Treatment of Psychological Distress in Parents of Premature Infants

Book excerpt: "Although the benefits of psychological consultation in the pediatric setting are well established, a gap often exists between the demand for these services and funding. We have embarked on our longstanding goal to develop a group-based intervention model for parents of premature infants, adapting our manual of individual trauma-focused cognitive behavioral therapy to help reduce feelings of parental isolation. This book describes a more global approach to psychological consultation in the NICU integrating interventions that begin prior to the infant's conception and extend well beyond the NICU hospitalization. Chapter 1 provides a context and review of the medical aspects of the NICU environment and the neurodevelopmental consequences of prematurity. In Chapter 2 reviews the common psychological reactions of mothers of premature infants, including specific risk factors associated with maternal psychological distress. It also discusses the relationship between parental posttraumatic stress and infant outcomes as it relates to such issues as breastfeeding, maternal-infant interaction, attachment, and infant development. Chapter 3 describes the form and prevalence of symptoms of paternal psychological distress and outline a curriculum for a group-based intervention specifically designed to address fathers' concerns. Chapter 4 addresses developmental care interventions that overlap with interventions more narrowly focused on parental psychological distress. Chapters 5 and 6 describe our intervention model in both the individualand group therapy formats. Chapter 7 addresses vulnerable child syndrome, which is associated with adverse developmental outcomes in children as well as overutilization of health care resources. Application of the trauma model to the concept provides a framework to understand how parental behavior is altered in the context of trauma. Finally, Chapter 8 discusses how to implement a psychological intervention program in the NICU that includes screening the parents of premature infants for symptoms of psychological distress"--