MIND-MINDEDNESS OF SOCIAL WORKERS, FAMILY HOME AND FOSTER PARENTS AND THE RELATIONSHIP WITH PARENTING STRESS
University of Amsterdam (UvA) | Spirit Jeugd en Opvoedhulp | Intermetzo
Masterthesis Forensic Science (Forensische Orthopedagogiek) Graduate School of Child Development and Education, University of Amsterdam
Marit (M.) Lourens Student number: 10766669 February 2016 Supervisor UvA: dr. M. (Marc) J. Noom Second assessor: mw. C. (Cristina) Colonnesi PhD Supervisor Spirit: drs. Carolien Konijn, policy coordinator effectiveness Number of words: 11730
Abstract
Professional caregivers in youth care are trained to be sensitive to recognise symptoms related to the wellbeing of children. A key component in this process is mind-mindedness: the caregiver’s tendency to see and treat their child as an individual with an active and autonomous mental ability. More specifically, the caregiver is able to identify the child’s beliefs, intentions, desires and emotions. This study investigated the relationship between mind-mindedness and parenting stress in a subsample of 39 professional caregivers: social workers, family home parents and foster parents employed by centres that provide care to out-of-home placed children and youth. Caregivers participated in a mind-mindedness interview and in addition they completed a questionnaire concerning the amount of perceived parenting stress. Based on theoretical models suggesting a strong relation between mind-mindedness and stress of biological parents, this examination extends previous attempts by including professional caregivers of traumatised children. Results showed that the total amount of mind-mindedness was not negatively related to parenting stress. A relatively low duration of care and stress resistance of caregivers may play an important role in not finding this relationship. However, positive mind-mindedness was associated with parenting stress: the more positive mind-minded comments caregivers made, the lower the levels of stress. Further research is necessary to obtain more insight into the relation between mind-mindedness and caregivers’ stress. This is valuable to improve the caregivers’ condition and indirectly the care of vulnerable out-of-home placed children and youth.
Keywords: mind-mindedness, parenting stress, social workers, family home parents, foster parents, traumatised children and youth
Mind-mindedness of Social Workers, Family Home and Foster Parents and the Relationship with Parenting Stress
Over 30.000 children in the Netherlands live in out-of-home care settings (www.nji.nl). Within all care sectors there are different forms of out-of-home care such as residential care, foster care, emergency care, group care and other planned permanent living arrangements (i.e., a non-family adult who takes care of the child; Trout, Hagaman, Casey, Reid & Epstein, 2008). Although the out-of-home care forms vary on a continuum from most limitative (residential care, group care) to least limitative (foster care), each setting is designed to provide explicit care (i.e. creating a safe and stable environment for the child in order to stimulate a healthy development) for children who are removed from their home context due to problems with the safety of the child, conflict between parent and child, or behavioural or physical issues in which services to emotional and social needs and mental health of children are priority (Trout et al., 2008; Weterings, 1998).
In the past ten years both the number of children and youth in foster care (Bureau Landelijke Voorlichting Pleegzorg, 2012) and in residential settings (Boendermaker, Van Rooijen, Berg & Bartelink, 2013) in the Netherlands has grown. This increase of needed care appeals to a large group of professional caregivers who provides care to children and youth, educates and guides them. Harder, Knorth and Zandberg (2006) describe professional caregivers within residential care as ‘interactional centipedes’, because they have to do multiple things at the same time, for instance supporting individuals emotionally and affectively, paying attention to the child’s family, ensuring compliance with the rules within the group and working together with other professionals. Number of surveys emphasise the important role of caregivers in creating and maintaining positive, supportive environments where the individual needs of young people are satisfied and in which young people are capable of developing important skills and feeling safe and understood (e.g. Thomson, McArthur, Long & Camilleri,
2005; Clough, Bullock & Ward, 2006). Specific skills are needed to being able to raise and support this vulnerable population (Bastiaensen, 2001). A lack of these different skills might be experienced as stressful during parenting which in turn may have an impact on the child. Children and youth who are involved in these settings experience physical, mental, social, developmental, behavioural and educational problems more frequently than children and youth from the general population (Armsden, Pecora, Payne & Szwatkiewics, 2000; Collin-Vézina, Coleman, Milne, Sell & Daigneault, 2011; Jee et al., 2006). These problems and corresponding symptoms might be derived from negative and damaged experiences in the past, for instance traumatic events (Cook et al., 2005).
Traumatic events
According to Harder et al. (2006), children and youth living in alternative settings have experienced a significantly larger number of stressors and traumatic events compared to children who are living with their biological parents. Traumatic events include physical abuse, sexual abuse, domestic, school and community violence, medical trauma, acts of terrorism, experiences during war, vehicle accidents, suicides or other traumatic loss. In the Netherlands each year more than 100.000 children and young people between the ages 0 and 18 are abused in one or more ways (Keesom, 2010). In 2010 34 per 1000 children in the ages of 0 to 17 were victim of maltreatment or neglect and approximately 99 per 1000 high school students indicated that they were abused. This number of abused youth has remained stable compared to 2005 (Alink et al., 2010). In addition to the events that may lead to the inclusion in youth care, the out-of-home placement itself is often experienced as traumatic (Newton, Litrownik & Landsverk, 2000).
Children who have experienced a traumatic event vary in their response to the event (Wolzak & Ten Berge, 2008). Nearly all children express behavioural change or some kind of distress in the acute phase of recovery from an event. Some reactions displayed by children who
have been exposed to events are separation anxiety (particularly in young children), anger, irritability, sadness, loss of interest in activities, sleep disturbance and nightmares and difficulties in the development in the coming years (American Psychiatric Association, 2008). Additionally, traumatised children are at exceptionally high risk for juvenile delinquency, substance abuse, reduced concentration and academic failure (Pears & Fisher, 2005). As a result of these symptoms, functioning in the family, peer group or at school might be impaired. Therefore, when caregivers (e.g. social workers, foster parents) work with children who might display such symptoms they must take into account the possibility that the child is exposed to trauma. In order to do that, caregivers must be able to recognise traumas in.
Although knowledge about traumatic events in general child welfare populations is growing, little is known about the childhood traumas of youth placed in a restrictive setting (e.g. foster care, residential care). To date studies among these youth have focussed on emotional and behavioural problems, but fail to link these problems to the actual trauma by using trauma specific measures. Although there is a slight increase in the awareness of high rates of traumatic events in the pasts of youth in out-of-home care, only a few studies have addressed this subject (Collin-Vézina et al., 2011). According to Gilbert et al. (2009), a frequently occurring problem in these settings might be that trauma symptoms remain unnoticed by foster parents and social workers in residential care. When these symptoms remain unnoticed and untreated the development of these children could (seriously) be affected (DeNigris, 2008). Due to the nature of the traumatic event, children might experience difficulty in trusting the predictability of life, they often lack a sense of control over life events and have a lowered level of self-efficacy and self-image. Overall, all these symptoms might lead to an increase in isolative episodes because of withdrawal and eventually affect their ability to set up healthy relationships. A better recognition of trauma symptoms and being able to adequately cope with these symptoms may induce stress during parenting and supervising.
