| Title: |
Acceptability of Circle of Security-Parenting groups in NHS community perinatal mental health services in England: parent and practitioner perspectives |
| Authors: |
Darwin, Zoë; Richards, Lani; Clarke, Amy; Trevena, Kavita; Nahz Rehman, Sophia; Field, Jude; Morris, Nina; Pettyll, Innamana; Aryal, Basanti; Alyousefi Van Dijk, Kim; O'Shaughnessy, Ruth; Fonagy, Peter; Horley, Nic; Waddingham, Ed; Babalis, Daphne; Cornelius, Victoria; Fearon, Pasco; Pilling, Steve; Wang, Jiunn; Pizzo, Elena; Rosan, Camilla |
| Source: |
BMC Psychology (2026) (In press). |
| Publisher Information: |
BMC |
| Publication Year: |
2026 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
acceptability; circle of security; infant mental health; perinatal mental health; qualitative |
| Description: |
Background: Perinatal mental health (PMH) difficulties are prevalent and often accompanied by parent-infant relationship difficulties. National Health Service community PMH services (PMHS) support birthing parents (typically mothers) experiencing moderate-to-severe and complex mental health difficulties. While PMHS primarily address maternal mental health, treatment can include interventions targeting parent-infant relationships. The Circle of Security-Parenting (COS-P) programme is widely used within PMHS in England and offers a potential solution to the evidence gaps for interventions that: i) target both parental mental health and parent-infant relationship quality; (ii) are transdiagnostic; and iii) delivered in groups. This study evaluates the acceptability of COS-P, an attachment-informed, group intervention delivered in PMHS in ten 90-minute sessions, predominantly online. Methods: This qualitative study analysed the perspectives of parents (COS-P recipients) and practitioners (COS-P providers) in the intervention arm of a wider randomised controlled trial. Data collection involved interviews (58 parents, 7 practitioners) and focus groups (6 practitioners). Reflexive thematic analysis was conducted by a team including co-researchers with lived experience and interdisciplinary academics and practitioners. Results: Four themes were constructed: (1) ‘flamingos’, capturing the power of the group in normalising and validating demands relating to motherhood and PMH; (2) ‘practise babies’, highlighting the universal necessity and benefit of practising relationship skills, without expectations of perfection and with opportunities for repair; (3) ‘the dark things’, describing the emotional intensity for parents and practitioners arising from current and past relationships, occasionally necessitating extra support; and (4) ‘the ripples’, illustrating shifts in understanding and compassion that may extend beyond the parent-infant relationship and interact with other interventions. These themes encompass both ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10220633/11/Fonagy_BMC%20Psych%20Acceptability_R2%2018.12.25_clean.pdf; https://discovery.ucl.ac.uk/id/eprint/10220633/9/Fonagy_Figure%201.pdf; https://discovery.ucl.ac.uk/id/eprint/10220633/10/Fonagy_Figure%202.pdf; https://discovery.ucl.ac.uk/id/eprint/10220633/13/Fonagy_Supplementary%20File%201%20CONSORT%20checklist.pdf; https://discovery.ucl.ac.uk/id/eprint/10220633/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10220633/11/Fonagy_BMC%20Psych%20Acceptability_R2%2018.12.25_clean.pdf; https://discovery.ucl.ac.uk/id/eprint/10220633/9/Fonagy_Figure%201.pdf; https://discovery.ucl.ac.uk/id/eprint/10220633/10/Fonagy_Figure%202.pdf; https://discovery.ucl.ac.uk/id/eprint/10220633/13/Fonagy_Supplementary%20File%201%20CONSORT%20checklist.pdf; https://discovery.ucl.ac.uk/id/eprint/10220633/ |
| Rights: |
open |
| Accession Number: |
edsbas.DF7C3B0B |
| Database: |
BASE |