Improving working relationships with families in German early childhood interventions home visitors: a quasi-experimental training study.

BACKGROUND: Home visitation services within German Early Childhood Interventions (ECI) for families with a child aged 0-3 are mainly provided by frontline pediatric nurses and family midwifes. Home visitors are often challenged by difficult interactions with families. Mentalizing, the ability to understand mental states of oneself and others, is a key skill for building effective working relationships, which in turn positively affect intervention outcomes. The aim of this study was to investigate if a mentalizing skills training offered to home visitors active in German ECI contributes to continued professional development. We investigated, whether the training positively affected the quality of the working relationships with families as well as home visitors' empathy, self-efficacy, and mentalizing. METHODS: To test the effects of a single day mentalizing skills training on the working relationship in N = 73 ECI home visitors, we used a quasi-experimental design with repeated measures (T0, T1, T2, T3) across seven weeks in order to assess immediate change from baseline (T0) after the training (T2) and stability of changes at follow up (T3). A literature-based intervention was implemented before the training to estimate possible repeated measurement and expectational effects (T1). Primary outcome was the quality of the working relationship experienced by the home visitors. Secondary outcome criteria were empathy, work-related self-efficacy, self-reported and observer-rated mentalizing. RESULTS: Significant positive change in the working relationship quality was observed at T2 and at T3. Results on the secondary outcomes were less consistent, with data indicating improvement in empathy and increase on some but not all components of mentalizing. CONCLUSIONS: This study provides preliminary evidence that brief mentalizing skills trainings may be an effective method for continuous professional qualification in frontline ECI home visitors who afterwards, experience better working relationships with families. Thus, training participation may positively impact efficacy and implementation of home visitations in ECI.

[Obstacles for the use of early childhood prevention services : The role of expected ability to control sources]. / Barrieren für die Inanspruchnahme Früher Hilfen : Die Rolle der elterlichen Steuerungskompetenz.

BACKGROUND: It is well established that preventive measures for pregnant women and families with small children do not reach all families alike. Often enough, it is those families, who due to heightened stresses and strains might gain the most from these measures, who cannot be reached (dilemma of prevention). GOAL: This investigation explores whether parents can be grouped according to their views on health, prevention and measures available to young families, and whether belonging to one of the identified groups explains differences in the use of (primary and secondary) preventive measures for pregnant women and young families. METHOD: In the context of home visits, parents of children aged two to four years (N = 273) completed questionnaires. Additionally, 203 parents took part in qualitative interviews. RESULTS AND DISCUSSION: Based on interview data, parents from different sociocultural backgrounds could be grouped along their expected ability to control sources for parental support (Steuerungskompetenz). Parents high and low in Steuerungskompetenz differ regarding their knowledge of, use of, and satisfaction with (primary) preventive measures. Steuerungskompetenz explains the use of primary preventive measures above and beyond socioeconomic control variables as well as family stresses and strains. The use of secondary preventive measures is better explained by family stresses and strains. Results are discussed in terms of untapped services, needs and possibilities of target group-oriented approach.

O método de observação de lactentes de Bick: um caminho rumo ao pensar psicanalítico e sua aproximação da comunidade. Experiência de Seminário de Discussão de Trabalho (Work Discussion) com professoras de um jardim maternal / El método de observación de lactantes de Bick: un camino hacia el pensar psicoanalítico y su acercamiento a la comunidad. Experiencia de Seminario de Discusión de Trabajo (Work Discussion) con maestras de un jardín maternal / Bick’s nursling observation method: a path towards the psychoanalytical thought and its closeness to the community. Experience in the Work Discussion Seminar with teachers from Kindergarden

A experiência que pretendo comunicar é a que realizei ao longo destes anos como coordenadora do seminário de discussão de trabalho (Work Discussion) em dois hospitais do Município de Buenos Aires. Ali organizamos, através da Fundação Kamala, criada em homenagem a nossa mestra Kamala Di Tella, o curso completo de observação de lactentes, modelo Tavistock, experiência que me colocou diante da riqueza de uma variada gama de emoções através do material aportado generosamente por diferentes profissionais que, na sua maioria, trabalham em diferentes áreas desses hospitais. O objetivo de um seminário como o de discussão de trabalho, criado por Martha Harris (Klauber 1999), discípula e sucessora de Mrs. Bick, é levar o pensamento psicanalítico às relações interpessoais desdobradas em diferentes cenários assistenciais (escolas, serviços de pediatria, de neonatologia, instituições para crianças de rua, etc.). Ou seja, propiciar oportunidades para que o profissional possa detectar o clima emocional suscitado ali e tentar descobrir os fatores inconscientes envolvidos na sua própria tarefa, além de conhecer as implicações dos mesmos no trabalho em realização. O método de Mrs. Bick facilita esse caminho da psicanálise para a sociedade, beneficiando a compreensão e o crescimento das crianças

The expertise I intend to pass on, it’s one I acquired along these years as coordinator of the Work Discussion Seminar in two hospitals in the city of Buenos Aires. We organized the complete course on nursling observation, Tavistock’s model, through the Kamala Di Tella Foundation, an experience which placed me in front of the richness of a varied wide range of emotions through the generously contributed material from different professionals which, in their majority, work in different areas of these hospitals. The objective of a seminar like the Work Discussion, created by Martha Harris (Klauber 1999), Mrs. Bick’s disciple and successor, is to take the psychoanalytic thought to the unfolded interpersonal relations in different assistance scenarios (schools, pediatric services, neonatology, children’s homeless institutions…). In other words, provides opportunities so that the professional can detect the emotional climate that exists, and tries to discover the unconscious factors involved in his or her own task, as well as to know the implications in the work they are performing. Mrs. Bick’s method facilitates the psychoanalysis path for society, helping children’s understanding and growth