Mind-mindedness
In order to recognise symptoms related to traumas, parental mind-mindedness is of major importance. Mind-mindedness is defined as the proclivity to treat children as individuals with their own minds, desires, intensions, beliefs and emotions, rather than children with needs that must be met (Meins, 1999). Mind-mindedness is proposed to function at the level of mind state, totally independent of any parental behaviour. So mind-mindedness focusses directly on how the parent perceives the child instead of how the parent perceives his or her own attachment experiences (Walker, Wheatcroft & Camic, 2011). Mind-minded parents tend to interpret their child’s behaviour with regard to the emotions and thoughts that might govern the child’s actions (McMahon & Meins, 2012). Additionally, mind-mindedness might be focussed on events the child has experienced where the parent recognises feelings, thoughts and mental states that arise from experiences of the child in the past. These events could also be damaging or traumatic events.
Many researcher have found broad support for the relation between mind-mindedness and sensitivity. Parental sensitivity is defined as the parent’s ability to perceive and interpret the signals and communications in their child’s behaviour and thereafter respond to them in an appropriate way (Ainsworth, Bell & Stayton, 1974). This definition suggests that it is the ability to use information from the child’s outward behaviour in drawing accurate conclusions about the child’s mental states regarding that behaviour (Meins, Fernyhough, Fradley, & Tuckey, 2001). It can be deduced that both constructs, sensitivity and mind-mindedness, have many similarities, but their operationalisation and theoretical background in particular are different. Levels of mind-mindedness may differ between various types of caregivers (e.g. foster parent, social worker). Kelly and Salmon (2014) indicated that fostering might affect the parent’s ability to interpret the child’s mental state: a majority of foster parents does not perceive the child’s need for affection and difficult behaviour as a threat. These representations
may affect the parent’s ability to take care of the child in a non-defensive way. Foster parenting might make higher demands on the parent’s ability to take the perspective of the child and to infer the child’s mental state from their behaviour. In addition to foster parents, according to Meins et al. (2003) the prevalence of mental descriptions in social workers is somewhat higher than the mental descriptions in biological mothers. A higher level of mind-mindedness in social workers might derive from professional’s pedagogical focus on the intentions and learning styles of children (Degotardi & Sweller, 2012).
According to Meins (2003), mind-mindedness is associated with parental sensitivity, parental representations and a secure parent-child attachment. A higher level of mind-mindedness at six months has been found to be an independent predictor of secure attachment in both mothers and fathers. However, mind-mindedness is unrelated to children’s general cognitive ability (Meins et al., 2001) and temperament (Meins et al., 2011), suggesting that individual child characteristics do not have an impact on parental mind-mindedness. Equally important, mind-mindedness is also unrelated to general social factors, for instance perceived social support and the socio-economic status of parents (Meins et al., 2011). Mind-mindedness is predominantly associated with several aspects of parenting.
Parenting stress
In addition to parental representations, sensitivity and attachment, mind-mindedness is also associated with parenting stress (McMahon & Meins, 2012). Parenting stress is defined in terms of whether parents experience difficulties with their child (Harrison & Sofronoff, 2002), the relationship with their child and themselves as parents rather than actual experiences of stressful life events (Abidin, 1995). Parents reporting greater levels of parenting stress have been found to be more authoritarian in their parenting styles (Rodriguez & Green, 1997), more negative in their interactions with their child and less involved in their child’s life (Anthony et
al., 2005; Crnic, Gaze & Hoffman, 2005). Parenting stress levels appears to be the highest during childhood years, diminishing when children are getting older (Baker & Blacher, 2002). Studies investigating the relation between mind-mindedness and parenting stress found that the parent’s proclivity to describe thoughts, intentions and feelings to their child (i.e. mind-mindedness) is negatively related to parenting stress: parents who used more mental words when describing their child reported lower parenting stress (McMahon & Meins, 2012). In other words, a focus on the emotional and mental life of their child may give parents more insight into the behaviour of their child. In this way, parents make the child’s behaviour more comprehensible, predictable and meaningful and thus less likely to induce parenting stress. Specially, positive mental words of parents are associated to lower levels of parental stress (McMahon & Meins, 2012) and to the perception of the child as being less difficult (Demers, Bernier, Tarabulsy & Provost, 2010). McMahon and Meins (2012) suggest that parents whose representations of the mental life of their child are mostly positive might be more likely to respond to them in a warm and positive way. However, this may depend on the kind of behaviour of the child: when children are performing positive and conforming behaviour, parents are probably more inclined to respond with positive affect and experience less stress. The amount of control and parental cognitions about the intention of the child’s behaviour are important factors that contribute to the level of parenting stress. Demers et al. (2010) found in their longitudinal study that both lower levels of parenting stress during the first months of children’s life and the perceptions of children as being relatively manageable or easy over the same period contribute to more (positive) mind-minded comments about the child as well as their relationship continues during the first two years. According to McMahon and Meins (2012), the direction of effect between mind-mindedness and parenting stress is questionable. On the one hand, it might be possible that the capacity to see their child as an individual agent is influenced by stressful life events that overwhelm the parent’s own mental
states. On the other hand, stress during parenthood may be influenced by the development of a higher level of mind-mindedness or more positive mind-minded representations of the child when the relationship increases over time.
As an important element of parenting stress, Lok and McMahon (2006) found that lower mind-mindedness is associated with depressive symptoms in parents assessing clinical services. Parents in clinical samples are more likely to experience high stress levels compared to community samples. Contrary to the finding of Lok and McMahon (2006), Demers et al. (2010) found no relation between mind-mindedness and parental depression.
Current study
In the current study, we aimed to investigate the relationship between mind-mindedness and stress of caregivers of traumatised children and youth. The study focussed on three groups: social workers in residential settings, family home parents and foster parents. Hereafter, for simplicity all three groups are termed ‘professional caregivers’. Although these professional caregivers deliberately choose to take care, support and work on the recovery of children with a variety of problems (Coppens & Van Kregten, 2015), it is striking that the majority of research is focussed on the child’s wellbeing and the effects of care on children. Caregivers are examined to a limited degree, while the caregivers’ wellbeing (including stress) affects negatively their relationship with their children (Jones & Morrissette, 1999) and the quality of care (De Schipper, Riksen-Walraven & Geurts, 2007). More specifically, as far as known none of the published research has used professional caregivers.
