Decomposing Relational Mechanisms of Parent Engagement in Early Intervention: An Examination of Working Alliance and Family-Centered Practices

Family-centered practices are the foundation of Part C Early Intervention (EI) services, emphasizing strategies that encourage the development of strong partnerships with parents and provide supports to strengthen broader family functioning. Although parent-provider partnerships are outlined as central to family-centered practices in early childhood, little work has clarified the quality and dimensions of these partnerships. Working alliance, the relationship between a client and a help-giving provider, offers another way to conceptualize the constellation of relationships among parents, children, and providers in early intervention settings as it focuses on the goal-driven collaboration and less on the participatory aspects or strategies used during service delivery. The purpose of this study was to examine how relational (working alliance) and participatory (family-centered practices) components of service delivery in EI predict parent satisfaction with services and maternal self-efficacy. In addition, we sought to examine how child social-emotional and behavioral (SEB) problems moderate these associations. Perceptions of working alliance and family-centered practices were rated by 58 mothers of children currently in EI. Surveys were administered remotely in English (75.9%) and in Spanish (24.1%). A majority of mothers identified as non-White (65.5%) and worked part-time or full-time (69.0%). On average, children were enrolled in EI for 13 months and were 25 months of age at the time of the study. Results from hierarchical regression models indicated that mothers’ perceptions of the use of family-centered practices significantly predicted more satisfaction with EI services. Counter to expectations, working alliance was not associated with caregiver satisfaction with EI services. Further, no significant associations with family-centered practices or working alliance were identified for maternal self-efficacy as an outcome. Finally, there was no moderating effect of SEB problems, but higher SEB problems were significantly associated with lower maternal self-efficacy. The findings provide empirical support for the use of family-centered practices within EI and point to child SEB problems as an important area of intervention for addressing child and family well-being