Professionals’ perception of the process of change during an attachment based parenting intervention (Video Interaction Guidance) with parents with intellectual disabilities

Background and objectives: Parents with intellectual disabilities (ID) face multiple challenges to their parenting and an assumption of parenting incompetence. However, many parents benefit from evidence-based training programmes and with the right support are able to raise children effectively. In the UK, attachment-based interventions such as Video Interaction Guidance (VIG), are increasingly being used to support positive parenting and have been found to increase parenting sensitivity and attachment security. Despite VIG being offered to parents with ID, little is known about how VIG facilitates change for parents with ID specifically. The current study explored VIG guiders experiences of using VIG with parents with ID, and highlighted their perspectives on the outcomes of VIG, and the factors which facilitated and hindered change.

Method: Nine VIG guiders were interviewed about their experiences using VIG with parents with ID, guided by a semi-structured interview schedule. The interviews were transcribed and analysed using grounded theory, to develop a model of the processes of change.

Results: When VIG is conducted with parents with ID, VIG guiders report a positive impact on child development, parenting skills, the parent-child relationship, and the parent’s relationship with the wider system. Importantly for parents with ID, these outcomes were facilitated by the visual aspect of VIG, the emotional response it elicits, and sharing successes with others, in the context of an attuned therapeutic relationship. In addition, VIG promotes the development of a new strengths based narrative, which contrasts to the disabling narratives held in society about parents with ID. The outcomes are further facilitated by adaptations for parents’ learning and psychological needs, and supervision for guiders, allowing them to reflect upon their assumptions about this client group. There are also interpersonal, intrapersonal and contextual factors which hinder the intervention.

Conclusion: VIG is a useful intervention with parents with ID. Although there are factors which may hinder its success for parents with ID specifically, appropriate adaptations can be used to compensate and promote positive parenting.

Keywords: parenting, learning disabilities, intellectual disabilities, video interaction guidance, attachment