Although the relation between mind-mindedness and perceived caregiver’s stress is clearly established in home context of biological parents, what we do not know is how this relationship relates to other contexts (i.e. residential care, foster care). Besides, to our knowledge this relationship has not been investigated with regard to traumatised children. In this study the mind-mindedness is related to traumas in children, which means that a
professional caregiver recognises feelings, thoughts and mental states arising from traumatic experiences the child has experienced. Given the fact that the children involved in this study are often (severe) traumatised or damaged and no longer live with their biological parents, based on literature it does not imply that mindedness of caregivers are less valuable than mind-mindedness of biological parents. For this reason it was expected that the same relationship exists between mind-mindedness and parenting stress for professional caregivers as for biological parents. In brief, the corresponding main research question is: “Is there a negative relationship between mind-mindedness and parenting stress in social workers, foster- and family home parents?” It was hypothesised that mind-mindedness would be negatively related to parenting stress. We expected to find a negative relationship to stress in caregivers.
In addition to the question whether a relationship exists between these constructs, the contributions of multiple variables were examined with regard to the relationship between caregivers’ mind-mindedness and parenting stress. The child’s and caregiver’s gender and age, the duration of care and the caregiver’s experience working in youth care were merged into one explorative analysis.
Most of the studies investigating mindedness were focussed on maternal mind-mindedness. Only a very limited number of studies examined the level of mind-mindedness of biological fathers and to our knowledge no study included male (and female) caregivers working in professional settings. Generally biological mothers are more mind-mindedness compared to biological fathers (Lundy, 2013) and mothers seems to have more parenting skills (Hudson, Elek & Ofe Fleck, 2009). Derived from these findings, a lower level of mind-mindedness of male caregivers and having relatively little parenting skills may increase the level of parenting stress. In other words, the caregiver’s gender might exacerbate the relationship between mind-mindedness and parenting stress. Additionally, regarding the contribution of the child’s gender, research showed no differences in levels of mind-mindedness
of mothers of female compared to male children (Farrow and Blissett, 2014). However, Lok and McMahon (2006) found that mothers of female children used more mental descriptions than mothers of male children did which eventually may result in a decrease of stress. Thus, female children may exacerbate the relationship between mind-mindedness and stress.
Furthermore, the contribution of the caregiver’s and child’s age was examined in the explorative analysis. Demers et al. (2010) found that adult parents are more mind-minded than adolescents parents. The age of caregivers may exacerbate the relationship between mind-mindedness and parenting stress, because older caregivers may compensate a lower level of mind-mindedness with parenting skills built up through the years resulting in a lower level of parenting stress compared to younger caregivers. In addition to the caregiver’s age the contribution of the child’s age was also relevant to examine, because of the little research that was done to older children with regard to mind-mindedness and stress. Moreover, the strength of the relationship between mind-mindedness and stress may depend on whether a younger child or an older child, who is in a different stage of life, comes into the alternative setting. Likewise, the influence of the duration of care (duration of contact between caregiver and child) was examined on the relation between mind-mindedness and parenting stress. It seems plausible that a caregiver only will reach a specific level of mind-mindedness after a certain period of time. Kirk et al. (2015) assessed in their study the level of mind-mindedness in biological mothers at several periods and found that mind-mindedness is relatively stable. However, the relationship between biological mothers and their children, who are together from birth, might differ from the relationship between caregivers and their children. The variety in the duration of contact between the caregiver and child may affect the level of mind-mindedness and in turn may change the level of stress. In other words, a low duration of care may exacerbate the relationship between mind-mindedness and parenting stress.
Lastly, the influence of the caregiver’s experience working in alternative settings was examined. As has been mentioned before, research of Demers et al. (2010) showed that adult parents are more mind-minded than adolescent parents and may have more experience. Caregivers with lots of experience may compensate a lower level of mind-mindedness with extra parenting skills.
Method Participants
The present study was part of a doctoral research investigating the effectiveness of a training called ‘Taking Care of Traumatised Children’ on several domains (e.g. the level of trauma symptoms, trauma knowledge, parent-child relationship and parenting stress). This training was specially designed for caregivers of children who were dealing with trauma symptoms by Coppens and Van Kregten (2012). Caregivers who were employed by mental health care centres Spirit and Intermetzo had the opportunity to participate in the training in trauma sensitive parenting given by a professional. Both centres are providing aid to children and young people from the age of 0 to 23 and their family. Of the total number of 39 professional caregivers used in this study, 34 (87%) of them were in service of Spirit and 5 (13%) were employed by Intermetzo. This study focussed on departments of these centres where children were placed out of the home and who were subsequently placed in residential centres, family home families or foster families of Spirit or Intermetzo. The participants, all living in the Netherlands, could be divided in three groups: social workers (n = 26; 67%), family home parents (n = 8; 21%), and foster parents (n = 5; 13%).
The chosen subsample of 39 caregivers for this study consisted of 12 males (31%) and 25 females (69%). The mean age of all caregivers was 39.66 years (SD = 10.1). The sample of target children about who the caregivers have spoken during an interview and filled in a questionnaire, consisted of 26 boys (67%) and 13 girls (33%) aged 1 to 18 (M = 13.69, SD =
4.02). The duration of the relationship between caregiver and child (i.e. duration of care) varied from 3 to 43 months (M = 10.64, SD = 8.08). For an overview of all demographic characteristics of the three groups and the total group of caregivers (n = 39), see Table 1.
Measurements
In this study the dependent variable was the caregiver’s stress level. The independent variable was the level of mind-mindedness of the caregiver. These variables have been measured by completing a questionnaire by the caregiver and participating in an interview. Mind-mindedness (MM)
Mind-mindedness was measured by conducting the mind-mindedness interviews (Meins et al., 1998). Caregivers’ responses to the following question were analysed: “Can you describe [name child] for me?” using the protocol of Meins and Fernyhough (2010). Additionally, a second question related to mind-mindedness was asked with the purpose gathering more information about the child’s past and traumas (“Would you like to add something regarding to [name child]’s past?”). In accordance with a few professors, this question was added to the protocol of Colonnesi, Noom and Zeegers (2015).
Prior to the interview of maximum 5 minutes caregivers were informed that there were no right or wrong answers. If caregivers were looking for guidance on the kind of response required they were told to talk about any of their child’s characteristics came to mind. Responses of caregivers were videotaped and subsequently transcribed verbatim. The rated mind-mindedness of each interview was coded in accordance with the mind-mindedness coding manual (Meins & Fernyhough, 2010). First, each attribute the caregiver brought up was placed into the category mindedness’ or ‘no mind-mindedness’. The category ‘mind-mindedness’ consisted of the following features: mental, wishes and preferences, interests and disinterest and emotions. Mental features included any references to the mental life of the child relating to: thoughts, imagination, intellect, knowledge, memory and meta-cognition.
