Attachment-Focused Parenting Program for Child Development

Recruiting at 1 trial location

Overseen By Susan Woodhouse, Ph.D.

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Maryland, College Park

Disqualifiers: Language fluency

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

249 Participants Needed

Trial Summary

What is the purpose of this trial?

Growing evidence demonstrates that secure attachment in childhood predicts children's healthy social, biological, and behavioral functioning, whereas insecure attachment predicts behavior problems and physiological dysregulation; thus, efforts to foster secure attachment are crucial for promoting the healthy development of children and families. This proposal describes a randomized controlled trial (RCT) of an innovative intervention program that can be widely implemented designed to foster children's secure attachment, promote healthy physiological regulation, and reduce the risk for behavior problems: The Circle of Security ® Parenting (COS-P) intervention. To this end, investigators will conduct an RCT with 249 parent-child dyads enrolled or are eligible but not yet enrolled in two diverse Early Head Start (EHS) programs.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Circle of Security Parenting (COS-P) for child development?

Research shows that the Circle of Security Parenting (COS-P) program helps parents better understand and respond to their children's needs, leading to improvements in parenting stress, parenting alliance, and caregiving behaviors. These positive changes are maintained over time, suggesting that COS-P can effectively support child development by enhancing parent-child interactions. ^{1 2 3 4 5}

Is the Attachment-Focused Parenting Program for Child Development safe for participants?

The available research on the Circle of Security Parenting (COS-P) program, which is part of the Attachment-Focused Parenting Program, does not report any safety concerns for participants. The studies focus on the program's effectiveness and its impact on parenting skills and child development, but do not mention any adverse effects or safety issues. ^{2 3 4 6 7}

How is the Circle of Security Parenting treatment different from other treatments for child development?

Circle of Security Parenting (COS-P) is unique because it focuses on improving the parent-child relationship by helping parents understand and respond to their child's attachment needs through video-based group sessions. Unlike other treatments, COS-P emphasizes changing the way parents perceive their role and their child's behavior, fostering empathy and confidence in parenting. ^{1 2 3 4 7}

Research Team

Jude Cassidy, Ph.D.

Principal Investigator

University of Maryland, College Park

Susan Woodhouse, Ph.D.

Principal Investigator

Lehigh University

Eligibility Criteria

This trial is for parents with children aged 8 to 36 months enrolled in Early Head Start programs in Harrisburg PA and Lehigh Valley PA. Participants must be fluent in English or Spanish, the languages used for the intervention.

Inclusion Criteria

My child, aged 8-36 months, is enrolled in an Early Head Start program in Harrisburg or Lehigh Valley, PA.

Exclusion Criteria

I am not fluent in English or Spanish, the languages used for the COS-P intervention.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive either the Circle of Security Parenting (COS-P) intervention or the Little Talks intervention, each consisting of 8 sessions of 90 minutes each.

8 weeks

Immediate Post-Intervention Assessment

Various assessments are conducted immediately after the intervention to evaluate outcomes such as parental emotional responses, cortisol stress reactivity, and intervention satisfaction.

Follow-up

Participants are monitored for outcomes such as child behavior problems and parental sensitivity at a 6-month follow-up.

6 months

Treatment Details

Interventions

• Circle of Security Parenting
• Little Talks

Trial Overview The study tests an innovative program called Circle of Security Parenting (COS-P) designed to foster secure child-parent attachments, promote healthy development, and reduce behavior problems in children through a randomized controlled trial.

Participant Groups

Group I: Circle of Security Parenting (COS-P) Experimental Treatment 1 Intervention

These participants will receive the Circle of Security Parenting (COS-P) intervention, an attachment-based, manualized, 8-session (90 minutes/session), home visiting intervention.

Group II: Little Talks Active Control 1 Intervention

These participants will receive the Little Talks intervention, a manualized, 8-session (90 minutes/session) early literacy home visiting intervention.

Circle of Security Parenting is already approved in United States for the following indications:

Approved in United States as Circle of Security Parenting for:

• Promoting secure attachment in children
• Reducing behavior problems
• Fostering healthy physiological regulation

Who Is Running the Clinical Trial?

University of Maryland, College Park

Lead Sponsor

Trials

163

Recruited

46,800+

Lehigh University

Collaborator

Trials

24

Recruited

6,800+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Findings from Research

The Circle of Security Parenting (COS-P) intervention effectively improved a father's self-agency and perception of his child's functioning in a custody conflict case, demonstrating its potential in attachment-based therapy.

