Lenses and mirrors: Reflecting on dyadic psychotherapy, supervision, and research with families involved in the child welfare system

Abstract

Historically, services for families in the child welfare system have been behaviorally and externally focused, rather than attuning to what is happening on the inside for parents and children. Rarely do families have access to psychodynamic treatment provided by highly trained and well supported therapists. The Building Blocks program was developed at New Alternatives to Children, a child welfare agency, to provide mentalization-based psychodynamic treatment to families with children in foster care or at risk of being removed from the home. This paper presents data from a case of a mother and her infant daughter, observed through three lenses – clinical observation, research and supervision – sharpening our understanding of factors that facilitate trust, healing and attachment within both parent-child and therapeutic relationships. To empirically evaluate the Building Blocks program, families participate in assessments at baseline and after 12 sessions. We observed meaningful changes in this dyad’s verbal and nonverbal behaviors, based on Coding Interactive Behavior System, confirming the clinical observations. Finally, reflective supervision supported positive movement, and the use of video aided therapist mentalization. Integration of clinical training and research can provide a more comprehensive view of clinical work and allow families to be more fully seen and known.