Adult mental health clinicians’ perspectives of parents with a mental illness and their children: single and dual focus approaches

Abstract

BackgroundWhen clinicians in the adult mental health sector work with clients who are parents with dependent children, it is critical they are able to acknowledge and respond to the needs of the parents and their children. However, little is known about clinicians’ personal perspectives and reactions towards these parents and children or if/how they balance the needs of both.MethodsSemi structured interviews were conducted with eleven clinicians from adult mental health services in Australia. Interviews focused on clinicians’ experiences when working with parents who have mental illness. Transcripts were analysed within an Interpretative Phenomenological Analysis framework to examine participants’ perspectives and personal reactions to parents and children.ResultsThere was considerable divergence in participants’ reactions towards parents and children and the focus of their perspectives when working with parental mental illness. Feelings of sympathy and responsibility made it difficult for some participants to maintain a dual focus on parents and children and contributed to some adopting practices that focused on the needs of parents (n = 3) or children (n = 1) exclusively. Other participants (n = 7) described strategies and supports that allowed them to manage these feelings and sustain a dual focus that incorporated the experiences and needs of both parents and children.ConclusionsIt is difficult for some mental health clinicians to maintain a dual focus that incorporates the needs and experiences of parents and their children. However, findings suggest that the challenges of a dual focus may be mitigated through adequate workplace support and a strengths-based practice framework that emphasises parental empowerment.

Adult mental health practitioner beliefs about psychosis, parenting, and the role of the practitioner: A Q methodological investigation

“…Participants believed that the impact of parenting stressors on mental health challenges was two‐directional and cyclical – a finding that is supported in the wider research literature (Goodyear et al ., 2015; Tchernegovski, Hine, Reupert, & Maybery, 2018; Ward, Reupert, McCormick, Waller, & Kidd, 2017). Participants consistently endorsed the need for parents to feel able to speak about parenting needs without fearing the removal of their children.…”

“…Despite the consensus that parenting impacts on mental health and vice versa, practitioners differed in their beliefs about their role with respect to this. This is an important finding, as recent research reports that beliefs about job role were crucial to the successful implementation of family‐focused approaches in adult mental health services (Tchernegovski, et al ., 2018). Most participants showed willingness to incorporate parenting interventions into their work, but there was stark contrast between practitioners’ level of confidence in doing so.…”

“…Finding ways in which to have transparent and supportive conversations about parenting needs is therefore likely to benefit the client and family. Such conversations can be fostered by boosting workplace support via supervision, multi‐disciplinary team discussions, and by both informal and formal debrief sessions (Grant & Reupert, 2016; Slack & Webber, 2008; Tchernegovski et al ., 2018). This might be best led by practitioners whose role requires broad training in service delivery and provision of supervision across varied mental health issues and client groups, such as that of clinical psychologists whose training spans the breadth of mental health clinical work alongside professional leadership and service development.…”

“…and How Are the Kids?” Psychoeducation for Adult Patients With Depressive and/or Anxiety Disorders: A Pilot Study

“…Other respondents mentioned (and perhaps rightly so) that they had enough conversation techniques to be capable to discuss parenthood. Interviews and case discussions during the team meetings provided more insight into the emerging dilemmas of professionals, such as the idea of having to choose between the good of the parent and that of the child (22). Reupert et al (13) warn that professionals, including social workers and nurses, seem to avoid such dilemmas by arguing that talking about parenthood can harm the confidentiality of the relation between professional and patient.…”

An explanatory model of factors enabling sustainability of let’s talk in an adult mental health service: a participatory case study

“…The models of practice common in AMHS are driven by policy and funding that focus on the adult as an individual and work in episodes of care to manage a crisis [23]. Furthermore, gaps in practitioners' skills, knowledge and confidence to work with families [24][25][26], perpetuated by a lack of regular access to parents on their caseload [27], have limited the use of these interventions in everyday practice. To mitigate these, the growing body of research into implementation [28,29], has been applied to practices for supporting parents with a mental illness [19,30].…”