Table 1
Demographic Characteristics of Social Workers, Family Home Parents and Foster Parents
Variable Social Workers
(n = 26) Family Home Parents (n = 8) Foster Parents (n = 5) Total Group (n = 39) Gender Male Female 9 (35%) 17 (65%) 2 (25%) 6 (75%) 1 (20%) 4 (80%) 12 (30%) 27 (69%) Mean Age in Years
Range in Years 35.92 (SD = 8.41) 24 – 55 48.43 (SD = 10.58) 27 – 60 46.8 (SD = 7.0) 40 – 57 39.66 (SD = 10.1) 24 – 60 Educational Level Intermediate vocational level
Higher vocational level University degree Other 5 (19%) 20 (77%) 0 (0%) 1 (4%) 4 (50 %) 4 (50%) 0 (0%) 0 (0%) 2 (40%) 1 ( 20%) 2 (40%) 0 (0%) 11 (28%) 25 (64%) 2 (5%) 1 (3%) Caring* Alone With Partner 4 (50%) 4 (50%) 0 (0%) 5 (100%) 4 (10%) 9 (23%) Duration of Care (months) 9.46 (SD = 6.4) 8.38 (SD = 5.50) 18.60 (SD =14.17) 10.64 (SD = 8.08) Children in Each Household* Other Children Yes No Number of Other Children 1 child 2 children 4 children Own Children Yes No Number of Own Children 1 child 2 children 3 children 4 children 6 (75%) 2 (25%) 1 (13%) 1 (13%) 4 (50%) 1 (13%) 7 (88%) 1 (100%) 0 (0%) 0 (0%) 0 (0%) 3 (60%) 2 (40%) 1 (20%) 1 (20%) 1 (20%) 2 (40%) 3 (60%) 1 (20%) 0 (0%) 1 (20%) 0 (0%) 9 (23%) 4 (10%) 2 (5%) 2 (5%) 3 (8%) 3 (8%) 10 (26%) 2 (5%) 0 (0%) 1 (3%) 0 (0%) Years of Experience 0 till 3 years 3 till 6 years 6 till 10 years 10 years or longer 4 (15%) 7 (27%) 8 (31%) 7 (27%) 4 (50%) 1 (13%) 2 (25%) 1 (13%) 3 (60%) 2 (40%) 0 (0%) 0 (0%) 11 (28%) 10 (26%) 10 (26 %) 8 (21%) Note. * Only refers to family home parents and foster parents. The age of one family home parent was missing (n = 1). The duration of care of two social workers was missing (n = 2).
Comments coded as mental may be those like “conscientious”, “wilful” and “responsible”. Comments related to children’s wishes and preferences (e.g. “loving animals”), likes and dislikes (e.g. “hate to share with other kids”), but also comments related to their emotions (e.g. “scared”, “proud”, “vulnerable”) were included.
The category ‘no mind-mindedness’ consisted of behavioural, physical or general features. Behavioural features included any references to the child’s behaviour, for instance activities, interactive style (e.g. “open”, “energetic”, “talkative”) and sociability (e.g. “loyal”, “shy”). Psychical features included any references to physical characteristics, such as comments about the child’s age, health, position in the family and appearance. Comments that did not fit into any of the other categories were classified as general features, for instance “normal child”, “lovely” and “cute”.
Mind-mindedness was measured by expressing the number of mental descriptions as a proportion of the total number of descriptions mentioned in the interview by caregivers, which is also recommended by the developers (Meins & Fernyhough, 2015). A higher proportional score indicated a higher level of mind-mindedness. In the present study a score in percentages was used for examining the total score of mind-mindedness. Subsequently, all mental descriptions were further coded as positive, neutral or negative. Comments such as “loving” and “intelligent” would be coded as positive, comments like “wilful” would be considered as neutral and comments such as “mean” and “manipulative” would be negative. Positive, neutral and negative mind-mindedness were measured by expressing the number of positive, neutral and negative mind-minded comments as a proportion of the total number of descriptions mentioned in the interview. Again, the scores of positive, neutral and negative mind-mindedness were expressed in percentages.
As part of this study three coders had attended a training in interviewing and coding the mind-mindedness interview. The three coders practised until the inter-rater agreement between
these coders was high (rs = .89 for a subsample of 12 interviews), comparing mental descriptions with non-mental descriptions. Thereafter, the rest of the interviews were transcribed and coded by the first author. Doubts about how to code specific comments were discussed by the three coders.
Parenting stress
In order to measure the level of stress of caregivers, a condensed version of the OBVL, the OBVL-k, was used. The OBVL was a 34-item self-report questionnaire designed for parents with children aged 0 to 18 years (Vermulst, Kroes, De Meyer & Veerman, 2012). Parents indicated the extent of their agreement or disagreement with a series of statements addressing their experience of parenting in five domains: (1) problems in the parent-child relationship (e.g. “My child listens to me”), (2) problems with parenting and problems as a consequence of parenting (e.g. “I am able to control my child’s life”), (3) parental depressive symptoms (e.g. “Sometimes I do not see the value of life anymore”), (4) the extent of experiencing parenting as a limitation of freedom (e.g. “Because of my child I do not see my friends as much as I want”) and (5) health problems (e.g. “I have pain in my chest or surrounding my heart”). Contrary to the OBVL, the OBVL-k was a 10-item self-report questionnaire, derived from the first three scales of the OBVL (Vermulst et al., 2012). The OBVL of 34 items and the
OBVL-k of 10 items were highly correlated (T1, r = .87; T2, r = .90). For each of the 10 items participants chose their level of agreement with a statement on a 4-point scale (1 = not true to 4 = completely true).
Eventually the OBVL-K was used instead of the entire OBVL of 34 items, because of the fact that several items of the OBVL were not intended for social workers (e.g. “Because of my child, I do not see my friends as much as I want”). Although the OBVL-k consists of three scales, the items of each scale could not be interpreted as a scale score. Because of the reliability, only the total score of perceived parenting stress was used in the analyses. A higher
score on the OBVL-k indicated a higher level of parenting stress. The cronbach’s alpha for the OBVL-k total score was .91 (Vermulst et al., 2012), showing that the OBVL-k was reliable. Procedure
The three groups of caregivers of Spirit and Intermetzo were recruited differently. Social workers were informed by mail by behavioural scientists, family home parents were informed by phone by a group of researchers and foster parents were informed by an information folder given by foster care employees. Caregivers who wanted to participate in the training received an information letter concerning the training and the research. Subsequently caregivers could give permission for participation and the use of the collected information. Participating in this study was completely voluntary and caregivers could refuse any time to participate in the investigation or break off their participation intermediately, which was also mentioned on the informed consent form.
