What is the Meaning of the Child Interview?
The Meaning of the Child Interview (MotC) is a method of understanding the parent-child relationship, though evaluating the way parents think about their child. It makes use of a semi-structured interview in which parents talk about their child, their relationship with their child, and their parenting, which is then carefully analysed using a manualised system.
“The children became ‘actors in someone else’s play'”
(Reder and Duncan, 1999)
The concept of the Meaning of the Child was developed by applying attachment theory and research on adult discourse (patterns of speaking about relationships) to the insights of Reder and Duncan (1995, 1999), whose seminal studies in the 1990’s of fatal child abuse highlighted the importance of attending to the particular psychological meaning that a child has for his or her parent(s). This is fundamental to all parent-child relationships, not just those in difficulty, reflecting the insight that that human development is shaped by how we are seen by those close to us (Fonagy et al. 2004).
“What cannot be communicated to the [m]other, cannot be communicated to the self”
(attributed to John Bowlby)
The Meaning of the Child Interview differs from similar procedures by its focus on the parent-child relationship (rather than some attribute of the parent), as understood by how the parent thinks and talks about their child. For this reason, it is uniquely suited to helping understand what is going in specific parent-child relationships, the potential impact of this on child development, and the kind of of supportive intervention (if any) that might be needed (Grey and Farnfield 2017a).
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Possessing a solid foundation basis in academic research and psychological theory, the MotC does not require a specific academic or professional background to learn or use. It has been successfully taught internationally to social workers, family centre workers, therapists, psychologists, occupational therapists, and psychiatrists alike, with training given to Local Authorities (it is currently integrated into the assessment process of Milton Keynes children’s services), CAMHS services, voluntary organisations, and independent social work, psychology and occupational therapy agencies. It forms part of the University of Roehampton’s pioneering postgraduate programme in Attachment.
The MotC is also used in adoption support, and in fostering services It is now a requirement for Level 2, Sensory Attachment Intervention (SAI) training. The MotC was an integral part of the successful Norfolk Parent-Infant Mental Health Attachment Project (PIMAP) with high-risk families, that significantly reduced the need for child protection involvement, preventing children being removed from their parents (Smith eg al. 2018).
“The Meaning of the Child Interview has proved to be one of the most powerful and informative clinical tools used in our clinical practice, and has helped make sense of some very complex cases… I would highly recommend attending training / seminars at the Cambridge Centre for Attachment.”
Dr Emma Hunnisett, Consultant Clinical Psychologist, Child and Family Psychology Clinic, Norwich
Why use the Meaning of the Child Interview?
“If a community values its children, it must cherish it’s parents” John Bowlby
Services to parents offer are often packaged around what can be resourced, or even what works with a general population, without knowing whether the particular parent or relationship is in a position to access or make use of them. Experience shapes the sense we make of our relationships and the information about them we can access. Trauma in particular can exert a major influence on what we can allow ourselves to know, and what we can’t bear to look at (Bowlby 1982). The MotC makes brings this process to light, showing its impact on the parent-child relationship. This offers the chance to offer services at a level at which they can be accessed can have an impact, which avoids wasting money on intervention that will not work, and blaming parents and children for not cooperating with inappropriate support (Crittenden et al. in press).
‘The MotC should be seen as a fundamental assessment within child protection. It is one of the very few assessments that is able to consider how both the parent thinks and feels about their child and how the child makes them feel. It is within this area of knowledge that risks posed of serious maltreatment can be safely assessed and managed.’
Barry Tilzey, Consultant Practice Development Lead – London Borough of Wandsworth
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Child Welfare and Forensic Settings
Recent UK guidelines for those involved in child welfare decision making (e.g. NICE guidance 26 on children’s attachment), and a consensus of prominent attachment researchers (Forslund et al. 2021) recommend welfare professionals pay attention to the conditions that facilitate supportive attachment relationships.
“Assessment of caregiving should be the primary focus [in family court cases], with attachment assessments a possible complement:
We should first and foremost assess the parent’s ability to understand and respond effectively to the child’s needs, to know and value the child, and to be consistently in charge in the relationship.” (Forslund et al 2021, p.31)
The MotC offers just this kind of information.
At the same time, these authors rightly advise caution around the use of procedures validated at the group level to make predictions or diagnose pathology in individuals. The MotC is designed to contribute to a wider assessment of the needs of children and their families, and should never be used in isolation to make life-changing decisions around the needs of a child. Neither should the categories yielded by the MotC be seen as a standalone risk assessment, without regard to context.
Instead, the MotC can offer help in these settings by bringing to light the positive intentions of parents to offer love and nurture to their children; giving insight into some of the obstacles that the relationship faces (in particular the impact of traumatic experiences); and guiding work with parents to tackle problems in their lives and parenting, rather than blaming them for complex and multi-faceted difficulties (White et al. 2019). A more systemic and relational understanding of ‘risk’ can help contribute to the broadest possible understanding of the challenges faced by all those concerned with the welfare of a particular child, without glossing over the need for effective action where it is warranted. Smith et al.’s 2018 study of the Norfolk PIMAP project shows how this kind of formulation-based approach using the MotC can achieve significant reductions in children coming into care and the need for child protective services with children at high risk of removal, whilst also helping make better decisions around risk (see also McPherson et al. 2018).
The History of the Meaning of the Child Interview
The MotC was developed by Dr Ben Grey, in conjunction with the University of Roehampton, and Family Care, a former voluntary organisation based in Peterborough, UK, where Dr Grey and Ms Kesteven led a team that carried out assessment and therapeutic intervention for Local Authorities and the Family Courts. The aim was to use expertise in attachment theory and research to develop a tool for understanding parent-child relationships, that was geared towards the needs of assessment, intervention, and decision-making in child welfare and therapeutic practice. It has been taught and used widely since 2011 and forms part of the University of Roehampton’s MSc in Attachment Studies, where Dr Grey is now Senior Lecturer and Programme Director.