Circle of Security parenting: a real-world study of intervention effectiveness
The Circle of Security Parenting (COS-P) intervention is widely disseminated, despite limited evidence for its effectiveness. The current research was designed to help address this evidence gap. Studies 1 and 2 together formed a non-randomised controlled evaluation of COS-P in four community organisations. Study 1 investigated intervention effectiveness in a sample of 256 parents (children aged 0 to 6 years) experiencing parenting challenges, often in the context of depression. Self-report data for 221 mothers (treatment group n = 169, waitlist control group n = 52) were included in the main study. Between-group analysis of complete data for 177 mothers showed significantly greater increases in parental mentalising and self-efficacy, and significantly greater decreases in caregiving helplessness, hostility and depression symptoms for treatment group, compared with control group participants. There was no difference between groups for the change in perceived child difficultness. Within-treatment-group analyses indicated that parents with older children reported greatest reductions in caregiving helplessness, and parents with probable clinical depression reported greatest reductions in hostility and depression symptoms. Exploratory within-group analyses indicated that fathers (n = 26) showed the same pattern of change as mothers.
Study 2 investigated the impact of COS-P on deeper-level change. A sample of 79 mothers (a subset of participants from Study 1) completed narrative interviews (audio recorded) and a 5-minute parent-child free play interaction (video recorded). Interview transcripts were coded for caregiving representations and representational mind-mindedness. Videos were coded for parent-child interaction quality and observed mind-mindedness. Between-group analyses indicated a significant increase in optimal caregiving representations and a significant decrease in intrusive behaviour for treatment group participants; there was no significant change for the control group. However, the Time x Group interaction was not significant. There was no significant change in other measures for either group.
Study 3 examined associations among (a) parent scores from the questionnaire subscales assessing caregiving representations and mentalising, (b) representations coded from narrative interview, and (c) mind-mindedness (interview and observed), in 80 mothers. Questionnaire scales were related to representations coded from interview in theoretically expected directions. Questionnaire scales were not related to mind-mindedness. Findings support the concurrent validity of the composite self-report measure for assessing caregiving representations in clinical settings. Further investigation of the mentalising measure is required.
Study 4 was a qualitative investigation of the experiences and perceptions of 20 COS-P facilitators and 14 parent recipients. Thematic analysis of combined parent and facilitator data identified the perception that COS-P primarily changes the lens through which parents view their child, themselves in the parenting role, and the parent-child relationship. Participants identified four program components that underpinned program impact: key content, skills practice, group processes and facilitator support. While COS-P was considered suitable for broad application, limitations were noted.
Together, findings provide some support for the use of COS-P with parents experiencing parenting challenges in the early parenting period. Further research is needed to confirm moderation of treatment effects, and long-term follow-up is required to investigate sustained and sleeper effects. Findings can guide clinical application of COS-P and inform further research.