Time Together is a structured home-visiting intervention that has used play to enhance the parent-child relationship and has provided the essential building blocks for children's positive social and emotional development.
Over the years, the programme has consistently helped parents to understand the world from their child's view, to recognise that a child's emotional response to a situation will be different from an adult's and to understand that their children are lovable and sociable beings who also like to please and respond to nurturing environments.
The 15-week programme was developed by the Somerset Educational Psychology Service in 2002 in response to the social, emotional and behavioural needs of some local young families and it now complements the authority's home-visiting work and parenting support in local Sure Start children's centres.
When devising the programme, we drew upon Bandura's Social Learning Theory (1977) and Bowlby's work on attachment theory (1969). Albert Bandura found that children developed behaviour patterns from observing and interacting with the various people who are around them, while John Bowlby emphasised that a child's first human relationship formed the foundation stone to their personality.
The negative impact that poverty, poor mental health and maternal depression and anxiety can have on the adult-child relationship and, in turn, on the child's brain development is well documented (Balbernie, 2001; Gerhardt, 2004).
Parents' preoccupation with their own worries or symptoms can also interfere with their ability to provide warm and consistent interaction or conversely result in overly cautious or protective parenting styles. As a result, children are provided with inappropriate coping strategies to manage their emotions.
It is our belief, therefore - and this is borne out in sound psychological research - that early professional intervention is both essential and cost-effective in cases where parents have difficulty understanding, containing and regulating their child's emotions, for whatever reason.
Research also suggests that children's need to resort to violence decreases with age, with physical aggression peaking during the child's second year of life (Nagin and Tremblay, 2001). So, it is our view that parents adopting a nurturing approach will reduce their child's physical aggression by recognising and understanding their child's fear, containing the emotion and redirecting their behaviour.
APPROACH
In contrast with many support programmes, we opted for a positive psychology approach (Seligman, 2005), which builds on parent's strengths and role as primary educators. The Time Together team works in partnership, sensitively and non-judgementally, with parents to promote their involvement in their child's life.
For the structure of the programme, we turned to the Peers Early Education Partnership (PEEP) and components from the Solihull Approach (Douglas and Ginty, 2001).
The PEEP model was developed in Oxford in 1995 as a community project to promote parental engagement and improve literacy and numeracy skills. At its heart is the ORIM learning framework (Hannon, 1995), which recognises that children benefit from:
- - Opportunities to learn
- - Recognition and valuing of their early efforts and achievements
- - Interaction with adults to talk about what they do and how they feel
- - Modelling by adults of behaviour, attitudes and activities.
The Solihull Approach is a psychotherapeutic method of working with parents who are having difficulties and is based upon three components: containment, reciprocity and behaviour management. We drew on the first two.
Containment describes the manner in which the parent is able to help the child process intense emotions and anxiety, rather than feeling overwhelmed by them.
The function of the professional delivering the Solihull Approach may be to contain the anxiety and overwhelming feelings of the parents, enabling them to think more clearly and solve issues themselves.
Reciprocity describes the process by which the parent and child actively develop their interaction to be in tune with one another. This is crucial as it forms the basis of the infant learning about language and relationships.
What we believe makes Time Together unique is that it addresses issues of containment and reciprocity in a thorough, structured specialist intervention within the home.
HOME ENVIRONMENT
Typically, professionals refer families who may be socially isolated, find it difficult to attend groups, have expressed difficulties in their relationship with their child or see that their child has 'challenging' behaviour. An educational psychologist first carries out an initial visit and assessment before discussing the family's expectations with the Time Together team of home visitors, who work with up to ten families at a time.
Play sessions aim to promote enjoyment, fun and interaction between parent and child and, though structured, the exact content is guided by the interests of the child and family.
Home visitors model appropriate responses to the child's behaviour, encourage positive engagement between parent and child, talk to parents about appropriate behaviours at different stages of development and celebrate the family's successes.
A typical session involves:
- - A song - to start and end sessions
- - A treasure box - this is introduced in the first week and used as a topic of conversation between home visitor, parent and child as, each week, the family adds a memento of an activity that parent and child have shared together.
- - A treasure book - objects from the box are then transferred to the treasure book (a scrapbook), which is given to the family at the end of the sessions. The book is often also used to record the positive things that the child has done during the intervention
- - A play pack - the various packs, containing an activity and book that relates to it, are used in the session and left with the family to enjoy during the coming week.
- - A creative activity, such as painting.
Crucial to the process is the involvement of the educational psychologist, who maintains the integrity of the intervention and applies psychological skills and expertise to understand the family dynamics.
The psychologist also provides for the home visitors regular professional supervision sessions, which act as a problem-solving forum and an opportunity for home visitors to express their emotions about their work with the family.
REFLECTIONS
We have evaluated the scheme through parent questionnaires (see feedback box, left), which have shown that Time Together has:
- - Provided families with a valuable insight into their child's development and the role of play
- - Contributed to a change in the family dynamics and provided families with alternate ways of operating and interacting
- - Given parents an understanding of their child's behaviour and why they respond way they do. At the outset, one mother said her son was 'demonstrating temper tantrums and hitting'. By the end, she said she and he 'definitely have fun together' and that her son was 'definitely happy and confident - he's brilliant'.
- - Helped parents see the importance of providing their child with opportunities to interact with other children, and feel supported by their home visitor to attend community-based group settings, such as PEEP groups
- - Given parents the confidence to further their own personal development, whether this is attending a college course, starting a drug rehabilitation course or learning to drive. Numerous parents were found to be experiencing agoraphobia and, through the programme, gained the confidence to leave home.
PARENTAL FEEDBACK
'Her concentration has got a lot better, she analyses what is in front of her and does the activity until she has finished.'
'Oh, we sing all the time! L's communication skills are now very good. We are going to Monday (group) sessions - which has made me really good friends, the toys have been brilliant.'
'He is so good to be around, he is more independent and happy now. I am more confident at understanding his behaviour. It is great to see him enjoying himself.'
'I learned how to play with her and I am more relaxed with her as a result.'
REFERENCES
- Balbernie, R (2001). 'Circuits and circumstances.' Journal of Child Psychotherapy, 27(3), 237-255.
- Bandura, A (1977). Social Learning Theory. Prentice-Hall.
- Blair, RJ (2001). 'Neurocognitive models of aggression ...' Journal of Neurology, Neurosurgery and Psychiatry, 71.
- Bowlby, J (1969). Attachment. Pimlico.
- Douglas, H & Ginty, M (2001). 'The Solihull Approach'. Community Practitioner, 74(6).
- Douglas, H (2007). Containment and Reciprocity. Routledge.
- Evangelou, M, & Sylva, K (2003). 'The Effects of the PEEP on Children's Developmental Progress', http://tinyurl.com/62gfazy
- Fellow-Smith, L (2000). 'Impact of parental anxiety disorder on children.' In Reder, McClure & Jolley (Eds.), Family Matters. Routledge.
- Fonagy, P. (2003). 'Towards an ... understanding of violence'. British Journal of Psychiatry, 183.
- Gerhardt, S (2004). Why Love Matters. Routledge.
- Hannon, P (1995). Literacy, Home and School. Falmer.
- Nagin et al (2001). 'Parental and early childhood predictors of aggression in boys ...' Archives of General Psychiatry 58.
- Seligman, M (2005). 'Positive Psychology ...' Handbook of Positive Psychology. OUP.
Rebecca Essex continues to work as an educational psychologist with the Somerset Educational Psychology Service. Julia Jennings now works as an independent psychologist for her company, Sound Thinking.