"Learning to 'waltz' rather than 'wrestle' … " : a novel, ultra-brief intervention supporting early child-caregiver relationships.

Abstract

Introduction: The quality of the early child-caregiver relationship plays a crucial role in shaping a child's development. In response to the lack of early intervention provisions for 2-5 year olds, the Leeds Infant Mental Health Service increased their offer to support children up to their fifth birthday (and their caregivers), where relational difficulties impact upon the child's emotional wellbeing.

Aims: This paper aims to evaluate the effectiveness of the direct therapeutic work (named 'Understanding Your Toddler'; UYT), in promoting the child-caregiver relationship.

Method: Nineteen families were accepted for UYT, where there was motivation and emotional availability to consider change within the relationship. Thirteen families engaged in the work. The UYT offer adopted a three session, home-visiting model, drawing upon several therapeutic approaches. A two-phased mixed methods design was adopted. Phase I analysed quantitative changes within the relationship. Phase II qualitatively evaluated families and professionals' experiences of UYT.

Results: Paired t-tests and Wilcoxon signed rank analyses illustrated significant differences pre and post UYT in caregiver: goals, confidence, perceptions and feelings of irritation. No significant differences were found in caregiver feelings of warmth. Themes from interviews suggested that the strengths-based approach was valued, and that video work supported caregivers to 'see the world from their (toddlers') point of view'.

Conclusion: This evaluation contributes to the limited evidence evaluating the efficacy of child-caregiver interventions in practice. Despite the small sample, the UYT model provides a helpful framework (applicable to clinical contexts) to foster early relationships and emotional development of young children.