Reflective group supervision: psychotherapists and child health centre nurses in collaboration

ABSTRACT Postpartum depression affects every sixth mother, and emotional distress in infants is also common. The need for parent-infant consultations and psychotherapies probably greatly exceeds the number of families who in fact receive qualified help. Nurses at child health centres are the first professionals to meet distressed families. Their readiness to help them is clouded by conflicting professional attitudes, patients’ expectations, and uncertainties of how to handle patient-nurse interactions. Nurses may experience clinical impasses that need attention. Reflective group supervision can be a valuable remedy, and a method for educating nurses in daily practice. The method is illustrated by a vignette, and a review of the nursing and psychoanalytic literature. Nurses often address problems with anger, guilt, and anxiety of uncertainty, which may block their understanding of the families’ emotional entanglements. Supervision combines the supervisor’s psychodynamic competence and the nurses’ experiences, to inspire self-reflection on difficult cases. It should be provided regularly with management support, and the supervisor should preferably be a psychotherapist experienced in child and adult work. The therapist can work simultaneously as a consultant clinician at the centre, thus increasing the opportunities for families to receive adequate help.