Participants were asked to take one specific child in mind with (severe) trauma symptoms during participating in the mind-mindedness interview and completing the questionnaires. They took part in a short video-recorded interview asking them to describe their child, without their child present. Additionally, participants were asked to provide demographic information and complete one questionnaire measuring parenting stress. Interviews took place at either one of the locations of Spirit and Intermetzo or at the caregivers’ home. In the case of social workers, researchers went to the social workers’ place of residential setting. Conducting the interview and completing the questionnaires took place before the start of the training. This research was approved by the Medical Ethical Testing Committee of the University of Amsterdam.
Statistical analysis
The analyses of this research will be performed using the Statistical Package for the Social Science (SPSS), version 20. For all statistical analyses an alpha level of .05 was used.
The first step in this study was to merge all independent data files into one. All irrelevant cases were removed (i.e. a missing mind-mindedness interview or a OBVL-k). The next step was to construct the study variables: mind-mindedness with regard to the child’s traumas and parenting stress. To create the study variable ‘total mind-mindedness’ the proportion of the total number of descriptions that were mental (proportional MM) were calculated. Thereafter, the study variables ‘positive mindedness’, ‘neutral mindedness’ and ‘negative mind-mindedness’ were created. Some social workers of Intermetzo filled in the total OBVL questionnaire, consisted of 34 items, instead of the shortened version (OBVL-k), consisted of ten items. In order to form the study variable ‘parenting stress’ several items of the OBVL were reversed after which the ten items of the OBVL were combined with the ten items of the OBVL-k. There were no missing items of the OBVL-OBVL-k.
Within the values of the ratios of mind-mindedness and the scores of the OBVL-k there has been controlled for outliers. No extreme values or outliers were found at mind-mindedness. However, one outlier was found in the variable ‘parenting stress’. It was decided not to replace the value by the mean, because the caregiver emphasised before starting the questionnaire that the duration of care was very low (i.e. caregiver and child did barely not know each other), so a widely divergent score of that participant with respect to the others was very plausible.
Initially, descriptive statistics and correlations were used to examine the extent to which study variables are correlated with each other. The main hypothesis, predicting that parental mind-mindedness would be negatively correlated with parenting stress in all groups, was assessed using Pearson’s correlations. Parental mind-mindedness functioned as the independent variable. The dependent variable in this study was perceived parenting stress. In addition, in order to carrying out the explorative analyses (variance analyses), all variables of ratio level were divided into low or high by examining the mean of that specific variable. After creating the new variables a check was carried out to make sure that no participant was excluded. The
explorative analyses were conducted with the purpose to examining the influence of the child’s and caregiver’s gender and age, the duration of care and the caregiver’s experience on the level of parenting stress and on the relation between mind-mindedness and parenting stress.
Results Descriptive Analyses
Through descriptive analyses the levels of mind-mindedness of professional caregivers (social workers, family home parents and foster parents) and the levels of stress reported by caregivers were examined. Initially one of the aims of this study was to compare these three groups: whether there were differences between the various caregivers in the level of mind-mindedness and perceived stress. However, these analyses could not be performed considering the low number of family home parents and foster parents.
As a first step the distributions of all relevant variables were examined. Although the hypothesis of this study was related to mind-mindedness (total score), the distribution of positive, neutral and negative mind-mindedness were also further investigated. Contrary to other studies to mind-mindedness, the total scores of mind-mindedness in this study were expressed in percentages rather than in proportions. Mind-mindedness (total) scores were normally distributed (M = 19.88, SD = 10.77, range 0.00 – 37.93). The total scores of mind-mindedness were comparable, although somewhat higher than those reported in a study of Demers et al. (2010), who found a mean proportion score of 1.62 (N = 106; SD = 1.75), but lower than those reported (M = 3.6, SD = .20, range 0 – 1.0) in the study of MacMahon and Meins (2012). Although positive, neutral and negative mental descriptions were all positively skewed, the frequency of positive descriptors was low and very skewed: 16 caregivers (41%) used no positive mental description to the question how they would describe their child. Additionally, 6 caregivers (15%) used no neutral mental description and 4 caregivers (10%) did not mention a negative description.
The parenting stress total score was normally distributed (M = 20.44, SD = 4.54, range 10 – 31) and was somewhat higher compared to those reported by parents of children aged 12 to 18 in Dutch community samples (n = 580, M = 16.0, SD = 4.1; Vermulst et al., 2012). Moreover, the reported parenting stress was also higher with regard to the reported parenting stress of the total group of parents of children aged 0 to 18 in the study of Vermulst et al. (2012) (N = 1425, M = 15.6, SD = 4.0). All descriptive statistics of each variable are presented in Table 2.
Table 2
Descriptive Statistics of Each Variable
n Minimum Maximum M SD Total mind-mindedness 39 0.00 37.93 19.88 10.77 Positive mind-mindedness 39 0.00 17.46 4.12 5.23 Neutral mind-mindedness 39 0.00 30.30 9.05 7.58 Negative mind-mindedness 39 0.00 24.39 6.71 6.22 Parenting stress 39 10 31 20.44 4.54
Note. The degree of positive, neutral and negative mind-mindedness were expressed in a percentage score.
Correlational Analyses
Subsequently, correlations were computed between the three categories of mind-mindedness: positive, neutral and negative. Table 3 shows that none of the categories were significantly correlated with each other, which means that the amount of negative mind-minded comments, the amount of neutral minded comments and the amount of positive mind-minded comments were not related to each other.
Table 3
Correlations Between Categories of Mind-mindedness concerning Emotions (Positive, Neutral and Negative) Positive Mind- mindedness Neutral Mind- mindedness Negative Mind- mindedness Positive Mind-mindedness 1 .02 -.11 Neutral Mind-mindedness .02 1 -.01 Negative Mind-mindedness -.11 -.01 1
Note. N = 39. None of the variables were significantly correlated.
Table 4 presents the correlations between the mind-minded variables on the one side and the independent variables on the other side. As can be seen in this table, the total amount of mind-minded comments did not correlate with the age of the child and caregiver. In addition to the total amount of mind-mindedness, positive, neutral and negative mind-minded comments were also not related to the child’s and caregiver’s age. Contrary, the total amount of mind-minded descriptions was negatively correlated with the caregiver’s experience (r = -.28, p < .05), indicating that mind-mindedness and the experience in years were related. In other words, the higher the level of mind-mindedness, the less experience in years of being a caregiver. However, positive, neutral and negative mind-minded descriptions did not correlate with the experience of being a caregiver. Furthermore, all categories of mind-mindedness did not correlate with the duration of care, as can be seen in Table 4. It is remarkable that the duration of care did not correlate with one of the variables of mind-mindedness, indicating that the numbers of months a child is staying in a residential setting or at a family home parent or a foster parent was not related to one of the components of mind-mindedness.
