IMPACT OF THE MEDIATIONAL INTERVENTION FOR SENSITIZING CAREGIVERS ON SOCIAL COGNITION IN ORPHANS AND VULNERABLE CHILDREN IN SOUTH AFRICA

Abstract

Orphans and vulnerable children (OVC) in South Africa have high rates of attachment trauma and are at increased risk of a multitude of adverse psychosocial outcomes, including disrupted social cognitive development (resulting in diminished mentalization capacity) and mental health difficulties. The Mediational Intervention for Sensitizing Caregivers (MISC) is an intervention aimed at improving child outcomes by increasing sensitive and responsive caregiving using operationalized mentalization-based behavioral components. MISC has demonstrated positive treatment effects on mental health and cognitive outcomes. However, no mentalization-based caregiver intervention’s impact on child mentalizing capacity has yet been evaluated. The present study had an overall aim of examining social cognition (mentalizing capacity) of OVC and evaluating MISC’s impact on social cognition (mentalizing capacity) compared with a TAU control group (Treatment as Usual). Social cognition was assessed using a culturally adapted version of the Affect Task at baseline and after 12 months of MISC with community-based organization (CBO) careworkers. Results of the study revealed a statistically significant treatment effect of MISC on social cognition when compared to the TAU group. However, when controlling for mental health difficulties at baseline, the treatment effect of MISC was not statistically significant. This study represents the first demonstrated increase in child mentalizing capacity by a mentalization-based caregiver intervention and adds to the MISC evidence base for children with attachment trauma. However, important future directions of research are also discussed, including the need to further assess how improvements in social cognition may represent a mechanism of change in improving mental health outcomes.