The objective of this work was to investigate reflective-functioning (RF) as a measure of process in two independent studies that included three types of brief psychotherapy. RF is defined as the ability to recognize the existence and nature of mental processes taking place in the self and in others (e.g., intentions, beliefs, desires, and wishes). Theorists have suggested the ability for RF is crucial for predicting social causality and low RF has been found related to mental disorders. It has recently been suggested in the literature that improved ability for RF might be an important component of successful psychotherapy outcome, especially with respect to achieving structuralchange. RF was in this work investigated during the process through discourse analysis of the patients’ narratives of self-other interactions in the treatment sessions. The Psychotherapy Process Q-set (PQS) was implemented in order to isolate specific components of the process (process correlates) that identified high and low RF and to investigate the links between the process correlates and outcome. The first study investigated 29 cases of cognitive-behavioral therapy(CBT) and 35 cases of interpersonal psychotherapy (IPT) with an average treatment length of 16.2 sessions in a sample from the National Institute of Mental Health (NIMH) randomized clinical trial Treatment of Depression Collaborative Research Program (TDCRP). The sample in the first study consisted of 128 sessions in total, were one session from the early part (on average the 4th session) and one session in the later part of the treatment (on average the 12th session) were rated for RF. The second study investigated a sample of 30 cases of brief psychodynamic psychotherapy (BPDT) with an average treatment length of 15.8 sessions in a naturalistic designand obtained from the Mount Zion Psychotherapy Research Group. In total, the second study included 90 sessions of BPDT, and RF was assessed during the 1st, the 5th, and the 14th session of each treatment. The results from these two studies suggested that the patients’ ability for RF, as measured through the discourse from therapy sessions, is stable (in CBT and BPDT) or decreased(IPT) during the treatments. Furthermore, the process correlates defining high RF had a relation with good outcome, and process correlates defining low RF had a relation with poor outcome.The process correlates identified during the PQS-analysis suggested that both high and low RF was linked with personality characteristics in the patients. For example, high RF was linked to patients’ ability for introspection, expression of negative emotions, and commitment to treatment.Low RF was linked to patients’ expression of passivity, defensiveness, and suspiciousness. This work supported theorists’ suggestions that brief treatments are supportive in their nature and therefore do not promote structural changes (e.g., changes in RF). It is suggested that the abilityfor RF as assessed pre-treatment might be a useful predictor for success in brief psychotherapy and could therefore be used as a patient inclusion criteria for such treatments.

This study set out to investigate the parent-infant interventions that are run by a community-based organisation on the outskirts of Johannesburg’s Alexandra township, South Africa. Community-based interventions that support the parent-infant dyad present an ideal opportunity to shape the development of youth as they aim to foster secure attachment relationships thereby providing the bedrock for future growth. This research specifically explores caregivers’ perceptions of the Baby Mat project in order to understand why some caregivers make optimal use of this intervention whereas others do not. It also gives insight into why some caregivers who are referred for parent-infant psychotherapy on the Baby Mat fail to take up this offer. In addition, it identifies needs caregivers have that are not being met by the Baby Mat. Data for this study was collected by holding a focus group with 11 caregivers in group discussion. The results of the data analysis indicate that caregivers are increasingly having to navigate the transition to motherhood alone, and are often overwhelmed with anxiety. Possibly this is because the support gleaned from extended families has diminished over the last few decades in South Africa. Consequently caregivers are often very receptive to the Baby Mat, which they see in the role of “grandmother”. By visiting the Baby Mat, caregivers realise that they are not alone in the challenges they face and often leave the mat feeling more hopeful about their problems. Yet several factors block them from making full use of this intervention. The primary one is their socially and economically weak position. They are also concerned that actions that they would rather avoid might be taken when facilitators on the mat learn of the abuse they are exposed to. Having limited resources, they are often looking for information and guidance and when this need cannot be met, frustration follows. Generally they want people running relevant interventions to come to them, as opposed to their going out to seek support. This may explain their failure to take up parent-infant psychotherapy. It is also was evident that the caregivers want to reach out to each other.