Van
IJzendoorn, 2007;Van IJzendoorn & Bakermans-Kranenburg, 2012).
Focusing on sensitive parenting in preventive interventions
Young children need the support of their parent (or caregiver) as a secure
base, receiving adequate responses to their needs and signals of distress,
and encouragement for their exploration behavior. Secure children feel
assured of such support and the secure relationship with the parent provides
the child with optimal prerequisites for their later competence. Meta-
analytical evidence has shown that sensitive parenting is the key to positive
parent-child relationships, and that it is possible to enhance sensitive parent-
ing with attachment-based interventions. Examples of recent attachment-
based interventions confirm that it is indeed possible to promote positive
parent-child relationships, even in samples of maltreated children (Bernard
et al., 2012; Moss et al., 2011).
It should be noted that although a brief intervention such as the VIPP-SD
program presented in this article may successfully change sensitive parenting,
it is not a panacea for all parental or family problems. A useful framework is
to combine a brief intervention with another treatment module. For example,
in an RCT testing the VIPP in mothers with eating disorders, the mothers not
only received VIPP to support parent-child interactions during mealtime, but
also used a guided cognitive behavior self-help manual to address their eating
problems (Stein et al., 2006; Woolley, Hertzmann, & Stein, 2008).
According to the meta-analysis ‘Less is more’ (Bakermans-Kranenburg
et al., 2003), brief interventions with video feedback are the most promising
preventive interventions. With the growing availability of video equipment
the technique of video feedback has been developed into a powerful and
210 F. JUFFER ET AL.
accepted approach for treatment of families at risk (Juffer & Steele, 2014;
Steele et al., 2014). In the VIPP-SD program, video feedback is an essential
and vital element. With video feedback parents can be supported to observe
and understand their child’s behavior and to look at their own behavior,
supported by the helpful feedback of an intervenor. Given the effectiveness
of the VIPP-SD program in different types of families and in daycare settings,
intervention programs such as the VIPP-SD could play an important role in
the community by serving families in need of parenting support.
Funding
Femmie Juffer is supported by Wereldkinderen. Marian Bakermans-Kranenburg is supported
by the Netherlands Organization for Scientific Research (VICI grant).
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... It is a useful tool to encourage self-reflection and facilitate positive behaviour change (Fukkink, 2008). During the sessions, parent-child interactions are recorded, viewed and discussed with the parents (Juffer, et al., 2017b). The visual contribution provides an additional type of material to feed into wider discourse about the child's developmental and attachment needs (Fukkink, 2008). ...
... It is based on Bowlby's (1969) attachment theory and is both preventive and curative in that it aims to increase the sensitivity of caregivers and promote positive child-carer interactions (Juffer, Bakermans-Kranenberg and van IJzendoorn, 2017). In the more specific Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD), elements were added to improve the discipline strategies of mothers dealing with difficult child behaviour and so obviate further problems (Juffer, et al., 2017b). These additions were based on Patterson's Coercion Theory (1982) which posits that inconsistent parental disciplining of children, the absence of positive reinforcement of desired behaviour and/or the reinforcement of their undesirable behaviour (e.g. by giving in) encourage the development and persistence of externalising behavioural problems. ...
... *Based onJuffer, et al. (2017b). ...
Article
Foster children are known to be at high risk for developing attachment problems. Moreover, their associated behavioural problems can be a burden for the foster family and increase the risk of placement breakdown. A sensitive parenting style promotes a secure attachment which, in turn, can reduce the chance of difficulties arising and protect against placement disruption. Interventions using video-feedback of parent–child interactions offer a method of increasing parental sensitivity and improving the quality of the parent–child attachment. The intervention discussed in this article was part of a wider initiative, Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD), fashioned to promote sensitive parenting, secure attachment and a reduction in children’s behavioural problems. Its effectiveness has been shown for a variety of target groups. A variant of the approach was developed specifically for foster and adopted children, Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline – Foster Care/Adoption (VIPP-FC/A). This article discusses the design and delivery of the intervention and illustrates these with case material.
... Challenging behavior that insecure children respond with is a direct result of their lack of a sense of security, attachment to a caregiver, and prosocial behaviors (Gross et al., 2017). Insecure children require a secure attachment to a loving adult to improve their outcomes (Juffer, Struis, Werner, & Bakermans-Kraneenburg, 2017). Without having strong attachment could lead to the child following what others are doing, withdrawn behavior, and aggressive behaviors (Juffer et al., 2017). ...
