Can transdiagnostic parent training in child psychiatry empower parents to support their children's emotional regulation? A qualitative interview study of parents' and clinicians' perspectives on Circle of Security-Parenting (COS-P).

Background: Many children referred to child psychiatry show insecure attachment, indicating difficulties in the parent-child relationship. Attachment-based interventions aim to strengthen this relationship by enhancing parental sensitivity and under-standing of the child's needs. As the quality of the parent-child relationship has a profound influence on a child's overall well-being and psychopathology, it is important to explore whether increased focus on parents' relational capacity can positively affect children's psychiatric symptoms. Objective: To investigate parents' experiences of participating in an attachment-based parenting intervention, Circle of Security Parenting (COS-P), within a child and adolescent mental health services setting. Method: Qualitative semi-structured interviews were conducted with six parents participating in COS-P, alongside a focus group interview with four clinical therapists, to gain insights into their experiences with the program in a child psychiatric context. Data were analyzed using NVivo 12 and a reflexive thematic analysis approach. Results: The analysis resulted in three main themes: (i) challenges prior to COS-P, (ii) expectations of the intervention, and (iii) perceived changes following the intervention. Conclusion: Several parents reported positive changes in their interactions with their children after participating in COS-P. They described an improved understanding of their children's behavior and needs, as well as increased use of appropriate strategies to meet those needs. Additionally, most parents reported gaining insight into how difficulties in regulating their own emotions, rooted in their own childhood experiences, had been unintentionally transmitted to their children. Transdiagnostic parent training programs such as COS-P have the potential to empower parents to support their children before, during, and/or after psychiatric assessment, regardless of diagnosis.