Parent-professional Relationships Research Articles

Parents’ experiences of perinatal child protection processes: A systematic review and thematic synthesis informed by a socio-ecological approach

BackgroundNationally and internationally, researchers and practitioners are increasingly expressing concerns regarding the number of babies removed by child protection systems soon after birth and how child protection processes in the perinatal period (conception to one year following birth) impact families. AimThis systematic review synthesises qualitative studies to gain an understanding of the experiences and needs of pregnant women, mothers, and fathers involved in perinatal child protection processes that occur in health, welfare, and legal systems. MethodsMulti-disciplinary electronic databases (13) were searched for relevant peer-reviewed journal articles written in English and published since 2000. Twenty-four articles met the inclusion criteria. Analysis adopted a socio-ecological approach and thematic synthesis. An expert advisory group comprised of lived experience advisors, service providers, and academics contributed to development of the thematic framework. ResultsAlthough the reviewed studies were conducted between 2005 and 2023 with diverse participants from six countries, they highlight parents’ similar experiences of perinatal child protection processes. Parents’ experiences are synthesised according to spheres of the socio-ecological model:(i) At the individual level, parents described their love, hope, confusion, fear, agency, and anguish.(ii) Within relationships parents recounted broken parent-baby bonds, limited personal and professional support, and the implications of trauma and trust for parent-professional relationships.(iii) When engaging with organisations parents reported pervasive surveillance and harmful processes, inadequate communication and support, and power imbalances.(iv) At policy and societal levels parents’ experiences pointed to dominant Western norms and values, increased poverty and homelessness, compromised rights, and prejudicial perinatal policies.Also synthesised are parents’, professionals’, and researchers’ recommendations for improving perinatal child protection processes and supporting families. ConclusionsOver the last 20 years, qualitative studies from around the globe have consistently reported the adverse biopsychosocial impacts of removing babies from their families. Addressing poverty and trauma, redressing power imbalances, and mitigating the enduring impact of perinatal child protection processes is critical for parents’ to be able to keep or be reunified with their babies. Shifts at institutional, policy, and societal levels are needed to: prioritise prevention and early intervention; enable relational practice and cross-sector collaboration; and move beyond traditional Western notions of family. Centring parents’ voices in efforts to improve child protection processes before and after birth will help inform the delivery of early and appropriate support to meet parents’ identified needs and promote family wellbeing.

Trusting parent-professional relationships in interprofessional interventions for expectant and new parents in vulnerable positions: A realist evaluation

ABSTRACT Interprofessional collaboration and trusting parent-professional relationships can be key to delivering interprofessional care to meet the needs of expectant and new parents in vulnerable positions. This, however, presents challenges. This study aimed to gain deeper understanding of how and under what circumstances trusting parent-professional relationships develop and work within interprofessional team-based care for this group, from the professionals’ perspectives. Realist evaluation was undertaken based on 14 semi-structured, realist interviews with midwives and health visitors and 11 observations. Multiple interrelated mechanisms were identified including patient/family-centered care, timely and relevant interprofessional involvement in care, gentle interprofessional bridging, transparency of intervention roles and purposes, and relational continuity. Good interprofessional collaboration was a primary condition for these mechanisms. Developed, trusting relationships supported parents’ engagements with interprofessional care and constituted a supportive safety net that promoted parenting skills and coping abilities. We identified harmful mechanisms: distanced encounters, uncertainty of interprofessional involvement, and compromising the safe space. These mechanisms caused distrust and disengagement. Ensuring trusting parent-professional relationships within interprofessional team-based care demands each professional involved competently engages in relational work and interprofessional collaboration. Uncontrollability is thus influenced regarding interpersonal connection and potentially gives an explanation when trust-building efforts fail.

Determinants of satisfaction with the detection process of autism in Europe: Results from the ASDEU study.

Professional guidance and support in response to first concerns appears to be an important predictor of the level of satisfaction with the detection process of autism in young children. In this study, we analyzed the views of 1342 family members, including 1278 parents, who completed an online survey form collecting information about their experience and satisfaction with the early detection of autism in their child. Specifically, we were interested in how specific experiences with the detection process relate to the satisfaction with it and whether we could identify important predictors of satisfaction. The detection process is an emotionally charged period for parents, often described as painful, chaotic, and lengthy. A better understanding of their experiences is important to take appropriate action to improve the detection process. In our sample, the level of satisfaction with the detection process varied greatly from one respondent to another. Among the different experiences we considered, whether or not respondents received professional guidance and support in response to first concerns explained most of this variation. We also found that difficulty finding information about detection services, lack of professional guidance and support in response to first concerns, having to find a diagnostic service on one's own, and longer delays between confirmation of concerns and first appointment with a specialist were experiences associated with a greater likelihood of being unsatisfied. The findings of this study highlight the importance of the parent-professional relationship in the detection process and have important practical implications for health administrations to improve the detection process.

