Mentally ill mothers in the parenting role: clinical management and treatment

Teresa Jacobsen

doi:10.1017/CBO9780511543838.010

8 - Mentally ill mothers in the parenting role: clinical management and treatment

from Part II - Comprehensive assessment and treatment

Published online by Cambridge University Press: 09 August 2009

Edited by

Jeni Webster and

Teresa Jacobsen: Affiliation:
University of Illinois at Chicago, Illinois, USA
Michael Göpfert: Affiliation:
Webb House Democratic Therapeutic Community, Crewe
Jeni Webster: Affiliation:
5 Boroughs Partnership, Warrington
Mary V. Seeman: Affiliation:
University of Toronto

Book contents

Get access

Summary

Introduction

When a woman with a major psychiatric disorder becomes a parent, the path that lies ahead for her and her child can be very uncertain. While some mothers are able, despite their illness, to raise their children successfully, as many as 60% of mothers with major mental disorders relinquish or lose custody of their children (Coverdale & Aruffo, 1989; Miller & Finnerty, 1996). Some mothers in this situation provide intermittent parenting or coparenting (Caton et al., 1998) during the years of infancy, childhood and adolescence. Even when mother and child lose contact, each may continue to exert a profound emotional influence over the life of the other (Holley & Holley, 1997).

Intervening to alleviate parenting problems in mothers with major psychiatric disorders is recognized as a challenge to mental health providers (Nicholson & Blanch, 1994). This chapter provides an overview of clinical services and treatments that address serious parenting problems in mothers with major mental illness.

Approach to treatment

Components of a comprehensive evaluation

A comprehensive parenting evaluation is the cornerstone of treatment. It directly examines a mother's ability to read her child's cues, her ability to empathize with and understand the child as an individual, her cognitive understanding of development and childrearing, her ways of coping with stress, her ability to meet basic parenting tasks such as providing food, housing, and safety, and her skill in adjusting her behaviour to meet the changing needs of children as they grow (Jacobsen et al., 1997).

Keywords

clinical services mentally ill mothers mother-infant psychotherapy parenting problems postpartum period psychiatric treatment

Type: Chapter
Information: Parental Psychiatric Disorder
Distressed Parents and their Families
, pp. 112 - 122

DOI: https://doi.org/10.1017/CBO9780511543838.010 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bowlby, J. (1988). A Secure Base: Clinical Applications of Attachment Theory. London: Routledge

Caton, C. L. M., Cournos, F., Felix, A. et al. (1998). Childhood experiences and current adjustment of offspring of indigent patients with schizophrenia. Psychiatric Services, 49, 86–90Google Scholar

Cooper, P. J. & Murray, L. (1997). The impact of psychological treatments of postpartum depression on maternal mood and infant development. In Postpartum Depression and Child Development, ed. L. Murray & P. J. Cooper, pp. 201–20. New York: Guilford Press

Coverdale, J. H. & Aruffo, J. F. (1989). Family needs of female chronic psychiatric outpatients. American Journal of Psychiatry, 146, 1489–91Google Scholar

Crittenden, P. M. (1985). Social networks, quality of child rearing, and child development. Child Development, 56, 1299–1313Google Scholar

Crittenden, P. M. & Snell, M. E. (1983). Intervention to improve mother–infant interaction and infant development. Infant Mental Health Journal, 4, 23–41Google Scholar

DePanfilis, D. (1999). Intervening with families when children are neglected. In Neglected Children: Research, Practice, and Policy, ed. H. Dubowitz, pp. 211–36. Beverley Hills, CA: Sage

Egeland, B., Weinfield, N. S., Bosquet, M. & Cheng, V. K. (2000). Remembering, repeating, and working through lessons from attachment-based interventions. In Infant Mental Health in Groups at High Risk, Vol. 4, ed. J. D. Osofsky & H. E. Fitzgerald, pp. 35–89. WAIMH Handbook of Infant Mental Health. New York: John Wiley & Sons

Forcier, K. (1990). Management and care of the mentally disturbed pregnant patient. Journal of Psychosocial Nursing, 28, 11–16Google Scholar

Fraiberg, S. (1980). Clinical Studies in Infant Mental Health. New York: Basic Books

Grunebaum, H., Weiss, J. L., Cohler, B. J. et al. (1982). Mentally Ill Mothers and their Children. Chicago: University of Chicago Press

