I suggest you read Dilys Daws' All Through the night which is directed toward therapists, maternal & child health nurses, and parents.

Talking about "attachment groups" for people with difficulties in "attaching" might be counter productive even if it seems, superficially, efficient,

If somebody has difficulty in attaching to a baby, the task of attaching to a group is probably beyond them unless given a lot of support, by which time the time savings of a group become marginal. Therapy always involves the question of attachment to a therapist and to a process.

Those who have had attachment difficulties can be helped but the initial task of actually turning up can make the group approach difficult.Successful group programs of all sorts run with effectiveness, but when there is no program, it is hard to get one started as participants have to be referred by others and usually prefer the person they are currently seeing to moving into groups. Established group programs get direct referrals and, after some time, the problem of having people feel confident in the process diminishes.

I was responding to Vivienne's idea that she may be able to mount a group program and help more people. I think getting such a program going is very hard work and even harder with a target population who are likely to be overwhelmed by even turning up. To see group work as somehow more cost effective is thinking guided by numbers, not by the needs of the clients.

I am glad you have joined this conversation and was impressed by your contribution to the Journal O Child Psychotherapy in 2000. I was not saying group work is impossible, I was saying it has great value once set up, but getting a program going does require much effort. overall, and with each potential client, and ongoing programs do not deliver numeric efficiencies, even if they can deliver the sorts of value that you have written about.

I can't remember who began this exchange, now, but I hope you are contacted to provide your valuable input. I can only add my best wishes to those who undertake such demanding work as I think the social value of such intervention is greatly underestimated as the babies grow and impact all sorts of systems prior to school, and then the troubles can be greatly compounded.

I am extremely interested in the emerging debate about the efficacy of groups for mothers and infants with attachment problems. In Melbourne we have been running a model of time limited group therapy for such mums and infants for over 5 years..we call it the P.A.I.R.S (Parent and Infant Relationship Support) group. Presented same at last years National conference in Brisbane. We find some of the mothers are indeed delicate and feel nervous about attending a group & we engage a Family Support worker to collect them from home for each of the 10 weeks.

A second point in this interesting debate is the capacity of such vulnerable or depressed or anxious or abused mums to engage in a group at all. We screen referrals and accept mother-baby pairs when the mums are stable on medication eg on discharge from Monash Medical Centre Mother Baby Unit, on methodone rather than heroine, sufficiently non depressed to at least be able to talk (tho only just able to get out of bed when collected).

The numbers in the program are small (not usually more than 6 families) & we meet and greet each pair individually to establish rapport, explain the program , answer questions & collect our pre-group measures (EPNDS. DMC & Bayleys Scales) for a few weeks before the program proper begins. Having committed to the program and met the leaders the mothers then usually attach to each other in the Mothers Group section of the program & derive enoumous support from each other and feel great relief that they are not 'the only ones'.

To explain further, we run a parallel combined (or double group) model of group work which envolves mostly time together for mothers and babies, sitting in a circle format on mats on the floor, but also time apart for both mother and baby group therapy to take place.. The group starts with all participants together. This phase is introductory, reporting back and activities time but also allows us to cue and comment on interaction, wait watch and wonder, enjoy the babies interaction with each other, contain overwhelming emotional displays, and validate any improvements seen.

After 45 min like this (in each 2 hour session) we spend the next 5 - 10 min preparing mums and babies to separate (lots of staff on hand). Mums provide for babies needs for the next half hour (food, security blanket, mum's hand bag, shoe, jumper etc ) & inform individually minding staff of baby's schedule. Mums take off to next room for a cup of coffee & mothers group. Half an hour later mothers and babes are prepared for re-union.

Greetings, feed back and secure base comments follow after they are re-united and when the group has settled into a circle again, a ritual goodbye song and routine is followed.

We have found that this model suits many mothers and infants, but is rather challenging for those with separation anxiety!! It enables us to 'facilitate' lots of work on attachment as well as addressing the mothers needs, via the mother's group (mothering the mothers who then find it within themselves to mother their babies), but we are still debating how much to stick to the structure and how much 'free-flow' to allow for 'interesting things' to happen spontaneously.

I'm looking forward to reading the next round of comments on e-mail....as we ponder on...

This sounds a fine idea...i would like to be able to at the Marce Meeting..and perhaps to present..

I am interested in finding out more about the conference. I manage the Sibling project in Adelaide and have particular interest in maternal mental health/attachment issues etc and the effect of these on both a child with special needs and the development of their siblings. Thanks

Yes, there is a lot of work going on, and interest in the topic it seems, I think a Workshop would be a good idea & would be interested in contributing.