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Circle of Security–Parenting: A randomized controlled trial in Head Start

Published online by Cambridge University Press:  12 April 2017

Jude Cassidy ,
Bonnie E. Brett ,
Jacquelyn T. Gross ,
Jessica A. Stern ,
David R. Martin ,
Jonathan J. Mohr  and
Susan S. Woodhouse
Jude Cassidy*
Affiliation:
University of Maryland at College Park
Bonnie E. Brett
Affiliation:
University of Maryland at College Park
Jacquelyn T. Gross
Affiliation:
University of Maryland at College Park
Jessica A. Stern
Affiliation:
University of Maryland at College Park
David R. Martin
Affiliation:
University of Maryland at College Park
Jonathan J. Mohr
Affiliation:
University of Maryland at College Park
Susan S. Woodhouse
Affiliation:
Lehigh University
*
Address correspondence and reprint requests to: Jude Cassidy, Department of Psychology, 2147C Biology/Psychology Building, University of Maryland, 4094 Campus Drive, College Park, MD 20742; E-mail: jcassidy@umd.edu.
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Abstract

Although evidence shows that attachment insecurity and disorganization increase risk for the development of psychopathology (Fearon, Bakermans-Kranenburg, van IJzendoorn, Lapsley, & Roisman, 2010; Groh, Roisman, van IJzendoorn, Bakermans-Kranenburg, & Fearon, 2012), implementation challenges have precluded dissemination of attachment interventions on the broad scale at which they are needed. The Circle of Security–Parenting Intervention (COS-P; Cooper, Hoffman, & Powell, 2009), designed with broad implementation in mind, addresses this gap by training community service providers to use a manualized, video-based program to help caregivers provide a secure base and a safe haven for their children. The present study is a randomized controlled trial of COS-P in a low-income sample of Head Start enrolled children and their mothers. Mothers (N = 141; 75 intervention, 66 waitlist control) completed a baseline assessment and returned with their children after the 10-week intervention for the outcome assessment, which included the Strange Situation. Intent to treat analyses revealed a main effect for maternal response to child distress, with mothers assigned to COS-P reporting fewer unsupportive (but not more supportive) responses to distress than control group mothers, and a main effect for one dimension of child executive functioning (inhibitory control but not cognitive flexibility when maternal age and marital status were controlled), with intervention group children showing greater control. There were, however, no main effects of intervention for child attachment or behavior problems. Exploratory follow-up analyses suggested intervention effects were moderated by maternal attachment style or depressive symptoms, with moderated intervention effects emerging for child attachment security and disorganization, but not avoidance; for inhibitory control but not cognitive flexibility; and for child internalizing but not externalizing behavior problems. This initial randomized controlled trial of the efficacy of COS-P sets the stage for further exploration of “what works for whom” in attachment intervention.

Type
Special Issue Articles
Information
Development and Psychopathology , Volume 29 , Special Issue 2: Attachment in the Context of Atypical Caregiving: Harnessing Insights From a Developmental Psychopathology Perspective , May 2017 , pp. 651 - 673
Copyright
Copyright © Cambridge University Press 2017 

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Footnotes

The Zanvyl and Isabelle Krieger Fund provided support to Jude Cassidy to conduct this study. Additional support for manuscript preparation was provided by Janet W. Johnson Fellowships (to J.T.G. and D.M.), the National Science Foundation Graduate Research Fellowship Program Fellowship (to J.A.S.), and Grant R01 HD068594 from the National Institute of Child Health and Human Development (to S.S.W.). We are grateful for the help of the following people: Betsy Krieger, Karen Kreisberg, Linda Heisner, and Brooke Hisle provided important leadership and coordination; Glen Cooper, Kent Hoffman, and Bert Powell developed the Circle of Security–Parenting intervention and served as intervention supervisors; Anna Ditkoff-Dorsey, Tara Doaty, Pam Hoehler, and Barbara Johnson served as interveners; Danielle Gregg and Elizabeth Thompson provided and coordinated laboratory space at the Family Center at Kennedy Krieger Institute in Baltimore, Maryland; Erika Johnson conducted waitlist control Circle of Security–Parenting groups; Susan Paris and Bonnie Conley assisted with Strange Situation coding; Audrey Bigham and Ben Mitchell supervised the executive functioning coding teams and managed the executive functioning data; Samiha Islam compiled the reference list; and many hardworking and dedicated undergraduate research assistants assisted with data collection and coding. We also thank the directors and staff of the participating Head Start centers: Dayspring Programs, Emily Price Jones Head Start/Y of Central Maryland, and Catholic Charities Head Start of Baltimore City. Above all, we are grateful to the families who generously participated in our study.

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