Health Visiting by McHugh Gretl A. Orr Jean Luker Karen

Author:McHugh, Gretl A., Orr, Jean, Luker, Karen
Language: eng
Format: epub
Publisher: John Wiley & Sons
Published: 2011-11-11T16:00:00+00:00

Working with families

While detailed evaluations are not yet fully available to date for all of the programmes reviewed above, there appears to be recognition of the importance of practitioners developing supportive, trusting relationships with parents and the need to work in partnership with families. These concepts are clearly articulated in some of the programmes, particularly in the FNP Programme, and form part of the conceptual underpinnings of this programme. These concepts, though, are not particularly ‘new’ in professional–client relationships, nor, many would argue, are they ‘new’ to health visiting practice. However, the importance of developing supportive relationships when working with young, vulnerable families is now clearly articulated (Hall & Hall, 2007).

What, though, is meant by supportive relationships? The current perspective would suggest that within supportive relationships there is respect for different values and the uniqueness and strengths of each individual is observed and recognised. This perspective is in contrast to the ‘traditional’ view of the professional as one with expert knowledge; this view recognises that parents are ‘expert’ in their knowledge of their own children. This perspective of ‘parents as experts’ was clearly articulated in the early Child Development Programme (see above) (Barker & Anderson, 1988). Within this approach, the health visitor acts not as the authority on child rearing but as an ‘advisor’ or ‘guide’ to assist the parent to move forward with their parenting goals.

However, I would suggest that the ‘traditional’ perspective of the relationship and the current view have many similarities. The professional still holds considerable power in structuring and directing the interaction (i.e. interview, home visit). The fluidity of the interaction may mask the agenda which the professional holds. It is largely the professional’s concept of the client’s needs and problems which shape who is recruited into programmes and what will be discussed. This is likely the case regardless of the type of interviewing/home visit (i.e. within structured or other programmes). In fact, many child visiting programmes have a type of ‘curriculum’ (i.e. Baby First Programme, Woodgate et al., 2007) and some, such as the FNP Programme even designate the percentage of the visit which is allocated to different topics (see above). While it remains to be determined if this is the ‘best way’ to assist high needs families, it may be helpful to ponder the response of the parent to the interaction. If parents do not feel that their needs are being addressed, they may withdraw from the interaction and the relationship between the health visitor and client may be impaired. As a result, critical life events which are affecting their health and parenting capacity may not be acknowledged and appropriate interventions, including referrals not made. It is interesting to reflect on reports of child abuse, spousal abuse and incest which have come to light months or years after professionals have ‘worked with’ people but did not uncover the core problems affecting the wellbeing of these families.

What, then, is the nature of the health visitor–parent relationship when working with young families? The health visitor–client relationship

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