Impact of the Mediational Intervention for Sensitizing Caregivers on Mentalizing in Orphans and Vulnerable Children in South Africa

ABSTRACT

Mediational Intervention for Sensitizing Caregivers (MISC) is a mentalization-based intervention which aims to enhance caregiver sensitivity and responsiveness. MISC has demonstrated treatment effects on mental health problems of Orphans and Vulnerable Children (OVC) in South Africa by working with Community-Based Organization (CBO) care workers as the point of intervention. Recent elaboration of mentalization-based theory points to alternate figures in a child’s early environment as critical resources for enhancing children’s mentalizing capacity. In this study, we evaluated the treatment effect of MISC on children’s mentalizing capacity at baseline and following 12-months of the intervention, controlling for the effects of age, gender, orphan status, socioeconomic status, quality of the home environment, and mental health difficulties at baseline. MISC and Treatment as Usual (TAU) groups were compared using a mixed model linear regression. Results demonstrated significant effects of MISC, time, and mental health difficulties on mentalizing capacity. To our knowledge, this study is the first mentalization-based caregiver intervention to demonstrate treatment effects on child mentalizing capacity, and MISC is the first mentalization-based caregiver intervention to focus on paraprofessionals as the point of intervention.

Acknowledgments

We wish to thank the children and caregivers who participated in this research and made the study possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development under Grant [R01HD081985].

Notes on contributors

Madeleine Allman

Madeleine Allman, M.P.H., M.A., is a doctoral student at the University of Houston Clinical Psychology Program in the Child track. She is interested in the translation and implementation of interventions for children and families who have suffered attachment trauma, as well as the development of social cognition.

Paulina Kulesz

Paulina Kulesz, Ph.D., works as a Research Associate Professor at the University of Houston and Statistical Consultant. She is an applied statistician, data scientist, and psychometrician with an extensive neuropsychological and educational psychology background.

Lochner Marais

Lochner Marais, Ph.D., is a Professor of Development Studies at the Centre for Development Support at the University of the Free State (UFS). His research interests include housing policy, small cities and towns (mining and renewable towns and cities), and public health focusing on children. In addition to concentrating on these themes separately, he focuses on integrating them. Marais has authored, coauthored, and compiled over 250 research reports, including 180 refereed articles in peer-reviewed journals or books. He has also co-edited nine books and is the author of one scholarly book. Over the past 10 years, he has been a collaborator, principal investigator, or co-principal investigator for international research grants of approximately R40 million. He is passionate about creating and managing interdisciplinary projects and prefers research focusing on real-world problems in housing policy, mine–community relations, mine closure, and urban health.

Carla Sharp

Carla Sharp, Ph.D., is a John and Rebecca Moores Professor of Psychology and Associate Dean for Faculty and Research at the University of Houston. She studies mental health outcomes in children and adolescents, its causes and correlates, as well as the interventions to address them. She has published over 330 publications and 8 books and her research has been federally funded for over 10 years.