A model for conceptualizing the role of the mother's representational world in various mother-infant therapies

A model of the mother-infant interaction/relationship is presented that permits systematic descriptions of different therapeutic approaches. The model consists of four interdependent elements in constant dynamic equilibrium. These elements are (1) the infant's overt interactive behavior; (2) the mother's overt interactive behavior (together these two constitute the interaction); (3) the infant's representation of the interaction; and (4) the mother's representation of the interaction (together the four constitute the relationship). Different therapeutic approaches, including a psychoanalytically oriented therapy, interactional coaching, a behavioral pediatric approach, a behaviorist approach, and a family therapy approach are each described in terms of (1) which element in the model provides the clinical information and (2) which element in the model is the direct focus of therapeutic action. Educational, clinical, and research implications of this perspective are discussed. In particular, the importance of changing the mother's representation of the interaction for therapeutic change is stressed. Further, it is argued that the mother's representation can be changed sufficiently by both direct and indirect approaches.