1. Supporting families in the community Georgina Alpe - Health Visitor

2. Aim of presentation To understand how Health Care Professionals work to support the 0 – 3 Framework by providing opportunities for parents to learn and develop with their children To describe the theoretical model which underpins our work. To highlight three groups which are currently running

3. Who we are We come from a nursing background and work in the community We are based geographically and have recently become attached to Children’s Centre’s. This means we are now working in partnership with nursery schools, play groups, other community services for children, and have become involved with 0 – 3 Matters We also work closely with other health professionals such as doctors, midwives, speech therapist’s and psychologists.

4. Neighbourhood Analysis Our working area has a high incident of the following: Social isolation Domestic violence Poor housing Unemployment Poor mental health Low self esteem Teenage mothers Single parents

5. What we do Our role is mainly preventative. All families are offered an ante natal visit at home and then ongoing post natal support which includes home visiting and through groups and clinics. Our work concentrates on children’s development and the emotional and physical health of the child and their families. More vunerable families are offered extra support.

6. How we work The best way to describe how Health Visitors work is by the theoretical model which underpins the Solihull Approach. The 0 – 3 Framework sits comfortably alongside this approach and is interchangeable. We support the 0 – 3 Framework by supporting the parents with their children, helping them to understand and enjoy their child’s emotional and physical development. The training and regular supervision has helped to forge stronger links with the nursery staff, play group leaders and child minders co-ordinator. This has improved communication has enabled children and their families receive appropriate support and help.

7. The Theoretical Model which underpins our practice Containment Behaviour Management Reciprocity SOLIHULL APPROACH These three concepts are closely linked although there is a progression between them Reciprocity and containment are 2 of the everyday processes that are vital to a child’s: Development Socialisation Language acquisition Ability to process emotions and anxiety

8. Containment Containment is a fundamental of what goes on between a mother and baby. It means the mother can grasp the importance of and take into herself some of the babies earliest and most primitive anxieties…She can think about things in her own way without being caught up in them, overwhelmed by them herself. Babies with mothers who can take the panic out of their anxieties, eventually take into themselves some version of a mother who can manage – who can get hold of something important emotionally without being knocked off balance by it. Eventually the baby takes into itself…the mothers capacity to tolerate and manage anxiety. Sourced: Garland 1998 cited in Solihull Approach Resource Pack (2004)

9. Containment As care professionals, by listening, it is possible to also contain parents anxieties and overwhelming emotions. Restoring in them the ability to think and empowering them to solve their problems.

10. Reciprocity Reciprocity is the process whereby the parent and infant actively develop their interaction and become in tune with each other (the dance Brazelton 94 ) Stern 1995 used the idea of attachment to describe the reciprocal relationship between parent and child.

11. As health professionals we can encourage this process by observing parent/child interaction and offer feedback on how parents can become more in tune with their babies i.e.: during Baby massage, baby clinics and post natal support groups. Once parents are able to think and try out new ideas and are in tune with their child, it is easier for them to develop behaviour skills and techniques.

12. Behaviour Management Both reciprocity and containment are involved in Behaviour Management If a child has experienced inadequate emotional containment and insufficient reciprocity, it is highly likely that he/she will have behavioural problems

13. Groups 3 Groups evolved to combat social isolation, improve mental health and encourage/maximise mother/baby relationships using the Solihull Approach Knit and Natter group Baby massage Mothers Group (mothers with depression)x3

14. Knit and Natter This Group was set up as a craft group for the mothers in the area, it is funded by health and education, run by a Health Visitor and takes place in a large hall in the Children’s centre The children come as well and there is a large area in the same room for them to play in, a nursery nurse is there to help but the mothers are responsible for their own children The group was specifically to encourage socially isolated mothers to meet other mothers, to help raise their self esteem and enable them to begin to access other community resources Those who attended were by invitation The group has now been running for about 3yrs

15. The Knit & Natter Group

16. Baby Massage We have an open group once a week, run by a Health Visitor or Nursery Nurse specifically trained in Baby Massage It is held in the centre and the atmosphere is very calm and relaxing, the mothers gain also by being part of a group and get to know each other. There is a great deal of evidence which supports the benefits of baby massage.

17. Baby Massage BENEFITS FOR PARENTS Promotes closeness and focuses time together (including fathers) Increases parents abilities to relax their child in times of stress Increases self esteem of parents by reinforcing parenting skills Offers parents a time to relax and unwind Builds communication and respect between parent and child

18. Baby Massage cont….. BENEFITS FOR BABIES Helps relieve colic, tummy pains and teething Helps stimulate body systems (e.g., immune, respiratory, nervous, endocrine) Helps child cope with birth traumas Promotes better sleep Deepens bonding Improves communication

19. Baby Massage Group

20. Mothers Group This group initially started about 4 years ago run by 2 Health Visitors for mothers with severe/chronic depression. There are now 3 groups running, one of which is a self help group the mothers run themselves. The aim was to provide a therapeutic group which would enable mothers to work to improve their lives and mental health They function as closed groups 8-9 members. Confidentiality and mutual respect is required by all members. There is a crèche provided for the children Time 1 hr 30 minutes Venue 1 is in the children’s centre and the other 2 are in a local church.

21. Mothers Group

22. Thankyou….