Adapting a perinatal empathic training method from South Africa to Germany

Abstract

BackgroundMaternal mental health conditions are prevalent across the world. For women, the perinatal period is associated with increased rates of depression and anxiety. At the same time, there is widespread documentation of disrespectful care for women by maternity health staff. Improving the empathic engagement skills of maternity healthcare workers may enable them to respond to the mental health needs of their clients more effectively. In South Africa, a participatory empathic training method, the “Secret History” has been used as part of a national Department of Health training program with maternity staff and has showed promising results. For this paper, we aimed to describe an adaptation of the Secret History empathic training method from the South African to the German setting and to evaluate the adapted training.MethodsThe pilot study occurred in an academic medical center in Germany. A focus group (n = 8) was used to adapt the training by describing the local context and changing the materials to be relevant to Germany. After adapting the materials, the pilot training was conducted with a mixed group of professionals (n = 15), many of whom were trainers themselves. A pre-post survey assessed the participants’ empathy levels and attitudes towards the training method.ResultsIn adapting the materials, the focus group discussion generated several experiences that were considered to be typical interpersonal and structural challenges facing healthcare workers in maternal care in Germany. These experiences were crafted into case scenarios that then formed the basis of the activities used in the Secret History empathic training pilot. Evaluation of the pilot training showed that although the participants had high levels of empathy in the pre-phase (100% estimated their empathic ability as high or very high), 69% became more aware of their own emotional experiences with patients and the need for self-care after the training. A majority, or 85%, indicated that the training was relevant to their work as clinicians and trainers, that it reflected the German situation, and that it may be useful ultimately to address emotional distress in mothers in the perinatal phase.ConclusionsOur study suggests that it is possible to adapt an empathic training method developed in a South African setting and apply it to a German setting, and that it is well received by participants who may be involved in healthcare worker training. More research is needed to assess adaptations with other groups of healthcare workers in different settings and to assess empathic skill outcomes for participants and women in the perinatal period.

Challenges for Behavioral Neuroscience: Prenatal, Postnatal, and Social Factors

“…Although for decades there have been efforts reaching out to prenatal aspects of mental health [112], structured programs are relatively new in Germany. As to overall parenting and early childhood, interdisciplinary and cross-cultural collaborations have emerged [113,114]. On an individual level of childhood education, structured programs have successfully been established in many educational institutions in Germany [115][116][117].…”

“…Comparisons between USA and German programs have proven to be difficult due to structural differences in health services [118]. In Germany, they mostly focus on the mother-infantrelationship [114], when a focus on postpartum depression and anxiety would be equally relevant. Recent meta-analyses show that programs starting during pregnancy were evaluated as the best when they had a high frequency of home visits [119,120].…”

Midwife empathy and its association with the childbirth experience: a cross-sectional study

“…In addition, maternal mental health problems are widespread around the world. A key recommendation for addressing the challenges of perinatal mental health is to integrate mental and maternal healthcare [ 8 ]. Improving the empathic engagement skills of maternity healthcare workers may enable them to respond more effectively to the mental health needs of their clients.…”

SKIP: emotional well-being intervention

“…To encourage a greater understanding of empathy, we are using a training technique based on ‘A Secret History’. 1 In this method, groups are split in half – one half acting as the SKIP volunteer while the other is the community member. The purpose of the role-play is to explore a scenario where a person experiences distress and consider what both parties’ feelings and needs might be as the scenario evolves.…”