... Insecure children require a secure attachment to a loving adult to improve their outcomes (Juffer, Struis, Werner, & Bakermans-Kraneenburg, 2017). Without having strong attachment could lead to the child following what others are doing, withdrawn behavior, and aggressive behaviors (Juffer et al., 2017). Insecure children experience the fear of not having a supportive adult, a sense of security, and attachment to a caregiver all of which can have long-term effects on children (Kim, Woodhouse, & Dai, 2018). ...
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The problem addressed in this basic qualitative study was understanding the underlying reasons for challenging behavior exhibited in preschool children who experience disruption in social bonds and trust following deployment of a parent. Many teachers and parents are challenged by the need to support these children during this stressful time and untreated stress can lead to long-term issues. The purpose of this study was to increase understanding of teacher and parent perspectives of challenging behavior exhibited in preschool children experiencing disruption in social bonds and trust following deployment of a parent. Interviews of 7 parents and 7 preschool teachers addressed 3 research questions about reasons for challenging behavior, and the disruption of social bonds and trust following a deployment. The conceptual framework for this study was the attachment theory of Bowlby and Ainsworth. Data were analyzed using a priori, open, and axial coding. Results indicated challenging behavior in preschool children following deployment is affected by the strength of the bond and level of trust a preschooler has with a caring adult. Most teachers and parents described the cause of disruption in social bonds as deployment for the reason for challenging behavior. Teachers believed that their strong relationship with preschoolers helps children feel safe and secure following parental deployment. Parents believed that a supportive environment with family and friends makes a positive difference when trust between the child and others is disrupted following parental deployment. Implications for positive social change include improved support strategies and positive outcomes for children that may result from new emphasis on support for social bonds and feelings of trust in children. Children’s challenging behavior may be alleviated when children of deployed parents feel more secure.
... Within this context, social support and peer-to-peer exchange may be also provided via online interventions [89], which gains special relevance during the pandemic. Furthermore, the use of video feedback may facilitate the observation of the child's as well as one's own behavior and thus provides a vital element to enhance preventive parenting programs [101]. Even though most preventive programs comprise psychoeducation elements, only few additionally provide opportunities for peer-to-peer exchange, specific interventions targeting parent-child interactions, and the use of video feedback. ...
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... There is an increasing interest in therapeutic interventions aimed at stimulating children's secure attachment development. Some of these interventions (e.g., VIPP-SD, Juffer et al., 2017;ABFT, Diamond et al., 2003) proved effective to promote children's secure attachment to parents. The current findings support the idea that exposing children to secure attachment experiences can contribute to short-term elevations in secure state attachment. ...
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Recent studies showed that attachment security can change within persons, suggesting that there might be an interplay between a rather stable (trait) and rather variable (state) part of attachment. The study’s first aim was to investigate whether attachment priming could influence the level of state attachment. The second aim was to explore possible moderators explaining individual differences in the relation between state attachment responses to attachment versus neutral primes. This can shed light on individual differences in attachment prime-induced state attachment. We conducted a within-subjects priming study in which children (9–13 years) were allocated to three priming procedures (neutral, secure, avoidant). Results showed an increase in secure state attachment after secure attachment priming. Individual differences in the strength of this effect were moderated by trait attachment and state attachment volatility. First findings cautiously suggest that state attachment security can change in response to environmental cues under certain circumstances.
... One of the "lessons learned" from the 3-year implementation of the program was to communicate more carefully to parents and EHS home visitors about the utility of the videotape and to emphasize confidentiality, which may have led to their change in perception of the videotapes. Accumulating evidence suggests that video feedback is an effective tool to promote sensitive caregiving (Balldin et al. 2018;Juffer et al. 2017). ...
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Elucidating factors that promote or hinder successful implementation of evidence-based practices in real-world settings is an essential component of intervention research. This qualitative study assessed implementation of an attachment-based parenting intervention, Attachment and Biobehavioral Catch-up (ABC), delivered in the context of federal Early Head Start (EHS) home visiting services, from the perspectives of EHS home visitors and ABC parent coaches. Findings demonstrated that the EHS plus ABC model was acceptable, appropriate, and feasible from the perspective of both the EHS home visitors and the ABC parent coaches. Home visitors described important ways in which ABC enhanced EHS, such as through its emphasis on strengthening child-parent attachment and its use of video feedback. EHS home visitors and parent coaches suggested specific improvements for this enhanced model that will inform future program implementation and research.