Fathers Matter: Enhancing Healthcare Experiences Among Fathers of Children With Developmental Disabilities.

Background: Being a parent of a child with a developmental disability (DD; e. g., cerebral palsy, autism) comes with great challenges and apprehensions. Mothers and fathers of children with DD are experiencing heightened levels of psychological distress, physical health problems, financial difficulties, social isolation, and struggles with respect to traditional parenting roles. In relation to the latter, the involvement of fathers in caregiving in today's society is increasing and is highlighted by its importance and positive contribution to the development of their children. However, fathers of children with DD report feeling excluded and marginalized by healthcare providers (HCPs) when arranging for and getting involved in healthcare services for their children. Currently, there is limited evidence as to what factors influence those experiences. We aimed to explore barriers to and facilitators of positive and empowering healthcare experiences, from the perspectives of fathers of children with DD and HCPs.Methods: A mixed-method approach, such as quantitative (survey) and qualitative (semi-structured interview) strategies, was used. Participants were fathers of children with DD and HCPs working in childhood disability. Data analysis consisted of using descriptive statistics and an inductive-thematic analysis of emergent themes.Results: Fathers (n = 7) and HCPs (n = 13, 6 disciplines) participated. The fathers indicated that while they were moderate to very much satisfied with their interactions with HCPs, they reported that HCPs were only sometimes attentive to them during interactions. Fathers also revealed that positive interactions with HCPs in relation to their children had multiple benefits. Several themes related to barriers and facilitators of optimal interactions and parent–professional relationships emerged. These included session factors (time, attention), personal factors (knowledge of the condition, child and healthcare system, acceptance vs. denial, previous experiences, culture, stereotypes, pre-existing beliefs, stress levels, working schedule), and family dynamics. The participants offered several insights into the different strategies that can be implemented to promote optimal interactions between fathers and HCPs.Conclusion: We identified several barriers, facilitators, and improvement strategies for optimal interactions and enhanced parent–professional relationships from the perspectives of fathers and HCPs. These can be integrated by existing clinical settings in efforts to enhance current clinical practices and improve child- and parent-related outcomes.

A scoping review of parental roles in rehabilitation interventions for children with developmental delay, disability, or long-term health condition

The importance of parental roles in rehabilitation interventions (i.e. the tasks and responsibilities assigned to parents in intervention) is widely reported but there is a paucity of information regarding the tasks linked with specific parental roles. A rigorous scoping review was conducted to understand the various roles that parents of children with developmental delays, disabilities, and long-term health conditions perform in intervention and the tasks and responsibilities associated with each role. The results confirm that parents take on distinct intervention roles which can be placed on a continuum from passive to active responsibility. Some parental roles are clearly associated with tasks completed in-session, some are linked with out-of-session tasks while others entail a combination of in-and out-of-session tasks. The in-session tasks linked with the Learner role emerged as central to enabling parents to assume other in-and out-of-session roles. The results also highlight the influence of the parent-professional relationship on the type of roles parents take on in their child’s intervention. The findings of the scoping review serve as the initial step in generating items for a tool to measure the type of roles that parents assume in intervention to empirically test the relationship between these roles and parental engagement.

A qualitative study on perspective of parents of children with autism on the nature of parent-professional relationship in Kerala, India.

This study explored the nature of relationship between parents of children with autism and professionals who provide therapy-based services for autism in Kerala, India. Given the shortage of professionally qualified therapists and educators (particularly in the case of autism) in low- and medium-income countries, parent-mediated interventions where professionals and parents work as partners are recommended as an effective means to meet the demand. However, for parent-mediated interventions to be effective, we first need to understand the customary nature of parent-professional relationship and develop the intervention accordingly. It is within this context that parents of 21 children with autism whose age ranged between 5.8 and 17.3 years were interviewed in order to understand the customary nature of parent-professional relationship. There was a dearth of scheduled, in-depth, and personalized one-on-one interaction between the parent and the professional. Though parents were involved hands on in their child's training under professional direction, they remained mere information providers in decision making. The parent-professional relationship did not nurture parent's self efficacy. This led to parents feeling inadequate to provide for their child's developmental needs and being apprehensive about adulthood. The customary nature of parent-professional relationship observed may be a reflection of the collectivist culture in India. The findings suggest that parent-mediated interventions will need to focus on enabling parents to break cultural barriers that might be holding them back from partnering with professionals as equals.

