ATTACH in Denmark: Feasibility randomized test of a 10-session parenting program

Attachment and Child Health (ATTACH) Added to Treatment As Usual Versus Treatment As Usual Alone for Parents With Psychosocial Problems: A Feasibility Randomized Controlled Trial

This project will try a 10-session ATTACH parenting program to see if it helps parents of children aged 0–5 who are receiving municipal psychosocial support improve their ability to reflect on thoughts and feelings.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 52 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: University of Copenhagen (other)
• Locations: 3 sites (Gribskov and 2 other locations)
• Trial ID: NCT07162493 on ClinicalTrials.gov

What this trial studies

This is a feasibility randomized controlled pilot in which eligible parents referred to municipal family treatment centers are randomly assigned to the 10-session ATTACH program or to treatment as usual. The trial will track recruitment and retention, how many parents complete at least 7 of 10 sessions by five months, and data-completion rates for the primary exploratory outcome. The main clinical outcome is change in parental mentalizing (reflective) skills measured five months after allocation. Participants are parents of children aged 0–5.7 years who speak Danish or English and have been referred for psychosocial support under the Danish Child Act.

Who should consider this trial

Good fit: Ideal candidates are parents (who speak Danish or English) of children aged 0–5.7 years who have been referred to municipal family treatment centers for psychosocial problems and can commit to attending multiple sessions.

Not a fit: Parents whose children are older than 5.7 years, who cannot attend the sessions, who do not speak Danish or English sufficiently, or who require immediate intensive psychiatric or social services beyond municipal support are unlikely to benefit from this program.

Why it matters

Potential benefit: If successful, ATTACH could strengthen parents' ability to understand their own and their child's mental states, which may improve parent–child interactions and reduce psychosocial problems.

How similar studies have performed: Other mentalization-based parenting programs have shown promise in improving parental reflective functioning, but ATTACH as implemented in Danish municipal settings is being tested here in a feasibility randomized design.

Eligibility criteria

Inclusion criteria

* Child aged 0 - 5.7 years at enrollment.
* Speaks Danish or English sufficiently to take part in assessments and intervention without an interpreter.
* Both parents provide consent in case of shared child custody. Parents experience psycho-social problems that have resulted in referral to the family treatment center on the basis of legislation from the Danish Child Act ("Barnets Lov"), under the following Sections defining support needs: Section 29: Family counselling: Includes open access to family counselling as an early preventive effort. In this context, the counselling may involve referring the family to other departments within the municipality or to other relevant authorities that can provide the appropriate guidance and support. Section 30: Early preventive intervention: Includes a variety of approaches, such as consultancy services and participation in network or discussion groups to address and prevent challenges faced by the family at an early stage. Section 32: Supportive interventions: May be initiated on the basis of a preliminary assessment or a child welfare investigation pursuant to Sections 19 and 20 of the Child Act, or concurrently with the completion of such an assessment or investigation. Support may include practical, pedagogical, or other types of support in the home; appointment of a permanent contact person for the entire family; family therapy or individual treatment for the child or young person; family placement involving residential care in a foster family, an approved child and youth residential facility, or a housing facility; supportive placement in a foster family or in an approved child and youth residential facility; other forms of assistance aimed at providing counseling, treatment, and practical and pedagogical support.
* Parents who have their child in out-of-home placement /foster care (with or without consent).
* Parental psychosocial problems such as (but are not limited to) mental health problems, cognitive difficulties, substance abuse, poverty, social isolation, adverse childhood experiences, functional or somatic disorders, criminal involvement, domestic violence, having a child with emotional regulation difficulties, having a child with developmental problems, having a child with functional or somatic problems, having a child with internalizing or externalizing problems.

Exclusion Criteria:

* Child is older than 5.7 years at enrollment.
* Parent does not speak Danish or English sufficiently to take part in assessments and intervention without an interpreter.
* Consent cannot be obtained from both parents in case of shared child custody.
* The parent is known to move to a different municipality within 5 months from randomization.

Where this trial is running

Gribskov and 2 other locations

• Center for Sociale Indsatser — Gribskov, Denmark (RECRUITING)
• Poppelgården Familiecenter — Hvidovre, Denmark (RECRUITING)
• Familie- og Dagtilbudscenter — Høje Taastrup, Denmark (RECRUITING)

Study contacts

• Principal investigator: Johanne Smith-Nielsen, PhD, associate professor — Centre of Excellence in Early Intervention and Family Studies, Department of Psychology, University of Copenhagen
• Study coordinator: Katrine Isabella Wendelboe, PhD

Conditions: Mentalization, Recruitment of Participants, Adherence, Treatment, Drop Out, Parenting Intervention, Vulnerable Families, Feasibility Studies, parenting