Holley, T. E. & Holley, J. (1997). My Mother's Keeper: A Daughter's Memoir of Growing Up in the Shadow of Schizophrenia. New York: Morrow

Jacobsen, T. & Miller, L. J. (1998). Mentally ill mothers who have killed: three cases addressing the issue of future parenting capability. Psychiatric Services, 49, 650–7Google Scholar

Jacobsen, T., Miller, L. J. & Kirkwood, K. (1997). Assessing parenting competency in mentally ill individuals: a comprehensive service. Journal of Mental Health Admnistration, 24, 189–99Google Scholar

Keller, M., Beardslee, W., Dorer, D. et al. (1986). Impact of severity and chronicity of parental affective illness on adaptive functioning and psychopathology in children. Archives of General Psychiatry, 43, 930–7Google Scholar

Kissane, D. & Ball, J. R. B. (1988). Postnatal depression and psychosis – a mother and baby unit in a general hospital. Australian and New Zealand Journal of Obstetrics and Gynaecology, 28, 208–12Google Scholar

Lieberman, A. F. (1989). What is culturally sensitive intervention?Early Child Development and Care, 50, 197–204Google Scholar

Lieberman, A. F., Horn, P., Grandison, C. M. et al. (1997). Mental health assessment of infants, toddlers, and preschoolers in a service program and a treatment outcome research program. Infant Mental Health Journal, 18, 158–70Google Scholar

Look, P. E. & Howe, B. (1984). Unusual use of ultrasound in a paranoid patient. Canadian Medical Association Journal, 131, 539Google Scholar

Lyons-Ruth, K. (1996). Attachment relationships among children with aggressive behavior problems: the role of disorganized early attachment patterns. Journal of Consulting and Clinical Psychology, 64, 64–73Google Scholar

Lyons-Ruth, K., Connell, D. B. & Grunebaum, H. U. (1990). Infants at risk: maternal depression and family support services as mediators of infant development and security of attachment. Child Development, 61, 85–98Google Scholar

Miller, L. J. (1990). Psychotic denial of pregnancy: phenomenology and clinical management. Hospital and Community Psychiatry, 41, 1233–7Google Scholar

Miller, L. J. (1991). Clinical strategies for the use of psychotropic drugs during pregnancy. Psychiatric Medicine, 9, 275–98Google Scholar

Miller, L. J. (1992). Comprehensive care of pregnant mentally ill women. Journal of Mental Health Administration, 19, 170–7Google Scholar

Miller, L. J. & Finnerty, M. (1996). Sexuality, pregnancy, and childrearing among women with schizophrenia-spectrum disorders. Psychiatric Services, 47, 502–6Google Scholar

Nicholson, J. & Blanch, A. (1994). Rehabilitation for parenting roles for people with serious mental illness. Psychosocial Rehabilitation Journal, 1, 109–19Google Scholar

Nicholson, J., Sweeney, E. M. & Geller, J. L. (1998). Mothers with mental illness: II. Family relationships and the context of parenting. Psychiatric Services, 49, 643–9Google Scholar

Ramsay, R., Howard, L. & Kumar, C. (1998). Schizophrenia and safety of parenting of infants: a report from a UK mother and baby service. International Journal of Social Psychiatry, 44, 127–34Google Scholar

Rynearson, E. K. (1982). Relinquishment and its maternal complications: a preliminary study. American Journal of Psychiatry, 139, 338–40Google Scholar

Seeman, M. V. & Cohen, R. (1998). A service for women with schizophrenia. Psychiatric Services, 49, 674–7Google Scholar

Sneddon, J., Kerry, B. J. & Bant, W. P. (1981). The psychiatric mother and baby unit: a 3-year study. Practitioner, 225, 1295–300Google Scholar

Spielvogel, A. & Hohener, H. (1995). Denial of pregnancy: a review and case reports. Birth, 22, 220–6Google Scholar

Spielvogel, A. & Wile, J. (1986). Treatment of the psychotic pregnant patient. Psychosomatics, 26, 487–92Google Scholar

Waldo, M. C., Roath, M., Levine, W. et al. (1987). Hospital and Community Psychiatry, 48, 1110–12

Book contents

8 - Mentally ill mothers in the parenting role: clinical management and treatment

Summary

Keywords

Access options

References

Save book to Kindle

Save book to Dropbox

Save book to Google Drive