Parent–professional interviews in child protection: Comparing viewpoints

AbstractSeveral studies have analysed the parent–professional relationship in the field of child protection. Although social workers tend to privilege interviews when working with families and view them as a means through which to build ties, few studies have focused on these interviews. To analyse how professionals and parents position themselves, we chose to focus on the content of these interviews and on the associated interactions. To this end, we recorded 13 parent–professional interviews after receiving the consent of the concerned parties. After analysing the interviews, we asked volunteer social workers and parents to analyse their own recorded interviews. Our results confirm the asymmetric nature of the parent–professional relationship. They show that professionals' viewpoints carry more weight than those of parents. They also underscore professionals' lack of openness and the strategies parents implement to cope with this power imbalance. Lastly, our results open new avenues for reflection on the evolution of practices that may enable professionals to better take into account families' viewpoints.

From Article to Action: Strategies for Promoting Parent–Professional Relationships and Parent–Child Interactions

From Article to Action: Strategies for Promoting Parent–Professional Relationships and Parent–Child Interactions

The practice of partnerships: A case study of the Disabled Children’s Action Group, South Africa

Background: Children with disabilities stand to gain from an array of services and interventions to support their development. However, relationships between parents of children with disabilities and professionals can be fraught, with the potential that professionals undermine the role of parents and overlook their agency.Aim: The aim of this study was to examine the nature of partnerships between parents of children with disabilities and professionals in the Early Childhood Development (ECD) sector, and the influences that shape partnerships within a particular context.Setting: This article documents the experiences of parents of children with disabilities from a national organisation, in respect of their partnerships with professionals.Methods: The research was a qualitative case study of a national organisation of parents of disabled children, the Disabled Children’s Action Group (DICAG), that has engaged in many different partnerships within different provinces of South Africa. Data generation techniques were document analysis and focus group discussion with staff and provincial branch members of the national DICAG office in Cape Town.Results: The findings of the study provide a nuanced and contextually situated understanding of the complexity of parent–professional partnerships in the disability sector. A key issue that emerges is that to recognise and disrupt pervasive dominant discourses and their potential to weaken partnerships, professionals need to critically attune themselves to the situated experiences of those whom they seek to support.Conclusion: The findings suggest that there is a need for a rights-based social justice agenda to underpin parent–professional relationships, to address the power dynamics and pervasive discourses that oppress the parent actors.

Getting Ready Strategies for Promoting Parent–Professional Relationships and Parent–Child Interactions

<i>Getting Ready</i> Strategies for Promoting Parent–Professional Relationships and Parent–Child Interactions

Sharing Power With Parents: Improving Educational Decision Making for Students With Learning Disabilities

In this closing commentary to the special edition of Learning Disability Quarterly ( LDQ) on parent voice in educational decision making for students with learning disabilities, we briefly survey main topics from each article, illuminating important findings from the authors, along with several questions they raise, and identify themes that reverberate throughout them as a collection. Subsequently, we offer suggestions to improve parental involvement in the decision-making process, in particular, the negotiation of Individualized Education Programs. In doing so, we emphasize the onus placed upon school professionals to better understand parental positionalities and needs, be culturally cognizant and competent in interactions, with the specific purpose of consciously addressing power differentials that have historically inhibited authentic parent–professional relationships. Finally, we end with a short note on the research methodologies used in this special edition.

A Qualitative Analysis of the Information Needs of Parents of Children with Cystic Fibrosis prior to First Admission

PurposeHospitalization can be stressful for patients and their families. Pre-hospitalization information is crucial in establishing a good basis for patient satisfaction. In order to develop better preparatory material for parents, this qualitative study explored whether parents of children with cystic fibrosis, admitted to a UK Children's Hospital, felt adequately prepared for their child's admission. Design and MethodsData were collected from twelve parents whose children had been admitted within the last two years for routine intravenous antibiotics. Semi-structured interviews were analyzed using thematic analysis. ResultsFour themes emerged from the analysis: (1) preparing for admission, (2) the ward as a challenging environment, (3) changes in the parent-professional relationship and (4) the parental role in medical care. ConclusionProvision of adequate preparatory information is essential in reducing parental stress, influencing how future experiences are appraised and managed. Effective parent-professional communication and opportunities to participate in care are likely to improve parental satisfaction. Practice ImplicationsPreparatory information prior to hospital admission greatly assists parents in making informed decisions and working as joint advocates in their child's inpatient care.

