Supporting the Professional Caregivers

 

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In each case when we referred to the parent consultation model that initiated every case, we talked about restoring power and authority to the parents in a helpful way. Two of the biggest challenges of the training were: (1) understanding parents’ roles in the development of children’s psychological problems; and, similarly, (2) understanding parents’ roles in the repair of the problems. 

Joshua and I talked from the beginning about our concern for the caregivers and our motivation to support them in their difficult work. I recalled the image of Leonardo da Vinci’s beautiful cartoon of the Virgin and Child with Saint Anne in which Mary is holding the baby Jesus while she is resting in the arms of her own mother, Saint Anne. I have long thought of that image as representing the natural intergenerational support of the caregiver in her caregiving function, whether the caregiver is the mother or another caregiving person, such as a helping professional. 

Josh and I discussed the enormous pressures on a caregiver when the child has a problem, and when the child is suffering. When a child is suffering, it stirs in each of us the wish to rescue the child and there is always a temptation to hold someone responsible for the child’s suffering. This simple framework easily slips into a “good guy”, “bad guy” scenario in which the parents are the bad guys and the professional or another observer is the good guy.  There is tendency to blame the parents, or the “first line” caregivers, in all professionals involved in the care of suffering children. Therefore, Josh and I were concerned to emphasize the complexity of these situations.  We repeated in many different contexts the idea that here are many reasons for children to have psychological problems, and no one is to blame.

After the four days of lectures, we were eager – and a little anxious – to hear the feedback from the caregivers in the training.   

Professional Caregivers’ Feedback after the Training: 

1. I used to blame parents for the problems of the child, but now I understand that it isn’t the parents’ fault, that it more complicated. Now I can be more empathic to the parents. 

2. I am going to use the PCM in my work with children and parents. I think it is a good tool, and it is empathic to the parents.

3. I liked it the way you treated the parent in the interview with the child. Even though she had angry feelings about him you were able to find something positive to say about the child and about the parents.

4. I liked the way you treated the parents in the interview. Even in the last case when the child’s problems were so serious, you were able to find some positive things to say to the mother; you were able to give her hope.

5. The Parent Consultation Model requires the consultant to listen more carefully to the parents and to be patient. The continuing personal growth of the therapist, consultant, or supervisor is necessary and beneficial to the professional role.

6. We do look at the strengths of the child and the parents as the basis of what we do. 

7. We desire openness and acceptance of all observations and thoughts about the cases. Our work is not to pretend that negative thoughts and feelings are not there, for example, the rescue fantasies the therapist may have towards a child whose parent has died, or even a child whose parents are angry or critical towards him or her. We want to have a full discussion including our negative reactions so that we can come to a more complex sense of the family that moves beyond blame.

8. Problem of PCM in China and many other societies – parents avoid consultation because of their fear of the consequences of having big problems –the negative judgments about mental disorders. 

9. They had discussion about the question re pet. It is not common for Chinese families to have a pet. If the purpose of the question about the pet was to get a sense of the family’s capacity to nurture and protect, what could we ask instead to discover something important about the role of the parent in this family? our Chinese students suggested an alternative: “What is your favorite fairy story or folk tale in the family?”

10. How we feed back our observations about the play sessions to the parents? It is important to strike a balance between protecting the confidentiality of the child against the need to help the parents grow in their empathy and their capacity to imagine the mind of their child.  

 

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