The main hypothesis of the current study was that highly mind-minded caregivers would experience less stress during taking care of the child and supporting him or her, and the other way around, that low mind-minded caregivers would experience more stress. The results
showed that the total amount of mental descriptions was not associated with parenting stress. Nonetheless, the hypothesis was partially supported, because a significantly negatively correlation was found between positive mind-minded descriptors and parenting stress (r = -.33, p < .05), indicating that the higher the level of being positively mind-minded, the lower the level of stress. In others words, caregivers who tended to describe their child using positive mental descriptions reported lower levels of parenting stress. This indicates that the higher the amount of positive mind-minded comments the less caregivers are experiencing stress.
Table 4
Correlations Between Study Variables Parenting Stress Duration of Care Experience of Caregiver Age of Child Age of Caregiver Total Mind-mindedness -.18 -.1 -.28* .05 -.07 Positive Mind-mindedness -.33* .21 -.13 -.05 .06 Neutral Mind-mindedness -.05 -.1 -.18 -.09 -.15 Negative Mind-mindedness .03 -.22 -.16 .23 .01
Note. N = 39. N (Duration of Care) = 37. N (Age of Caregiver is) = 38. *p < .05. **p < .01.
In order to examine if the relationship between total mind-mindedness and parenting stress was moderated through a third variable a univariate analysis (ANOVA) was conducted, with parenting stress as dependent variable and the total amount of mind-minded comments, the gender and age of the child and caregiver, the duration of care and the years of experience of the caregiver as independent variables. Besides the aforementioned main effects, interaction effects between total mind-mindedness and the child’s and caregiver’s gender and age, the duration of care and the caregiver’s level of experience were included. When looking at the main effects in Table 5, it can be seen that the total amount of mind-minded descriptions was not related to the degree of parenting stress (the main hypothesis). Only a significant effect of
the child’s gender on parenting stress was found (F(1,22) = 4.75, p = .040), indicating that caregivers experienced more stress when dealing with girls (M = 22.82, SD = 2.42) than with boys (M = 16.84, SD = 1.45). In addition to the total score of mind-mindedness, the caregiver’s gender and age, the child’s age, the duration of care and the caregiver’s experience were not related to the level of stress.
Table 5
One-way Analysis of Variances of Total Mind-mindedness and Parenting Stress Sum of Squares df Mean Square F p
Total Mind-mindedness 41.40 1 41.40 2.39 .136 Gender of Child 82.15 1 82.15 4.75 .040* Gender of Caregiver 1.76 1 1.76 .10 .753 Age of Child 51.47 1 51.47 2.98 .099 Age of Caregiver 21.99 1 21.99 1.27 .272 Duration of Care 49.72 1 49.72 2.87 .104 Experience of Caregiver 20.61 1 20.61 1.19 .287 Total Mind-mindedness * Gender of Child 86.07 1 86.07 4.97 .036* Total Mind-mindedness * Gender of Caregiver 60.03 1 60.03 3.47 .076 Total Mind-mindedness * Age of Child 5.03 1 5.03 .29 .595 Total Mind-mindedness * Age of Caregiver .01 1 .01 .00 .982 Total Mind-mindedness * Duration of Care 10.25 1 10.25 .59 .450 Total Mind-mindedness * Experience of Caregiver .17 1 .17 .01 .921 Error 380.65 22 17.30 Total 15310.00 36 Note. N = 39. *p < .05. **p < .01.
Examining the interaction term of total mind-mindedness with the gender of child and caregiver, the child’s and caregiver’s age, the duration of care and the experience of the caregiver, a significant interaction effect of total mind-mindedness and the child’s gender was found (F(1,22) = 4.97, p = .036). For girls, the hypothesis was confirmed that caregivers being low minded experienced high levels of stress and caregivers who were highly mind-minded experienced significantly less stress. This hypothesis was not confirmed for boys. With the exception of the child’s gender, the remaining variables did not influence the relation between mind-mindedness and parenting stress.
Because of the significant correlation between positive mind-minded comments and caregiver’s level of parenting stress, the same analysis was conducted in order to examine the relationship between positive mind-minded comments and parenting stress. The results of the univariate analysis concerning the positive mind-minded descriptors are presented in Table 6. Contrary to the expectation no relationship was found between positive mind-minded comments and the caregiver’s level of experienced stress. Once more, only a main effect of the child’s gender was found (F(1,22) = 6.19, p = .021), which was an expected outcome considering the analysis of total mind-mindedness (see above). Again, this outcome showed that caregivers experienced more stress among girls (M = 23.01, SD = 1.65) than among boys (M = 18.01, SD = 1.03).
When looking at the interaction terms, no significant effects were found (see Table 6). None of the variables did influence the relation between positive mind-mindedness and parenting stress. This deviates from the analysis with regard to the total mind-mindedness in which a significant interaction effect of the child’s gender was found.
Table 6
Multivariate Analysis of Variances of Positive Mind-mindedness and Parenting Stress Sum of Squares df Mean Square F p
Positive Mind-mindedness .867 1 .867 .05 .819 Gender of Child 99.82 1 99.82 6.19 .021* Gender of Caregiver .07 1 .07 .00 .947 Age of Child 3.12 1 3.12 .19 .664 Age of Caregiver 42.21 1 42.21 2.62 .120 Duration of Care .64 1 .64 .04 .843 Experience of Caregiver 2.10 1 2.10 .13 .722 Positive Mind-mindedness * Gender of Child .60 1 .60 .04 .849 Positive Mind-mindedness * Gender of Caregiver 10.95 1 10.95 .68 .419 Positive Mind-mindedness * Age of Child .29 1 .29 .02 .895 Positive Mind-mindedness * Age of Caregiver 13.21 1 . 13.21 .82 .375 Positive Mind-mindedness * Duration of Care 47.76 1 47.76 2.96 .099 Positive Mind-mindedness * Experience of Caregiver 30.29 1 30.29 1.88 .184 Error 354.58 22 16.12 Total 15310.00 36 Note. N = 39. *p < .05. **p < .01. Discussion
The current study examined the relationship between mind-minded and parenting stress of professional caregivers. This group of caregivers, consisting of social workers, family home and foster parents, supported and guided out-of-home placed children in mental health care centres who often had to deal with trauma symptoms. Literature related to biological parents describes a negative link between mind-mindedness and stress in mothers of pre-school aged
children (McMahon & Meins, 2012), suggesting that mother’s proclivity to mention thoughts, intentions and feelings of her child is negatively related to parenting stress. The association between mind-mindedness and parental stress is consistent with the extensive proposition that a certain amount of control and cognitions of parents about the intention of their child’s behaviour are important factors contributing to a lower level of parenting stress. More mind-minded parents are likely to see their child as an individual with a mind and consider behaviour as meaningful to the child. Thus, parents may better understand the child’s challenging behaviour and therefore may experience that behaviour as less stressful (Deater-Deckard, Smith, Ivy & Petril, 2005).
