Infant and Early Childhood Mental Health-Informed Therapeutic Visitation: An Overview and Evaluation

Abstract

This article describes an infant and early childhood mental health-informed therapeutic visitation program that offers clinical support, systems-level advocacy, and developmentally appropriate guidance to families navigating the child welfare and family court systems. The program offers treatment, permanency, and placement planning for infants, young children, and their families experiencing trauma, attachment disruption, foster care, and permanency-ambiguity. Through exploration of a programmatic theoretical framework, the authors discuss the process of identifying community gaps, garnering system support, and program design, and they also offer a summary of results from a recent program evaluation including implications for future direction.

Given the rates of child abuse, divorce, and high-conflict custody disputes in families with infants and young children, supervised visitation services (SVS) and therapeutic visitation services (TVS) are in high demand (Children’s Bureau, 2016; Cicchetti, 2004; Symons, 2010). Derived from SVS, TVS is an emerging service designed for families experiencing high-conflict custody as well as for children in out-of-home placements due to child welfare involvement (Supervised Visitation Network [SVN] Standards Task Force, 2006). TVS was developed for families in which the child(ren) and parent(s) have been separated or otherwise unable to form a healthy attachment, display less-than-optimal ways of interacting, have experienced trauma or other experiences that are barriers to engaging in a healthy parent–child relationship, or are approaching a modification in custody arrangements that could benefit from therapeutic support to make the transition successful. Because of the critical importance of healthy caregiving relationships, rapid development, and impact of stress in the first years of life, children from birth to 6 years old have a unique need for infant and early childhood mental health (IECMH)-informed TVS.