Becoming a Parent of a Child with Special Needs: Perspectives from Korean Mothers Living in the United States

The current study aimed to explore how cultural contexts influence the attitudes of mothers raising children with disabilities. Semi-structured in-depth interviews of seven immigrant Korean mothers regarding their personal experiences within the complexities of the special education system in the United States were analysed to identify factors that help mothers to thrive in the face of numerous challenges they encountered when working with professionals from different cultural and linguistic backgrounds. Narratives revealed that support groups, parent–professional relationships and cultural norms served as motivational factors that encouraged mothers to take initiative in proactively seeking ways to meet the needs of their children. Findings highlight the importance of a professional’s genuine attitude and open-mindedness when approaching culturally and linguistically diverse families.

Professionals' understanding of partnership with parents in the context of family support programmes

AbstractPartnership has become a dominant concept in current thinking about the parent–professional relationship within a variety of interventions aimed at child welfare, including family support practice. However, despite the burgeoning policy and research attention, the meaning of partnership in practice remains unclear. Based on interviews with professionals in a family support intervention in Flanders (the Dutch‐speaking part of Belgium), this paper offers an insight into professionals' daily interactions with parents. The analysis reveals a tension between professionals' commitment towards parents on the one hand, and the way professionals take up this commitment in an expert role on the other. Consequences for professionals' relationships in child and family welfare interventions are discussed, as well as some implications for the realization of proper partnerships that acknowledge the power imbalances that exist in such partnerships.

Exploring risk for abuse of children with chronic conditions or disabilities – parent's perceptions of stressors and the role of professionals

Children with chronic conditions or disabilities are at an increased risk for abuse. High level of parental stress has been identified as possible trigger for abuse, were a combination of several factors are of importance, as lack of social support and limited resources in the neighbourhood. Suggestions for preventive measures have merely focused on parenting strategies and targeted intervention programmes. So far, little attention has been paid on how the risk for abuse might relate to parent's perceptions of stressors and the role of professionals. The purpose of the current study was therefore to explore risk factors for abuse with focus on both parent-child and parent-professional relationships. Semi-structured in-depth interviews with 15 parents of children with chronic conditions or disability were collected and analysed according to qualitative content analysis. Three major themes were found that could be seen as risk factors for child abuse: (1) Emotional demands in precarious situations between parent and child. (2) Gradual shift in responsibility from professionals to parents concerning access to and co-ordination of service and support. (3) Emotionally closed environment between professionals and parents and taboo on talking about abuse. The gradual shift in responsibility had emotional implications, which could reinforce parental stress and thereby also indirect increase the risk of child abuse. The gradual shift in responsibility also seemed to generate an emotionally closed environment and reinforce the taboo on talking about abuse, which in turn hindered preventive measures. In the light of parent's perceptions of stressors and the role of professionals the findings indicate that abuse against children with chronic conditions or disability is not only a family matter, but also depending on qualities in service, professional support and social norms. The result pinpoints three challenges for preventive measures, all with emotional implications, parental strategies, organizational efforts and cultural awareness.

Father’s experiences of involvement in the daily care of their child with developmental disability in a Chinese context

This study explored Taiwanese fathers' experience of involvement in the daily care of a child with developmental disability within Chinese culture. Most studies on parents' experiences of having a child with a disability have focused on mothers or mixed fathers' voices with mothers'. Focussing only on mothers and ignoring fathers may hinder the latter's engagement with their child's care and encourage traditional or detached fathering roles. A hermeneutic phenomenological approach was applied to explore and interpret fathers' experience. Sixteen fathers were purposively sampled from a medical centre in central Taiwan. All participants were interviewed twice with semi-structured and in-depth interviews. All transcripts and journal notes were analysed with the hermeneutic circle to achieve thick descriptions that richly described the meaning of fathers' experience. Analysis of interviews with fathers on their experiences of raising the disabled child at home revealed three shared meanings: keeping hope alive, concerns about quality of medical care and maximising family function. Hope for their disabled child's good outcome and future was highly significant for these fathers, but hope was diminished when their child received poor medical care or their own ability was too poor to care for the disabled child. However, fathers still did not give up working for their children and for the well-being of their families and society. Nurses should acknowledge that fathers' involvement in their disabled child's care can contribute to the well-being of both child and family. Also, nurses should educate parents on the best possible ways to help their child. Finally, nurses need to encourage discussions between parents and professionals about their own and the family's situation to develop a trusting and equal parent-professional relationship, thus alleviating fathers' concerns and better meeting the child's care needs.