... It is worth noting that this is not always self-evident. For example in the broader literature parent feedback models have been developed from both operant conditioning (Brookman-Frazee et al., 2006) and attachment theory perspectives (Juffer et al., 2017). In the present review, feedback approaches were one of the most common intervention types and were largely based on more naturalistic behaviourist approaches (e.g. ...
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Cornerstones of Attachment Research re-examines the work of key laboratories that have contributed to the study of attachment. In doing so, the book traces the development in a single scientific paradigm through parallel but separate lines of inquiry. Chapters address the work of Bowlby, Ainsworth, Main and Hesse, Sroufe and Egeland, and Shaver and Mikulincer. Cornerstones of Attachment Research utilises attention to these five research groups as a lens on wider themes and challenges faced by attachment research over the decades. The chapters draw on a complete analysis of published scholarly and popular works by each research group, as well as much unpublished material.
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This study assessed the psychometric properties of three versions of the Parenting Scale (PS; original PS, 13‐item version, and 10‐item version) in three European middle‐income countries. The PS is one of the most frequently used questionnaires for measuring dysfunctional discipline strategies. Although its validity has been extensively investigated in American samples, there are mixed results regarding the recommended number of items and subscales, raising the question of replicability across European middle‐income countries. Multigroup confirmatory factor analysis (MCFA) and item response theory (IRT) were applied to N = 835 parents from North Macedonia, Moldova, and Romania. All three versions were significantly correlated with parental‐ and child‐related variables. Confirmatory factor analysis indicated the best model fit for the 10‐item version, and configural and partial metric invariance across countries could be established for this version. Item response theory analyses also supported this measure. Our findings show that the 10‐item version performed better than the 13‐item version and the original PS both overall and on the country level. Reliability values were somewhat lower than reported in studies from the United States. The 10‐item version constitutes a promising short measure for assessing dysfunctional parenting in European middle‐income countries for researchers and practitioners.
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Mealtime is a parent–toddler interaction that occurs multiple times a day. This study examined whether observed maternal sensitivity differed between a mealtime and free‐play setting, aiming to explain differences between the two situations by studying moderating effects of children's eating behavior. The sample consisted of 103 first‐time mothers and their 18‐month‐old children. Maternal sensitivity was assessed by coding videotaped interactions of free‐play sessions and mealtimes, using the Ainsworth Sensitivity Scale (range 1–9). Additionally, child eating behavior during the meal was coded and also assessed through the Child Eating Behavior Questionnaire—Toddlers. First, a small but significant amount of stability was found between sensitivity during mealtime and sensitivity during play (r = 0.24). Second, mothers were more sensitive during free play (mean = 7.11) than during mealtime (mean = 6.52). Third, observed child eating behavior was related to maternal sensitivity during mealtime, with more food enjoyment being associated with higher levels of sensitivity, and more challenging child behavior with lower levels of sensitivity. Finally, when children showed a high degree of challenging behavior during the meal, there was more discrepancy between sensitivity during mealtime and free play. Our results highlight the importance of taking context into account when observing parental sensitivity.
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We evaluated frontal electroencephalogram (EEG) asymmetry across multiple contexts as an index of a general affective response predisposition in 12‐month‐old infants whose mothers were at elevated risk for perinatal depression due to their mother’s history of depression. We further examined mothers’ prenatal, postnatal, and concurrent depressive symptom levels in relation to infants’ frontal EEG asymmetry consistency. Mothers (n = 132) with a history of depression prior to pregnancy completed depressive symptom scales repeatedly during pregnancy and the first year postpartum. Their 12‐month‐old infants’ frontal EEG asymmetry was recorded across five contexts (baseline/bubbles, peek‐a‐boo, play, feeding, and distract). Frontal EEG asymmetries showed small to moderate correlations across contexts. Mothers’ prenatal depression symptom levels (not postnatal or concurrent) were associated with infants having consistent right, rather than left, frontal EEG asymmetry, even after controlling for infants’ observed affect. These findings demonstrate the consistency of EEG asymmetry scores across contexts in 12‐month‐old infants at risk for the development of psychopathology, providing support for relative right frontal EEG asymmetry as a trait marker of vulnerability to depression. Findings also suggest the importance of mothers’ prenatal, rather than postnatal or concurrent depression, in predicting infants’ consistent patterns of relative right frontal EEG asymmetry across contexts.
