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By the University at Buffalo
An infant’s ability to securely attach to a caregiver or parent is among the most important steps in the life course, according to Mickey Sperlich, Ph.D., an assistant professor in the University at Buffalo School of Social Work (SSW).
That relationship is a cornerstone of the foundational learning experience so critical to early brain development. It’s not only the beginning of an infant’s exploration of the world, it’s also a safe haven where a child can return, rest and refuel. It’s where infants learn to regulate emotions, thoughts and behaviors, first through co-regulation with their caregiver, but eventually by adopting strategies to self-regulate.
This secure attachment plays out within the discipline of infant mental health, an emerging field of study and practice that grew from pioneering work in attachment theory in the mid-20th century by psychologists such as John Bowlby, Mary Ainsworth and Mary Main.
“Infant mental health is all about attachment,” said Sperlich, an expert in trauma-informed approaches to mental health, and the instructor of an online course in infant mental health offered in UB’s SSW. “It’s about assessing and intervening to promote caregiver sensitivity and fostering secure attachment paradigms for infants and toddlers.”
Prior to her academic work, Sperlich had a long career as a midwife and started research in that field to attend to trauma survivors in her practice. That led to work in perinatal mental health research. Her graduate studies at Wayne State University offered a program that conferred a Ph.D. in social work and infant mental health. Though some universities offered certificates in infant mental health, Wayne State was the first to confer a title in the field.
“It warms my heart as a midwife to have a degree with babies in the title,” she said.
She started the infant mental health course shortly after joining the UB faculty in 2015, the same year the New York State Association for Infant Mental Health (NYS-AIMH) was founded.
In the case of infant mental health, the relationship itself, between caregiver and child, is the actual client. Although the definition of “infant” can vary by discipline, Sperlich said in the field of infant mental health researchers and practitioners usually work with children from birth to about 5 or 6 years old.
Early research in infant mental health started by studying disruptions to the relationship between infants and caregivers. Categories of secure and insecure attachments resulted from these observations. Later work at the University of Michigan, led by Selma Fraiberg, a psychoanalyst and social worker, created pathways of assessment and intervention.
Fraiberg’s early research involved infants with congenital blindness and how they interacted with their parents. She started the technique of “kitchen table therapy,” the foundation for home visiting programs in general, by visiting the homes of parents with young children.
“Her influential article The Ghosts in the Nursery is one of the first studies to identify intergenerational trauma,” Sperlich said. “That paper set the stage for conceptualizing infant mental health as a profession.”
There are now 34 state associations and three international associations that have adopted much of what Fraiberg and her colleagues developed.
“That work shows how it is possible to intervene in real time to head off developmental and behavioral problems for these affected relationships,” she said.
Sperlich said the core elements of infant mental health align well with the SSW’s trauma-informed and human rights perspective.
“Intergenerational trauma is often transmitted through insecure attachments,” she said. “So people who have experienced early trauma, and have insecure attachments, or factors like mental health problems, separation issues, or have experienced complications related to the child’s birth, might not be prepared for the demands of parental sensitivity and responsivity.
“But intervening with these affected families needs to be done with the kind of compassion and care that is foundational to the caregivers’ and the infant’s mental health.”
Infant mental health services locally are growing but still somewhat limited.
“I’d like to see more practitioners and services, maybe even a certification program in the School of Social Work as part of a partnership with NYS-AIMH,” Sperlich said. “But for anyone exploring services today, NYS-AIMH and the Child Care Resource Network are both great places to start.”