Post-intervention assessments indicated significant reductions in parenting stress and improvements in the father's alliance with the child's mother, suggesting COS-P can enhance parental relationships and child outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The circle of security parenting and parental conflict: a single case study. Pazzagli, C., Laghezza, L., Manaresi, F., et al.[2023]

The Circle of Security-Parenting (COS-P) intervention is an effective, manualized program designed to improve children's attachment security, which is crucial for preventing negative outcomes like behavior problems.

COS-P helps parents, like the example of 'Alexa,' develop skills to better understand and respond to their children's needs, ultimately promoting healthier parent-child relationships.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Learning to provide children with a secure base and a safe haven: The Circle of Security-Parenting (COS-P) group intervention. Kim, M., Woodhouse, SS., Dai, C.[2019]

The study evaluates the effectiveness of the Circle of Security Parenting (COS-P) intervention in a non-randomized controlled setting, involving caregivers of children aged 6 years and under facing early parenting challenges, which addresses a significant evidence gap in existing research.

By assessing changes in caregiving attitudes and caregiver depression symptoms, this study aims to provide insights into the effectiveness of COS-P and identify which demographic factors may influence its success, making it one of the first controlled evaluations of this intervention in Australia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addressing the Evidence Gap: Protocol for an Effectiveness Study of Circle of Security Parenting, an Attachment-Based Intervention. Maxwell, AM., McMahon, C., Huber, A., et al.[2021]

The Circle of Security (COS) approach helps parents understand their children's attachment needs and has been adapted for individual therapy, enhancing its accessibility and effectiveness.

Incorporating video reviews of parent-child interactions in the COS intervention allows for personalized feedback, which can improve the parent’s ability to manage separation issues with their children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Travelling the circle together, solo: An individual protocol for the Circle of Security intensive intervention. Andrews, E., Coyne, J.[2019]

The Circle of Security Intensive intervention (COS-I-RH) significantly improved caregiver capacities, including supportive parenting and parenting self-efficacy, in a study of 36 parent-child dyads over a year.

These positive changes in caregiving behavior and representations were sustained at a one-year follow-up, indicating the long-term effectiveness of the intervention regardless of whether it was delivered individually or in groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Postintervention and follow-up changes in caregiving behavior and representations after individually or group delivered hybrid Circle of Security-intensive intervention with New Zealand caregiver-child dyads. Huber, A., Hicks, AM., Ball, M., et al.[2021]

The study evaluates the effectiveness of the Circle of Security-Parenting (COS-P) program in improving maternal sensitivity and child attachment among 314 families with infants aged 2-12 months, compared to standard care.

By screening a larger population of 17,600 families for risks like maternal postnatal depression, the study aims to address early childhood adversity and promote better long-term developmental outcomes for children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Copenhagen infant mental health project: study protocol for a randomized controlled trial comparing circle of security -parenting and care as usual as interventions targeting infant mental health risks. Væver, MS., Smith-Nielsen, J., Lange, T.[2019]

Circle of Security Parenting (COS-P) effectively shifts parents' perspectives on their child, themselves, and their relationship with their child, leading to increased empathy, compassion, and confidence in parenting, based on qualitative insights from 20 facilitators and 14 parents in Australia.

The program's impact is supported by four key components: essential content, skills practice, group dynamics, and facilitator support, although some limitations were noted regarding its application.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent and practitioner perspectives on Circle of Security Parenting (COS-P): A qualitative study. Maxwell, AM., Reay, RE., Huber, A., et al.[2021]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

The circle of security parenting and parental conflict: a single case study. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Learning to provide children with a secure base and a safe haven: The Circle of Security-Parenting (COS-P) group intervention. [2019]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Addressing the Evidence Gap: Protocol for an Effectiveness Study of Circle of Security Parenting, an Attachment-Based Intervention. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Travelling the circle together, solo: An individual protocol for the Circle of Security intensive intervention. [2019]

5. England pubmed.ncbi.nlm.nih.gov

Postintervention and follow-up changes in caregiving behavior and representations after individually or group delivered hybrid Circle of Security-intensive intervention with New Zealand caregiver-child dyads. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Copenhagen infant mental health project: study protocol for a randomized controlled trial comparing circle of security -parenting and care as usual as interventions targeting infant mental health risks. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Parent and practitioner perspectives on Circle of Security Parenting (COS-P): A qualitative study. [2021]