SafeCare April 2021

In this issue:

• Interview with Amanda Joseph and the SafeCare team at Wesley Mission
• Working with Families where a parent or both may have a disability – Case study Janet Birks, Samaritans

Interview with Amanda Joseph and the SafeCare team at Wesley Mission

Thank you Amanda and the SafeCare team at Wesley Mission for agreeing to feature in our fourth edition of the SafeCare newsletter. Could you introduce yourself and tell us a bit about who you are and your role at Wesley Mission including your role in the delivery of SafeCare?

I am a Practice Specialist at Wesley and the project lead for SafeCare implementation. I manage our fabulous team of coaches and trainers and work closely with all our leaders and providers to achieve best practice when it comes to SafeCare.

The following insights below are from some of our coaches and trainers here at Wesley who do an amazing job championing SafeCare and supporting our SafeCare providers to deliver a high standard of practice to the children and families in our program.

What strategies have providers at Wesley implemented to address some of the complexities and support families? Could you highlight those that have been most successful so far and explain how delivering SafeCare to families where a parent or child may have a disability, may differ from other families?

In some cases, delivering the Safe Care program to parents with a disability isn’t any different, but for some families we have adapted the program to support parent’s learning and understanding of the sessions.

For example, we may schedule additional sessions and make them shorter or slower, to allow for more modelling rather than explaining the skills. We might also incorporate more regular check-ins to gauge a parent’s understanding of the module. We sometimes include other support people in a parent’s life such as their partner, parents or carer, to assist with their learning, practice and understanding of the modules.

However, having a child with a disability means that we may have to change the developmental expectations and adapt some of the skills when we’re delivering the Parent- Infant Interaction (PII) or Parent Child Interaction (PCI) module. An example of this would be, asking parents about their expectations and what they expect might happen if the child doesn’t respond, then depending on the child’s response or level of comprehension, we may need to adapt and shape the skills that are outlined in the module, to be more in line with the child’s behaviour. It is always important to make sure that we aren’t contradicting what ‘experts’ or therapists in that child’s life is saying and recommend a care team approach prior to delivering SafeCare, so that we can complement other advice parents are receiving.

Another example of a strategy used comes from one of our providers who was delivering SafeCare to a refugee family that could not read or write. The provider used lots of visuals and adaptations, slowing the sessions down and incorporating more sessions to help the parents learn the skills.

How does SafeCare address the complexities of families where a parent has a disability?

SafeCare is structured and follows a predictable pattern, which means that families can be informed of what will be happening in advance. This helps to ease any anxieties or worries about the unknown and suits parents with a disability in particular.

SafeCare is flexible in how it is delivered in terms of clarifying and modifying language and resources. It allows for the provider to deliver the sessions and information in a way that benefits the parent’s learning capabilities.

Using the Health booklet, as an alternative to the Health manual is an example of how visuals can help, as is the Safety module which is really flexible in exploring ways of how we make the home safe. The structure of the Explain Model and Practice Feedback (EMPF) model works well with parents with a disability as the provider is always modelling first before asking parents to practice. The one on one delivery suits parents with a disability and providing feedback on the spot with the opportunity to repeat activities to support progress which is also helpful for parents needing extra support.

What do you perceive to be the barriers to families initially engaging, and remaining engaged with the SafeCare program?

Initially we have to earn the trust of the family and clearly outline our role and expectations so that everyone has a shared understanding of what it is we are doing. Sometimes how we introduce and explain the program can have a big impact on how parents engage with it. Explaining that the length of the program is three modules and 18 sessions can be really overwhelming for some families and sometimes we need to break this down and look at modules one by one. Linking modules to the reason the family was referred to us and the goals they want to achieve is key to initial and ongoing engagement.

If the parent or the provider doesn’t have a clear understanding of why the family is doing SafeCare and how it fits with their goal and motivation to change, this can have a real impact on the family’s investment and continued engagement with the program.

Parents may have a fear of trying something different and feel shame about having their children’s behaviours or having their parenting practices ‘assessed’. When behaviours don’t change straight away parents may become disengaged and they can fall into old parenting practices - because it seems easier. Parents sometimes want help putting out ‘spot fires’ and want to prioritise what seems immediate, rather than, focusing on long term change in their children’s behaviour and their parenting practices.

