A hermeneutic study of integrating psychotherapist competence in postnatal child health care: nurses’ perspectives

Abstract

BackgroundThere is a considerable prevalence of and an increasing attention to emotional problems in families with infants. Yet, knowledge is scant of how to create efficient and accessible mental health services for this population. The study qualitatively explored public health nurses’ conceptions of a clinical project, in which psychotherapists provided short-term consultations and supervisions for nurses at Child Health Centres in Stockholm.MethodsIn-depth interviews with fifteen nurses. The guideline of the interviews contained open-ended questions that were analysed applying a hermeneutical approach.ResultsFour main themes crystallized; The nurses’ conceptions of their psychosocial work, Trespassing on another professional role, Interprofessional collaboration at the Child Health Centre, and The nurses’ conceptions of the psychotherapist’s function. In a second step, an analysis that clustered the nurses’ attitudes towards handling mental health problems yielded one last theme with three “Ideal types”; nurses who expressed “I don’t want to”, “I want to but I cannot”, and “I want to and I can” (take care of families’ emotional problems at the CHC).ConclusionThe nurses appreciated the easy referral and accessibility to the psychotherapists, and the possibilities of learning more about perinatal mental illness and parent-infant interactions. For a successful cooperation with the nurses, the therapist should be a team member, be transparent about his/her work, and give feedback about cases in treatment. The study also shows how the organization needs to clarify its guidelines and competence to improve psychological child health care. The paper suggests improvements for an integrated perinatal mental health care.

Stigma in relation to families living with parental mental illness: An integrative review

“…Other researchers found that health professionals took a negative (Kornaros et al . 2018) or paternalistic attitude towards patients who aspired to be parents, cautioning against pregnancy due to an over‐emphasis on genetic inheritance of psychiatric conditions (Bhugra et al . 2016; Koschade & Lynd‐Stevenson 2011).…”

“…In one first person narrative, the silence surrounding parental mental illness was medically instructed and sanctioned in that a psychiatrist explicitly recommended that parents not discuss a father's psychiatric condition or symptoms with their children (Hinshaw 2005). Other researchers found that health professionals took a negative (Kornaros et al 2018) or paternalistic attitude towards patients who aspired to be parents, cautioning against pregnancy due to an over-emphasis on genetic inheritance of psychiatric conditions (Bhugra et al 2016;Koschade & Lynd-Stevenson 2011).…”

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.…”

‘So, the circle has grown’ – Child Health Services nurses’ experiences of giving parental interviews with nonbirthing parents

“…It has been shown by others that although the healthcare organisation demands nurses to focus on psychosocial issues, it does not provide them with the necessary support or education. Despite that, today's CHS nurse has a much greater psychosocial responsibility than just a few years ago.…”