The Efficacy of Brief Parent-Infant Psychotherapy for Treating Early Regulatory Disorders: A Randomized-Controlled Trial.

Abstract Objective Early regulatory disorders (ERD) place considerable strain on the parent-infant relationship and are associated with high parental distress. Brief (4-session) psychodynamic-based focused parent-infant psychotherapy (fPIP) treats ERD by strengthening the quality of the parent-infant relationship. This RCT investigates the efficacy of fPIP for treating ERD compared to standard pediatric care (TAU). Method Participants were N = 154 mothers and infants from 4 to 15 months who met criteria for persistent excessive crying, sleeping disorders, feeding disorders, or regulation disorders of sensory processing and were randomly assigned to fPIP (n = 81) or TAU (n = 73). Assessments took place at baseline and at the end of treatment after 12 weeks. Primary outcomes were the infants’ regulatory symptoms and remission rate. Secondary outcomes were parents’ psychological distress, depression, parenting stress, maternal self-efficacy, parental reflective functioning, and observer-rated emotional availability. Results fPIP was superior to TAU in reducing infants’ overall symptoms (p = .004, η 2 = .05, CI = 0.01–0.12), night-waking disorders (p = .030, OR = 3.12, CI = 1.21–9.22), and mothers’ psychological distress (p = .000, η 2 = .08, CI = 0.03–0.16) and depression (p = .002, η 2 = .06, CI = 0.02–0.13). There was a trend suggesting that fPIP led to increased maternal self-efficacy and parental reflective functioning. Conclusion Results underscore the efficacy of brief fPIP in significantly reducing symptoms in infants with ERD and their mothers. Generalizability is restricted to low psychosocial risk samples with highly distressed mothers and comorbid ERD with a predominance of night-waking disorders.