Clinical Interviews with Families of Infants

Infant mental health assessments are even more challenging than is commonly realized. They are clinically and interpersonally complex, with multiple purposes and data from an array of psychological, developmental, and cultural perspectives. Moreover, since infants' worlds are nonverbally and affectively organized, we cannot rely on verbal inquiries as with older children and adults. Even more daunting, infants' distress evokes extraordinary and often puzzling emotions, especially when parents are besieged by delicate and intense anxieties that are even more pervasive than those accompanying other mental health referrals. We are often pressed to respond to urgent demands, despite limited information and a meager collaboration with the family. In addition, the special technical demands of working with several family members, such as splitting one's clinical attention, may be especially exacting. Yet offering emotional developmental help to an infant's family can be among the most satisfying and effective of all mental health interventions. When it goes well, evaluating infants and parents offers both the intellectual appeal of sorting out complex diagnostic puzzles and the emotional gratification of providing sorely needed relief to distressed families, often with rapid and dramatic effects.

With such complex challenges in mind, this paper presents a perspective on interviews with infants and their families that emphasizes the interplay of information gathering and relationship building. It begins with a conceptual framework, synthesizing basic mental health approaches with the broad psychodynamic relationship systems approach that has emerged from contemporary development research. Goals and practical guidelines for setting up the assessment phase of an infant mental health intervention will then be presented.