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Over the last several years, I have returned repeatedly to a sense that what we know about attachment should have repercussions for interventions with mothers and children. But a series of unanswered questions leads me back to doubts about the wisdom of starting an intervention study. These are the questions I come back to:
What is the process through which parental working models “translate” into parental sensitivity and in turn to infant attachment and child behavior/working models? Associations among these constructs are well established statistically, but we still lack answers to questions concerning the “transmission gap” between working models and sensitivity. Specifically, are we unable to demonstrate strong associations among working models, sensitivity, and infant attachment because our measures of sensitivity are inadequate, because we are not looking at the most meaningful aspects of parent-child interaction, or is the issue still more complex?
For the sake of intervention, addressing what to do is crucial. Do we focus on dynamic issues with parents, effecting changes in working models and hoping that there are resultant changes in sensitivity? Do we take advantage of babies' presence to give parents practical skills for providing sensitive care and hope to effect changes in parents' mental representations as a side effect?
How do we accomplish interventions in any kind of practical and replicable way? What kind of time is required to effect lasting and meaningful change in parent-infant dyads? At what point in an infant's development are we in the best position to offer our interventions? How far astray can parenting go and still be “good enough” to promote healthy development? How do those of us who are not
part of a family provide strengths to its members, while still allowing autonomy and self-determination?
Marinus van IJzendoom's (van IJzendoorn et al. 1995) meta-analysis of intervention studies provides some answers to these questions, but poses addi