Minding the Baby® Home Visiting (MTB-HV)
Last updated: 2014
Minding the Baby® Home Visiting (MTB-HV) is based on a multi-generation care model designed to integrate primary care and mental health services for infants by pairing a nurse with a mental health professional to conduct home visits. MTB-HV is grounded in the theories of attachment, reflective parenting, social ecology, and self-efficacy. The intervention aims to enhance maternal and child health, reflective parenting, early attachment between mothers and children, and relationships between families and communities.
MTB-HV consists of home visits with a nurse and a mental health professional. The home visitors primarily meet with families separately on an alternating schedule, but in the following circumstances both home visitors meet with the family at the same time: at recruitment, at the first and last home visits, when mothers transition from weekly visits to visits every other week, and as needed (such as during a crisis).
During visits, home visitors work to develop mothers’ abilities to become reflective and responsive in their interactions with their infants by doing the following:
- Giving voice to the baby’s experience (both physical and emotional);
- Giving voice to the mother’s experience of herself as a parent;
- Highlighting the mother’s positive feelings for the child; and
- Developing the mother’s capacities to reflect and contemplate, especially in the face of difficult emotions.
When indicated, the mental health home visitor conducts a mental health assessment and provides treatment in the home.
In addition to making home visits, the visitors maintain close contact with the mothers’ prenatal and pediatric clinicians, who might be based in a partnering community health center. Clinicians and staff at the community health centers guide home visitors in working with families who have numerous physical, medical, and mental health needs. Home visitors also facilitate a close relationship between families and their primary care clinicians, and coach families on how to be good consumers of health care information and access needed social services.
MTB-HV is intended for young first-time parents between the ages of 14 to 25 who are living in low-income settings. As guided by the mother, home visit activities include fathers or other family members. The model starts serving families in the second or early third trimester of pregnancy and continuing until the child’s second birthday.