Sometimes there may be trauma triggers in session. For example, in the family we mentioned  earlier where there were literacy challenges, there was shame in not knowing how to read or write. The mother stated that she felt bad that she couldn’t read and write which affected her being open to trying anything she might not be able to do. We worked with the family to develop visual resources for each module, which meant the sessions were quicker and mum felt more prepared when starting the modules as she not only knew what was going to happen but knew that it was appropriate for her needs.

As a SafeCare coach what strategies have you and the other coaches at Wesley Mission, established to overcome these barriers?

Some strategies our SafeCare team use, include:

• Ensuring each family is at a stage where SafeCare can be delivered effectively, setting the family up to succeed.
• Making sure that all families have a sound understanding of the Safe Care program and that the expectations of the parent and the provider are clearly outlined before starting each module.
• Maintaining contact and flexibility as the program progresses if the family needs it, including pausing the delivery of SafeCare briefly, to allow the parent opportunity to share how they’re feeling about SafeCare and what barriers are in the way for them to be able to fully participate in the session.
• Working in a trauma informed way, checking in and slowing down, reviewing their motivation for SafeCare rather than just wanting to complete the module.
• Making sure that families have a project or goal that links to the SafeCare module that they are working on and is related to the reason they were referred to Brighter Futures. Integrating the reason the family  came to Brighter Futures and  the parenting values that drive their behaviour with how SafeCare can help achieve their goals can be really effective in maintaining the energy and commitment needed to maximise the family’s learning from SafeCare.
• Parents at times have an idea or previous experiences of what parenting programs have been like, so talking about how SafeCare is individually tailored and occurs in-home with one on one coaching rather than a teaching model, really helps with engagement.
• During recordings we are often listening out for both change ambivalence and early signs of disengagement from the program, so we can have those conversations with families quickly and try and resolve those concerns.

Other examples of innovative work by the coach and SafeCare provider  to prepare for sessions with the family with literacy issues, shows how these strategies can be used

• The provider and their coach spent a lot of time planning out what could be done to allow for smoother delivery
• In pre- session coaching planning around scenario’s that were short to allow for a quick time to explain, and bringing pictures along each to help explain the scenario.
• In pre- session coaching identified words that could be broken down and would be easier for the family to understand, exploring the importance of meaning of particular words to mum. This meant that instead of using ‘supervision’ the provider used the words ‘watching the kids’.

In delivering SafeCare to so many families, has there been a moment or memory that stands out for you?

I’ve gathered some moments from the SafeCare team who have provided their thoughts and experiences:

Alex Wagner - One moment in particular was where the mother talked about how she loves to show people her certificate and explain that she is in the process of achieving her goals of education and getting long term work.

Sophie Varvel - There are so many memories that stand out! I love that SafeCare doesn’t just teach families new skills but that it also builds their confidence. I love seeing that turning point for families when they reach the end of the module and have gained mastery of the skills and you can see that they have confidence in doing this and how the children respond, especially in PII or PCI.

I remember working with one mother, when I first started SafeCare. She mentioned that she had an older child in Out of Home Care (OOHC). She said that she had made her mistakes in the past and wouldn’t disrupt her daughter’s life because of that to have her come back into her care. She felt that she could be a different parent to her youngest but wasn’t sure how she would manage. After doing the three modules of SafeCare, her confidence as a parent grew and she successfully was able to get her daughter restored to her care. There are just so many good news stories about SafeCare, the families that we work with love it.

Louise Vincin - I always enjoy observing practices unique to families and culture. A stand out for me was observing a nappy change activity with an African mother. Whilst this was an activity she wanted to see behaviour change in, I was impressed by the way she didn’t just change the child’s nappy but rubbed cream into his legs, rubbed his feet and hummed to him while doing this. The parents we work with have many strengths and I loved being able to share with her how I loved being able to observe this.

Kate Beasley - A stand out moment for me, was delivering PCI session two to a family and we were discussing the importance of parent-child interactions. I read out the first point from the manual and the parent started to cry. They had never seen themselves as a teacher in their child’s life in these early years of critical development. I will never forget the power this gave the parent and their response.

This is now a stand out for me in all coaching and training sessions as I feel there are many parents out there that under estimate their role in their child/ren’s lives.

Lastly, what inspires you?

Alex Wagner - As a coach creating additional material to help explain things to families whilst keeping fidelity is important. As every family needs are different therefore the plan would be different for each family such as additional visuals, extra modelling, cutting visits, focusing on skills.

