The Body as Transmitter and Receiver of Light: Adaptation and feasibility trial of the mentalization-based Lighthouse parenting programme for patients with functional somatic disorders.

Parents are an important resource for their children's development (Sanders et al., 2018). However, parental mental health problems are also one of the biggest risk factors for child psychopathology, leading to a 50% increase in the likelihood of their children developing mental health problems in adolescence (Adjei et al., 2024). A key aim of parenting programmes such as the Lighthouse Parenting Programme (LPP; Byrne et al., 2018; Taubner et al., 2020; Volkert et al., 2019) is to prevent the intergenerational transmission of psychopathology. Mentalization-based parenting programmes, such as the LPP, have demonstrated potential in alleviating parental stress, enhancing sensitivity and improving self-efficacy (Byrne et al., 2018; Gervinskaitė-Paulaitienė et al., 2023; Volkert et al., 2019; Harfouche, 2022), and improving parental emotion regulation (Harfouche, 2022) and mentalization skills (Gervinskaitė-Paulaitienė et al., 2023). They have also been shown to improve parental and child behaviour (Gervinskaitė-Paulaitienė et al., 2023). Furthermore, improvements in the parent–child relationship and a decrease in parental anxiety and depressive symptoms have been observed (Gervinskaitė-Paulaitienė et al., 2023). Although deficits in mentalizing have been recognised in patients with Functional Somatic Disorders (FSD), the LPP has yet to be adapted for this group. This is especially relevant given the high prevalence of FSD (Luyten et al., 2015), estimated at 4 % in the general population (Bass & May, 2002). It is particularly important to focus on mentalizing skills in this patient group, since impairments in mentalizing associated with the re-emergence of non-mentalizing modes may trigger the onset of FSD, perpetuate its symptoms, or constitute a consequence of FSD (Luyten et al., 2012). Regarding parental mentalizing, children whose parents have recurring or persistent somatic impairments that negatively affect their thoughts, feelings, behaviour, and daily functioning may grow up in an environment that makes it particularly challenging to develop differentiated representations and understandings of own emotional and somatic states, and how these interact. The primary aim of this feasibility study will be to assess the adherence, acceptance, and satisfaction of the LPP programme for parents with FSD. Secondary aims include evaluating changes in parent-child relationships, parental stress, mentalizing capacity and psychological symptoms in both parents and children. A single-arm pre-post study with n = 22 parents with FSD in psychosomatic treatment, with a child aged 0-15 years and who report parent-child relationship difficulties. Data on adherence, satisfaction, parental stress, and related outcomes will be analysed using t-tests and ANOVAs, with regression and correlation analyses exploring links between parental mentalizing and psychological variables, including non-verbal communication patterns. Preliminary findings will evaluate feasibility, satisfaction, and improvements in psychological outcomes and the parent-child relationship. The findings aim to refine LPP for parents with mental health problems including body-related symptoms in order to enhance reflection and symbolisation about their psychological and somatic symptoms and their child’s mind. If feasible, results will inform an RCT to assess its effectiveness in reducing psychopathology, enhancing parental mentalizing, and improving parent-child interactions.