La experiencia que pretendo comunicar es la que he recogido a través de éstos años coordinando el seminario de discusión de trabajo (Work discussion), dentro de dos hospitales de la ciudad de Buenos Aires, donde hemos organizado, a través de la Fundación Kamala, creada en homenaje a nuestra maestra Kamala Di Tella, el curso completo de observación de lactantes, modelo Tavistock, experiência que me ha enfrentado a la riqueza de una variada gama de emociones a través del material aportado generosamente por diferentes profesionales, que, en su mayoría, trabajan en distintas áreas de dichos hospitales. El objetivo de un seminario como el de discusión de trabajo, creado por Martha Harris (Klauber 1999), discípula y sucesora de Mrs. Bick, es llevar el pensamiento psicoanalítico a las relaciones interpersonales desplegadas en diferentes settings asistenciales(escuelas, servicios de pediatría, de neonatología, instituciones para niños de la calle. etc.) Es decir, que el profesional pueda detectar el clima emocional allí suscitado e intentar descubrir los factores inconscientes involucrados en su propia tarea y saber de las implicancias que estos tienen sobre el trabajo que está realizando. El método de Mrs. Bick facilita ese camino del psicoanálisis hacia la sociedad en beneficio de la comprensión y el crecimiento de los niños

O método de observação de lactentes de Bick: um caminho rumo ao pensar psicanalítico e sua aproximação da comunidade. Experiência de Seminário de Discussão de Trabalho (Work Discussion) com professoras de um jardim maternal / El método de observación de lactantes de Bick: un camino hacia el pensar psicoanalítico y su acercamiento a la comunidad. Experiencia de Seminario de Discusión de Trabajo (Work Discussion) con maestras de un jardín maternal / Bick’s nursling observation method: a path towards the psychoanalytical thought and its closeness to the community. Experience in the Work Discussion Seminar with teachers from Kindergarden

A experiência que pretendo comunicar é a que realizei ao longo destes anos como coordenadora do seminário de discussão de trabalho (Work Discussion) em dois hospitais do Município de Buenos Aires. Ali organizamos, através da Fundação Kamala, criada em homenagem a nossa mestra Kamala Di Tella, o curso completo de observação de lactentes, modelo Tavistock, experiência que me colocou diante da riqueza de uma variada gama de emoções através do material aportado generosamente por diferentes profissionais que, na sua maioria, trabalham em diferentes áreas desses hospitais. O objetivo de um seminário como o de discussão de trabalho, criado por Martha Harris (Klauber 1999), discípula e sucessora de Mrs. Bick, é levar o pensamento psicanalítico às relações interpessoais desdobradas em diferentes cenários assistenciais (escolas, serviços de pediatria, de neonatologia, instituições para crianças de rua, etc.). Ou seja, propiciar oportunidades para que o profissional possa detectar o clima emocional suscitado ali e tentar descobrir os fatores inconscientes envolvidos na sua própria tarefa, além de conhecer as implicações dos mesmos no trabalho em realização. O método de Mrs. Bick facilita esse caminho da psicanálise para a sociedade, beneficiando a compreensão e o crescimento das crianças(AU)

The expertise I intend to pass on, it’s one I acquired along these years as coordinator of the Work Discussion Seminar in two hospitals in the city of Buenos Aires. We organized the complete course on nursling observation, Tavistock’s model, through the Kamala Di Tella Foundation, an experience which placed me in front of the richness of a varied wide range of emotions through the generously contributed material from different professionals which, in their majority, work in different areas of these hospitals. The objective of a seminar like the Work Discussion, created by Martha Harris (Klauber 1999), Mrs. Bick’s disciple and successor, is to take the psychoanalytic thought to the unfolded interpersonal relations in different assistance scenarios (schools, pediatric services, neonatology, children’s homeless institutions…). In other words, provides opportunities so that the professional can detect the emotional climate that exists, and tries to discover the unconscious factors involved in his or her own task, as well as to know the implications in the work they are performing. Mrs. Bick’s method facilitates the psychoanalysis path for society, helping children’s understanding and growth(AU)

La experiencia que pretendo comunicar es la que he recogido a través de éstos años coordinando el seminario de discusión de trabajo (Work discussion), dentro de dos hospitales de la ciudad de Buenos Aires, donde hemos organizado, a través de la Fundación Kamala, creada en homenaje a nuestra maestra Kamala Di Tella, el curso completo de observación de lactantes, modelo Tavistock, experiência que me ha enfrentado a la riqueza de una variada gama de emociones a través del material aportado generosamente por diferentes profesionales, que, en su mayoría, trabajan en distintas áreas de dichos hospitales. El objetivo de un seminario como el de discusión de trabajo, creado por Martha Harris (Klauber 1999), discípula y sucesora de Mrs. Bick, es llevar el pensamiento psicoanalítico a las relaciones interpersonales desplegadas en diferentes settings asistenciales(escuelas, servicios de pediatría, de neonatología, instituciones para niños de la calle. etc.) Es decir, que el profesional pueda detectar el clima emocional allí suscitado e intentar descubrir los factores inconscientes involucrados en su propia tarea y saber de las implicancias que estos tienen sobre el trabajo que está realizando. El método de Mrs. Bick facilita ese camino del psicoanálisis hacia la sociedad en beneficio de la comprensión y el crecimiento de los niños(AU)