Prevention, the appropriate target of infant psychotherapy

The aim of this paper is to evaluate the case for preventive interventions in infancy aimed at the reduction of childhood psychopathology. The paper considers the terminology of prevention and the case for prevention in infancy. It is argued that increased knowledge concerning the developmental pathways involved in many psychological disorders opens the door to prevention initiatives. An overview of recent prevention trials is provided and the implications from treatment evaluation studies are explored. The case for prevention of conduct disorders is taken as an illustration of the potential for interventions in infancy. A developmental model of conduct disorder implicates a vicious cycle of parent–child interactions, a process that may arguably be preempted by early intervention. Three modalities are considered in detail: (a) early parent training; (b) the enhancement of attachment security; and (c) the facilitation of the development of reflective function. Studies in each of these areas are reviewed. The paper concludes that increased emphasis on the prevention aspect of infant mental health interventions is justified and desirable. © 1998 Michigan Association for Infant Mental Health