To the best of our knowledge the relationship between mind-mindedness and parenting stress was only examined among biological parents. Previous research did not focus on the level of mind-mindedness and parenting stress of caregivers working in professional settings. Because of that fact, in the current study the relationship between mind-mindedness and stress of social workers, family home parents and foster parents was examined. The main research question was whether a relationship exists between mind-minded comments made during the interview by caregivers and their stress level. More specifically, whether there is a negative relationship between mind-mindedness and stress of professional caregivers: the higher the level of mind-mindedness, the lower the stress level of the caregiver and vice versa.
The hypothesis that mind-minded professional caregivers would experience less stress was partially confirmed. Mind-mindedness regarding positive mental descriptions of the child was in fact related to the level of stress. Caregivers who were focussed on positive features of their child were less likely to perceive difficulties with their child or the relationship with their child. This relationship supports the outcomes of the study of McMahon and Meins (2012) where positive mental words of biological parents were associated with lower levels of stress. Besides, this finding is consistent with the study of Demers et al. (2010) where positive
mind-mindedness was related to the perception of the child as being less difficult. Caregivers who focus in a positive way on the child’s mental life are more likely to respond to their child in a positive and warm way. In other words, when caregivers are noticing rather positive characteristics of the child, they validate the child more quickly by naming these positive thoughts, qualities or features of the child. This is consistent with other research showing that positive reinforcement leads to a reduction of the child’s problem behaviour (Sanders, Markie-Dadds, Tully & Bor, 2000) and may leads indirectly to less stress.
A further substantiation of the relation between positive mind-mindedness and parenting stress could be that the focus on positive characteristics of the child may change and improve the caregiver’s mood, supporting the finding of Lok and McMahon (2006). In their study they found that mind-mindedness is associated with depressive symptoms in parents, suggesting that a positively higher level of mind-mindedness would decrease current depressive complaints which also may decrease the level of stress.
It is remarkable that the use of more positive-minded comments were related to a lower of stress, while the main hypothesis, that a higher level of mind-mindedness in general would be associated with a lower stress level, could not be confirmed. This discrepancy could be due to the distribution of the variable positive mind-mindedness. As has been mentioned before, positive mind-mindedness was positively skewed, meaning that many caregivers used no positive mental description during the mind-mindedness interview. This distribution may result quicker in significant findings when only a few caregivers were using positive mind-minded words when describing their child.
A possible explanation for the inconsistent finding that mind-mindedness in general was not (negatively) related to parenting stress might be the relatively low duration of care (mean of 10 months). When children and youth recently came into a family home, foster home or residential setting, it seems plausible that caregivers and children/youth are not completely
accustomed to each other in a couple of months. In the first months after placement children and youth are reluctant to communicate about all their thoughts, feelings and wishes to their relatively new caregiver, making caregivers less likely to consider the child as an individual with minds, thoughts and emotions. In other words, when due to a low duration of contact between caregiver and child the secure attachment is missing or could not built up it might be harder for the caregiver to be mind-minded (Meins et al., 2003). Additionally, when the caregiver and child are not attached that well, the caregiver is not directly aware of the problems around that child and thus will be less likely to induce parenting stress, because of not knowing about the severity of the child’s problems. It might be possible that the level of mind-mindedness of the caregiver will be increased after a certain period of time. After which period a caregiver is able to be mind-minded may be examined in future research.
Continuing on the relatively low duration of care, another possible explanation for not finding a relation between the total mind-mindedness and stress is related to the stress level of caregivers. During childhood the caregivers’ stress level appears to the be highest and diminish when children become an adolescent (Baker & Blacher, 2002). Most of the children in this study were in the phase of early adolescence, resulting in a lower level of caregivers’ stress. Because of a limited amount of contact between caregiver and child, the caregiver might be confined in the degree of being mind-minded. All together this may result in a lower level of mind-mindedness and stress, making it more difficult to find a negative link between both.
Moreover, it might also be possible that professional caregivers do not experience that much stress from themselves compared to biological parents. According to Jones and Morrissette (1999) foster parents reported being genuinely less stressful while events relating to the child’s behaviour occurred with a high degree of frequency. Likewise, Wilson (2006) found that foster parents do not experience much stress, because they do not perceive the challenging behaviour of their child as a threat. Foster parents are more likely to view the child’s
behaviour as manageable. Besides, caregivers deliberately make the choice to raise, guide and support children who may perform problem behaviour or may have experienced traumatic events which could generate stress. It can be assumed that people will not be a professional caregiver when they know about themselves that they cannot cope adequately with stress. Besides a lower level of caregivers’ stress, the level of being mind-minded might also be lower than expected. It was assumed that the professional caregivers in this sample, mainly social workers, would be more mind-minded to the child, because of their skills, training and experience in working with children. However, caregivers in this study were less mind-minded than biological parents in the study of MacMahon and Meins (2012) which may contribute to not finding a relationship between (total) mind-mindedness and parenting stress.
In addition to the main question of this study, the contributions of the child’s and caregiver’s gender, the duration of care and the caregiver’s experience were examined. Only the sex of the child had his impact on the level of parenting stress: caregivers reported more stress when taking care of and supporting girls rather than boys. This finding is inconsistent with several studies which found that mothers of boys experience more parental stress than mothers of girls, given the fact that disruptive behaviour problems are more common among boys and that boys have generally a lower inhibitory control and a underdeveloped ability to regulate their attention (Williford, Calkins & Keane, 2007). However, the study of Fossum, Morch, Handegard and Drugli (2007) found that even when there were no differences in problem behaviour between boys and girls, the stress level was higher in girls’ than boys’ parents. Besides, mothers of girls reported higher level of depressive symptoms. Caregivers may experience more stress because of the complex internalising problems which are much more common in girls than boys (Zahn-Waxler, Klimes-Dougan & Slattery, 2000).
When looking at the contribution of the aforementioned factors on the relationship between mind-mindedness and parenting stress, the hypothesis that the stress level of
professional caregivers would be less when caregivers are mind-minded could be confirmed for the factor ‘gender of the child’. More specifically, the hypothesis could only be confirmed for girls, not for boys. A possible explanation for this finding might be the strong relationship between mind-mindedness and internalising problem behaviour (Meins, Centifanti & Fishburn, 2013). The study of Meins et al. (2013) showed that mind-mindedness is effective in decreasing internalising problems of children. Given the fact that girls are performing more often internalising problem behaviour, including trauma symptoms (Zahn-Waxler et al., 2000) and boys externalising problem behaviour (Williford et al., 2007), a higher level of the caregivers’ mind-mindedness might result in a lower level of internalising problems of girls which eventually may decrease the caregivers’ stress level. It might be the case in this study that the caregivers’ mind-mindedness and internalising problems are more related to each other than mind-mindedness and externalising problems.