Sophie Varvel - I am inspired to see parents grow in their confidence and skills as a parent and the benefit that has on their children. I want parents to be walking away from SafeCare saying “I’ve got this”. I love that, often towards that end of the parenting modules, the children are more interested in playing with their parent whereas at the beginning sometimes it’s the worker. I love that shift and what that means to the parent. Ultimately I am inspired by our families, their strength, their determination and their drive to keep going under challenging circumstances to give their kids the life that they dream of for them.

Louise Vincin - The fact that I have seen how SafeCare has made a change in so many families over the past 5 years. Hearing providers share stories from their families and how it adds purpose to their casework. Seeing children’s faces light up or hearing the excitement in their voices as parents spend time with their children and use the skills they have learnt, especially in a play activity, and seeing or hearing the light bulb go on for parents when they see how the skills work.

Kate Beasley - My greatest inspiration is being able to teach parents a set of skills that gives them the permission to interact with their children in all parts of the day. The smallest positive interaction with a child has the biggest long lasting effect that is going to empower that child to grow and develop. The Parent- Infant Interaction (PII) or Parent Child Interaction (PCI) module teaches the importance of these interactions and the evidence behind it to show parents that it is necessary.

All three modules are an inspiration really. As they are all child focused and look at making positive changes for the families we are working with.

A huge thank you to one and all at Wesley Mission, we really appreciate the time you’ve taken to chat with us!

Working with Families where a parent or both may have a disability – Case study Janet Birks, Samaritans

Janet Birks is a SafeCare practitioner with Samaritans who has had experience delivering SafeCare to a family where a parent has a disability.

Janet discusses some of the challenges and innovative ways she has tailored SafeCare to provide support for the family using visual cues, shortening session times, involving a third party and developing videos.

I have been delivering the SafeCare program to a single mum since April 2020 and today as I write this article I feel like the family and I are at a crossroads.  We are half way through the program with Health under our belt and half way through Parent Child Interactions (PII). I want to be a glass half full practitioner but its’ been a three months since our last SafeCare session and I’m wondering if we can get it going again.

Mary was referred to Brighter Futures in March 2020 by DCJ and I have provided case management, delivering SafeCare to her since that time. Upon initially meeting Mary she had a new baby and was parenting for the first time.  She has three other children – two are under the care of the Minister and one lives with his father.  Mary has a brain injury with diagnosed Attention Deficit Hyperactivity Disorder (ADHD) and has an extensive trauma history. Mum and bub live with Mary’s grandparents and her brother.

Mary loves being a mum and has been very good at linking into supports and services.  She was quick to agree to and engage with SafeCare, and initially, we met most weeks to do the Health module.  However, overtime  sessions were postponed because of child protection concerns and the other areas of unmet need that had to be responded to along with competing demands, which have extensively impacted on the teaching and on our motivation.

Strategies to overcome challenges

Mary does have a cognitive impairment and I’ve had to adapt the program to make it accessible for her.  Mary’s strengths are that she learns by doing, she has confidence to give things a go and she responds well to positive feedback. Mary has always had fantastic eye contact and warm facial expressions with the baby, but responding to baby’s cues and the verbal communication has been a challenge for Mary. I have found that Mary struggles with the length of sessions and absorbing a lot of information. Initially I broke the session into half but I’m not sure that always worked as it took us months to finish the module and by that time, we both lost momentum and our enthusiasm for the material.

I’ve introduced some visual cues in the PII module and these are giving Mary more scaffolding to learn the skills and material.   My SafeCare coach and I are brainstorming some ideas which include having us both present at sessions for the modelling of PII and we are going to give Mary some videos of the Parent Infant Interaction skills to watch together, with emphasis on identifying the individual skills one at a time during a daily activity.

I am due to see Mary today and having written this article I do feel a renewed desire to find a way through.  I have been an advocate for people with disability and argued on many occasions for adjustments to environments and programs to ensure that people with disability have what they need to meet their full potential.

SafeCare has a lot to offer Mary and her children.  The way it is individually delivered really gives me the opportunity to meet Mary where she is at.  So there is a way forward.

*A note from the coach:

Janet (Case Manager) has really committed to finding flexible solutions to make the sessions meaningful for the parent participating in SafeCare. She has done this by observing how the parent responds to each of the Explain, Model, Practice and Feedback (EMPF) steps and building on the strengths of the parent. Providing more opportunity to explain the skills visually through using larger individualised and coloured cards that the parent understands has been a great to enhance engagement from the parent.