Book
Contemporary theories have generally focused on either the behavioral, cognitive or emotional dimensions of prosocial moral development. In this volume, these three dimensions are brought together while providing the first comprehensive account of prosocial moral development in children. The main concept is empathy - one feels what is appropriate for another person's situation, not one's own. Hoffman discusses empathy's role in five moral situations. The book's focus is empathy's contribution to altruism and compassion for others in physical, psychological, or economic distress. Also highlighted are the psychological processes involved in empathy's interaction with certain parental behaviors that foster moral internalization in children and the psychological processes involved in empathy's relation to abstract moral principles such as caring and distributive justice. This important book is the culmination of three decades of study and research by a leading figure in the area of child and developmental psychology.
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Objective: Maternal eating disorders interfere with parenting, adversely affecting mother-infant interaction and infant outcome. This trial tested whether video-feedback treatment specifically targeting mother-child interaction would be superior to counseling in improving mother-child interaction, especially mealtime conflict, and infant weight and autonomy. Method: The participants were 80 mothers with bulimia nervosa or similar eating disorder who were attending routine baby clinics and whose infants were 4-6 months old. They were randomly assigned to video-feedback interactional treatment or supportive counseling. Both groups also received guided cognitive behavior self-help for their eating disorder. Each group received 13 sessions. The primary outcome measure was mealtime conflict; secondary outcome measures were infant weight, aspects of mother-infant interaction, and infant autonomy. Results: Seventy-seven mothers were followed up when their infants were 13 months old. The video-feedback group exhibited significantly less mealtime conflict than the control subjects. Nine of 38 (23.7%) in the video-feedback group showed episodes of marked or severe conflict, compared with 21 of 39 (53.8%) control subjects (odds ratio=0.27, 95% confidence interval=0.10 to 0.73). Video feedback produced significant improvements in several other interaction measures and greater infant autonomy. Both groups maintained good infant weight, with no differences between groups. Maternal eating psychopathology was reduced across both groups. Conclusions: Video-feedback treatment focusing on mother-infant interaction produced improvements in interaction and infant autonomy, and both groups maintained adequate infant weight. To the authors' knowledge, this is the first controlled trial to show key improvements in interaction between mothers with postnatal psychiatric disorders and their infants.
Article
In the current study we aimed to improve center-based child care quality with an attachment-based program: The Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline for Child Care (VIPP-CC). Professional caregivers (N = 64) from child care centers in urban areas in the Netherlands participated in our pretest-posttest randomized controlled trial. The VIPP-CC was effective for increased observed sensitive responsiveness in the group setting of the professional caregiver and led to a more positive attitude towards caregiving and limit setting. Post hoc analyses revealed that the intervention effect was apparent for caregiver sensitive responsiveness in structured play situations. The VIPP approach can now be expanded from the family setting to out-of–home group settings with larger groups of children and professional caregivers. This is a promising conclusion for millions of children enrolled in center child care from a very young age.
Article
Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) is a social-learning and attachment-based intervention using video feedback to support sensitive parenting and at the same time setting firm limits. Empirical studies and meta-analyses have shown that sensitive parenting is the key determinant to promote secure child-parent attachment relationships and that adequate parental discipline contributes to fewer behavior problems in children. Building on this evidence, VIPP-SD has been tested in various populations of at-risk parents and vulnerable children (in the age range of zero to six years), as well as in the context of child care. In twelve randomized controlled trials including 1,116 parents and caregivers, VIPP-SD proved to be effective in promoting sensitive caregiving, while positive social-emotional child outcomes were also found.
Article
Evidence that adverse rearing environments exert negative effects particularly on children presumed "vulnerable" for temperamental or genetic reasons may actually reflect something else: heightened susceptibility to the negative effects of risky environments and to the beneficial effects of supportive environments. Building on Belsky's (1997, 2005) evolutionary-inspired proposition that some children are more affected-both for better and for worse-by their rearing experiences than are others, we consider recent work on child vulnerability, including that involving measured genes, along with evidence showing that putatively vulnerable children are especially susceptible to both positive and negative rearing effects. We also consider methodological issues and unanswered questions in the differential-susceptibility equation.
Article
This book illuminates the successful implementations of one of the few evidence-based parenting intervention programs. More than 20 years ago the editors began experimenting with videotaping parental behavior in order to enhance parents' sensitivity to their children’s signals. This new book presents the outcome of this effort.