Parents' Experiences in Role Negotiation Within an Infant Services Program

Effective partnerships between families and health providers have been identified as the cornerstone of family-centered care. Role negotiation between parents and rehabilitation professionals is recognized as a key component to developing this effective partnership. The purpose of this study was to explore perceptions of the role-negotiation process among parents of young children. An exploratory qualitative research approach was used and in-depth interviews were conducted with 11 parents of children under the age of 3 years who were receiving services through an early intervention rehabilitation program. A 6-phase interpretive thematic framework guided the data analysis. Two major themes emerged from the data: (1) roles and expectations, and (2) the evolution of a symbiotic relationship. Parents recognized and defined the roles they assumed in their child's care and had distinct expectations of the roles attributed to rehabilitation professionals. No formalized role-negotiation process was identified. Instead, the evolution of a symbiotic parent-professional relationship was described, in which dependency on professionals to meet parent specific needs subsequently fostered their assumption of primary responsibility. This relationship appeared to be the precursor to the development of effective parent-professional collaboration and key to parent satisfaction with rehabilitation services.

Observe, listen, wonder, and respond: A preliminary exploration of reflective function skills in early care providers

Parents' behaviors demonstrating reflective capacity towards their children, parental reflective functioning, have been identified as central to both the formation of a secure attachment and therapeutic efforts to remediate attachment problems (Fonagy & Target, 2005; Sadler, Slade, & Mayes, 2006). We hypothesize that reflective skills in providers may be key elements in effecting change through the parent-professional relationship. As a first step, the present study examined early care and intervention providers' self-report of the importance of reflective practice skills in their work with families of young children. We further examined whether provider characteristics such as professional affiliation and experience related to importance ratings. Lastly, we examined, in a preliminary fashion, whether provider valuing of reflective functioning skills is associated with reported practice using hypothetical vignettes drawn from common home-visiting scenarios.

Experiencing the pediatric intensive care unit: Perspective from parents of children with severe antecedent disabilities*

To describe the experience of pediatric intensive care hospitalization from the perspective of a parents of children with severe, antecedent disability. Qualitative analysis of data obtained through semistructured interviews. Pediatric intensive care unit (PICU) in a children's hospital. Parents of eight children admitted to the PICU with severe antecedent disabilities. None. Data were collected between May and July 2006. Parents were interviewed during, or just after, PICU admission until data saturation was achieved. Seven major themes emerged from analysis: 1) know my child's baseline; 2) integrate and bridge multiple services; 3) disconnect between role of parent at home versus parent in the PICU; 4) a PICU admission does not equate with respite; 5) high stakes learning environment; 6) heterogeneity within group; and 7) lack of fit within the acute care model. The need for stellar communication and mutuality within the parent-professional relationship were common conceptual threads through all interviews. Children with severe antecedent disabilities and their parents are inextricably linked with critical care services. Study results provide data that can be used to help clinicians better understand the perspectives of these parents and also help guide interventions to improve care and support. Although communication is essential, the structure and processes of critical care including rounding format, continuity in management, and mutual participation models should be tested and tailored to better meet parental needs and expectations.

Exploring the Experiences of “Not Being Listened To” from the Perspective of Parents with Disabled Children

Several studies report that parents of children with disabilities complain about professionals ignoring the parents’ view and understanding of the child's needs. The aim of this paper is to explore the parents’ experience of not being listened to from their own perspective. Findings are based on a longitudinal study including qualitative interviews with parents of 31 children with different types of impairments in pre-school (1999) and early school years (2002). Incidents where parents reported “not being listened to” were distinguished according to different types of conflicts or disagreements: (1) problem-defining; (2) gate-keeping; and (3) jurisdiction. The underlying problem as viewed by the parents was that their knowledge was not valued. Dilemmas and obstacles towards practising user-participation in parent–professional relationships are discussed. The findings suggest a necessity of negotiating partnership, as well as a more humble approach towards parents.