Another explanation of not finding an effect of boys on the relation between mind-mindedness and parenting stress is that girls have relatively more often experienced traumatic events (Costello, Erkanli, Fairbank & Angold, 2002). Given that fact, it might be possible that caregivers recognising trauma symptoms earlier in girls than boys. Providing insight into the situation and problems may ensure a higher level of mind-mindedness and a reduction in stress. However, this finding should be interpreted with caution because no relationship was found between positive mind-mindedness and parenting stress using the same statistical analysis and the same variables. Examining the influence of gender on the relation between positive mind-mindedness and parenting stress, no effects of both girls or boys were found. All other variables (i.e. the child’s age, caregiver’s gender and age, the duration of care and the caregiver’s experience) did not influence the relation between (total and positive) mind-mindedness and parenting stress. Nonetheless, it should be noted that the sample in these analyses were relatively small which may negatively affect the reliability of the analyses (Field, 2009).
Strengths and Limitations
One of the strengths of the current study is the innovative aspect of the insertion of the group of professional caregivers. To our knowledge the relationship between mind-mindedness and caregivers’ stress and multiple factors on this relationship have not been examined. Additionally, investigating the mind-mindedness related to the trauma of children was also not examined before, while this is of major importance in order to understand children and eventually being able to help them. Another strength contains the insertion of high quality measurements. Both the mind-mindedness interview and the questionnaire measuring the degree of parenting stress are internally consistent and in previous research assessed as valid. Besides those strengths, the study also contains several limitations which needs to be addressed. The first one is the relatively small sample size: the amount of groups of social workers (n = 26), family home parents (n = 8) and foster parents (n = 5) was too limited. Because of the fact that several questionnaires were not entered correctly and only caregivers who completed both the mind-mindedness interview and the questionnaire related to stress could be incorporated, the total number of participants was increasingly reduced. Due to the small sample size, the statistical power of this study may reduce. Besides, a small sample size makes is harder to find a significant result.
A second limitation is the heterogeneity of the sample of caregivers which may affect the statistical validity of this study. Because of the limited number of family home parents and foster parents, the participants were analysed as one group. Consequently, it was not possible to investigate the level of mind-mindedness and parenting stress for each group which was initially one of the aims of this study. Due to the heterogeneity the associations between mind-mindedness and stress might differ for each group of caregivers because there are some differences between these three groups, for instance in the nature of the activities and the intensity of the relationship between caregiver and child. More specifically, the intensity of the
relationship with the child differs for each setting. In general social workers are responsible for a group of children, while family home parents and foster parents are responsible for only one or just a few children. Furthermore, social workers do have the ability to take some days off, which family home and foster parents do not have or to a smaller extent. Thus, it is conceivable that the relationship between mind-mindedness of family home and foster parents and stress may be stronger compared to the relationship of social workers and stress. In addition to the heterogeneous sample of caregivers, the heterogeneous group of children may also be a limitation. The wide variety of the children’s problems and the duration of care might also have an impact on the validity.
A third limitation is related to the inclusion of the second question of the mind-mindedness interview. This question was added to the original protocol in accordance with a group of professors aimed to gather more information about the child’s traumatic experience(s). However, the contribution of this question to the mind-mindedness protocol was not measured resulting in not knowing the effect of this question.
Relevance of the present study
Despite these limitations, the results of this study are relevant to clinical settings since, to our knowledge, there are no studies investigating the relationship between mind-mindedness and stress of professional caregivers in alternative settings. Multiple studies focussed on the child’s wellbeing and corresponding emotional and behavioural problems, while a substantially smaller section focussed on parents or other caregivers. These studies emphasise that there is strong consensus that parents matter in the way their child functions and that they play a fundamental role in the development of emotional and behavioural problems in children (Grusec, 2007). Caregivers in this study reported a lower level of mind-mindedness and higher level of parenting stress compared to some other studies (MacMahon & Meins, 2012; Vermulst
et al., 2012), suggesting that not only services for children and youth are important, but also services of support for their professional caregivers.
The current study showed a negative link between positive mind-mindedness and parenting stress. This result implies that the use of positive mind-minded comments might contribute to lower levels of stress. Therefore, focussing on and investing in enhancing caregivers’ mind-mindedness seems to be essential. Knowledge about these processes might be indirectly important for the development of prevention and intervention methods for treatments of children or support programmes helping families to cope with stress.
Directions for Future Research
Based on these findings it can be concluded that further research is of major importance. Although a relationship between total mind-mindedness and parenting stress was not found, future research should examine the same relationship with a bigger and homogenous sample of caregivers. When future research shows that total mind-mindedness is related to lower stress levels of caregivers, mental health care centres have to pay more attention to the level of mind-mindedness of their employees by going on training. Moreover, future research should emphasise the importance of mind-mindedness during the education of children in an alternative setting, because mind-mindedness may contribute indirectly to a decrease of emotional and behavioural problems of children.
Because a cross-sectional design was used in this study it was not possible to investigate causal relationships. Therefore, it is important to examine the relationship between mind-mindedness and stress by carrying out a longitudinal study and thereafter examine the causal direction of the relationship, because the direction of effect between mind-mindedness and caregivers’ stress might be the other way around. More specifically, the caregivers’ capacity to see the child as a psychological individual might be influenced by stressful life conditions which may overwhelm their awareness of their own mental states or adjust their ability in order to
reflect and respond on their children’s emotional and mental experience (McMahon & Meins, 2012),
Furthermore, examining the distinctions between the different groups of caregivers are of major importance. Effects of mind-mindedness on parenting stress may differ for each type of caregiver. Moreover, other variables should be taken into account in further research, for instance the number of placements of children which may have an impact on both child (i.e. experiencing the placement as traumatic) and caregiver.
Conclusion
This study provides a first implication that mind-mindedness of professional caregivers working in a substitute home environment is associated with parenting stress. Although the total amount of mind-mindedness was not related to parenting stress, positive mind-minded comments were associated with caregivers’ stress which means that the more positive mind-minded comments, the lower the stress levels. Further, the gender of the child influenced the caregivers’ level of stress. In specific, caregivers of girls being low mind-minded experienced higher levels of stress and caregivers who were highly mind-minded experienced significantly lower levels of stress, but this did not apply to boys. Based on these findings and the study design no conclusions could be made about the causality. Therefore, it is important that future research uses a longitudinal design to investigate the relationship between total mind-mindedness and parenting stress of caregivers of out-of-home placed children.
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