A hermeneutic study of integrating psychotherapist competence in postnatal Child Health Care: Parents’ perspectives

Abstract

A child's emotional and social development depends on the parents’ provision of optimal support. Many parents with perinatal distress experience difficulties in mastering parenthood and seek help from professionals within primary healthcare. A clinical project was launched in Stockholm, where psychodynamic psychotherapists provided short‐term consultations at Child Health Centers. This study qualitatively explored parents’ experiences of perinatal distress and of receiving help by nurses and therapists in the project. Thirteen parents were interviewed, and their responses were analyzed with a hermeneutical method. Three main themes crystallized; accessibility of psychological help and detection of emotional problems; experiences of therapy at the Child Health Center; and the therapists’ technique. Parents were also clustered into three so‐called ideal types: the insecure; parents in crisis; and parents with lifelong psychological problems. Parents experienced obstacles in accessing psychological care within primary healthcare. Psychotherapists with a holistic family perspective and who managed to oscillate between insight‐promoting and supportive interventions were especially appreciated. Patient categories who benefitted from insight promotion and support, respectively, were identified.

Short‐term psychodynamic infant–parent interventions at Child health centers: Outcomes on parental depression and infant social–emotional functioning

“…Bearing in mind the reservations at the beginning of the discussion, we interpret that the SPIPIC therapies, whose duration had a mean of only 4.3 sessions, contributed to a non‐negligible extent to the improvements–at 9 months follow‐ups–on mother‐reported depressive symptoms and infant functioning. Qualitative studies of interviews with nurses, parents, and psychotherapists (Kornaros, Zwedberg & Nissen & Salomonsson, 2018, 2020 and Kornaros, Zwedberg & Nissen, 2019, respectively) identified salient features such as a flexibility in therapeutic technique and a confident nurse–therapist collaboration. Improvements seemed not to be obtained merely due to the psychotherapies but also to their integration with an enhanced health care provided by supervised nurses.…”

“…Therapies aim to promote infant attachment and to uncover "ghosts in the nursery" (Fraiberg, 1987) that prevent parents from achieving optimal sensitivity and bonding with the child. For clinical illustrations and recommendations on therapeutic technique, we refer to Salomonsson (2018) and Kornaros, Zwedberg & Nissen (2019). See also the Appendix at the end of the article.…”

Defensive patterns in reflective group supervisions at Child Health Centres

“…The aim of integrating psychological help for such families with ordinary infant heathcare is complex and clashes with organizational and professional traditions, parents’ embarrassment, and nurses’ discomfort with addressing perinatal emotional problems. It is therefore essential to investigate the obstacles among nurses (Kornaros, Nissen, Zwedberg, & Salomonsson, ), parents (Kornaros, Nissen, Zwedberg, & Salomonsson, ), and therapists, to reach out to the many distressed parents and infants.…”

Listening to the Voices of Mothers Who Participated in a Video Feedback Intervention for Postpartum Depression

“…In general, there is limited research on understanding mothers’ perspectives related to video-feedback intervention. While recommended ( N. L. Letourneau et al, 2017 ), opportunities for mother-infant dyads to engage in treatment together are currently uncommon, indicating that more evidence about this type of intervention is needed ( Kornaros et al, 2019 ).…”