PREVENTION, THE APPROPRIATE TARGET OF INFANT PSYCHOTHERAPY

The aim of this paper is to evaluate the case for preventive intervent ions in infancy aimed at the reduction of childhood psychopathology. T he paper considers the terminology of prevention and the case for prev ention in infancy. It is argued that increased knowledge concerning th e developmental pathways involved in many psychological disorders open s the door to prevention initiatives. An overview of recent prevention trials is provided and the implications from treatment evaluation stu dies are explored. The case for prevention of conduct disorders is tak en as an illustration of the potential for interventions in infancy. A developmental model of conduct disorder implicates a vicious cycle of parent-child interactions, a process that may arguably be preempted b y early intervention. Three modalities are considered in detail: (a) e arly parent training; (b) the enhancement of attachment security; and (c) the facilitation of the development of reflective function. Studie s in each of these areas are reviewed. The paper concludes that increa sed emphasis on the prevention aspect of infant mental health interven tions is justified and desirable.