Watch, Wait and Wonder (WWW) is a therapeutic intervention for mothers experiencing difficulties caring for a child between 0 and 4 years old. It is delivered by a single therapist to mother and child pairs for an average of 15 one-hour sessions. During each session, the mother receives coaching as she plays with her child.
The information above is as offered/supported by the intervention provider.
0 to 3 years old
Individual
Watch, Wait and Wonder (WWW) is a therapeutic intervention for mothers experiencing difficulties caring for a child between 0 and 4 years old.
It is delivered by a therapist to mother and child pairs for an average of 15 one-hour sessions. During each session, the mother receives coaching as she plays with her child.
WWW sessions are an hour long each, and are divided into two parts. The first half hour is infant-led, and the mother is encouraged to be on the floor with her child, to observe and to follow their lead, without guiding the child’s play in any way. During this time, the therapist is watching, waiting, and wondering about the interactions between mother and infant.
In the second part of the session, the mother and therapist discuss the mother’s observations of her child, her understanding of her child’s experience and her experience of the first part of the session, and any difficulties the mother experienced in following her child’s lead.
Throughout the sessions, mothers are encouraged to consider their child’s feelings, thoughts and desires, to understand their child as a distinct individual. Mothers are also asked to reflect on their own emotional responses to their child and representations of their child’s intentions and feelings. The mothers’ feelings are then addressed through feedback and support from the therapist.
0 to 4 years old
Parents and young children where parents are experiencing difficulty with their young child.
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Attachment security lays the foundation for children to develop positive expectations of themselves and others
Attachment security is thought to reduce the risk of mental health problems as children develop.
Science-based assumption
Sensitive parent–child interactions increase the likelihood of children developing secure attachment relationships
Sensitive parenting is supported by the parents’ ability to form positive representations of the child.
Science-based assumption
Maternal sensitivity and positive representations of the child’s behaviour are informed by the mothers’ own attachment history
Mental health problems and adverse childhood experiences increase the likelihood of negative representations of child behaviour.
Intervention
Mothers are encouraged to reflect on their own emotions while they watch their child play
Mothers are encouraged to reflect on their child’s needs separately from their own.
Short-term
Mothers develop positive representations of their child
Mothers are less likely to have negative representations of their child
Mothers become more sensitive to their child’s needs.
Medium-term
Improved mother–infant interaction
Reduced risk of the child developing an insecure attachment.
Long-term
Children develop positive expectations of themselves and others
Children are at less risk of future mental health problems
Children are at less risk of child maltreatment.
Parents and young children where parents are experiencing difficulty with their young child.
Watch, Wait and Wonder is delivered in 15 sessions of one hours’ duration each by one practitioner, to individual parent–child pairs.
Mothers and children engage in free infant-led play, in which mothers are encouraged to follow their child’s lead and to observe. Therapists support mothers in considering their and their child’s experiences and working through any difficulties in following their child’s lead in play.
The practitioner who delivers this intervention is a Watch, Wait and Wonder Practitioner.
The practitioners have approximately 70 hours of intervention training. Booster training of practitioners is recommended.
It is recommended that practitioners are supervised by one host-agency supervisor, with 86 hours of intervention training.
Information on intervention fidelity is not available.
Contact person: Mirek Lojkasek
Email address: mlojkasek@watchwaitandwonder.com
mlojkasek@protonmail.com
Website: https://watchwaitandwonder.com
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
WWW’s most rigorous evidence comes from one comparison group study conducted in Canada consistent with Foundations’ Level 2+ evidence strength criteria.
This study identified significantly significant improvements in researchers’ observations of WWW children’s attachment security, emotion regulation, and cognitive development in comparison to children whose mothers participated in a different therapeutic intervention. Additionally, WWW mothers reported less stress and greater confidence immediately after completing the intervention in comparison to the mothers receiving an alternative intervention.
Watch, Wait and Wonder has preliminary evidence of improving a child outcome, but we cannot be confident that the intervention caused the improvement.
| Identified in search | 1 |
| Studies reviewed | 1 |
| Meeting the L2 threshold | 1 |
| Meeting the L3 threshold | 0 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 0 |
| Study design | QED |
| Country | Canada |
| Sample characteristics | 67 mother–infant pairs with children aged 10 to 30 months old, attending a children’s mental health clinic and experiencing functional or emotional difficulties and physically able to participate in play |
| Race, ethnicities, and nationalities | Not reported |
| Population risk factors | Infants and mothers attended a children’s mental health clinic, presenting with functional or emotional difficulties |
| Timing |
|
| Child outcomes | Post-intervention
Six-month follow-up
|
| Other outcomes |
|
| Study rating | 2+ |
| Citations | Study 1a: Cohen, N. J., Muir, E., Lojkasek, M., Muir, R. Parker, C. J., Barwick, M. & Brown, M. (1999) Watch, Wait and Wonder: Testing the effectiveness of a new approach to mother-infant psychotherapy. Infant Mental Health Journal. 20, 429-451. Study 1b: Cohen, N. J. Lojkasek, M., Muir, E., Muir, R. & Parker, C. J. (2002) Six-month follow-up of two mother-infant psychotherapies: Convergence of therapeutic outcomes. Infant Mental Health Journal. 23, 361–380. |
No other studies were identified for this intervention.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
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Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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