Improving Infant Mental Health Home Visiting Training to Strengthen Cultural Responsiveness and Increase Equity

被引:0
作者
Torres, Chioma [1 ]
Walsh, Tova [2 ]
Tamkin, Vivian L. [3 ]
Quince, Helenia [2 ]
Riggs, Jessica [4 ]
Muzik, Maria [4 ]
Rosenblum, Katherine L. [4 ]
机构
[1] Michigan State Univ, Dept Pediat, Dev & Behav Pediat, Coll Human Med, 4660 S Hagadorn Rd Suite 405, E Lansing, MI 48823 USA
[2] Univ Wisconsin Madison, Sandra Rosenbaum Sch Social Work, Madison, WI USA
[3] Santa Clara Univ, Sch Educ & Counseling Psychol, Santa Clara, CA USA
[4] Michigan Med, Dept Psychiat, Ann Arbor, MI USA
关键词
Infant mental health; Home visiting; Culturally responsive practice; Equity; SERVICES;
D O I
10.1007/s10995-024-04004-3
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Infant Mental Health Home Visiting (IMH-HV) is a needs-driven, relationship-based home visiting intervention with demonstrated positive outcomes for parents and young children. Prior research found that higher therapeutic alliance (TA) was associated with improved program retention and provider race affected TA and retention for clients. The objective of this quality improvement project was to inform improvements to IMH-HV provider trainings to better prepare providers to effectively engage and support diverse families. Focus groups or individual interviews were completed with 18 providers and 7 clients (parents/caregivers). Participants self-selected into one of three groups offered separately to providers and clients: White identifying, Black identifying and Non-Specified identity groups. A racially diverse, interdisciplinary team facilitated focus groups and interviews and conducted thematic analysis of the data. Analysis identified barriers and opportunities for effective engagement of clients: when providers and clients are of different racial/ethnic backgrounds, provider attempts to forge a connection may make families feel 'othered'; providers may not see their racial identity as salient, yet it influences their practice and the establishment of rapport with families; patience, tolerating discomfort, and allowing a family to determine whether the provider can be trusted are key. Effective IMH-HV practice with clients of diverse backgrounds requires a high level of self-understanding on the part of providers. Enhancing training to promote deeper consideration of both the perspectives of diverse clients and the salience of one's own identity has potential to reduce barriers to TA, improve program retention, and address health disparities. Therapeutic alliance, or the working relationship between parents and infant mental health home visitors, is associated with program retention. Differences between white and Black/African American home visitors' ratings of therapeutic alliance with their clients suggest that white home visitors may feel less equipped to work with families from diverse backgrounds. This report adds to understanding of barriers to therapeutic alliance within the context of IMH-HV in Michigan. Findings can be applied to improve IMH-HV training and better prepare home visitors to engage and support diverse families.
引用
收藏
页码:1841 / 1851
页数:11
相关论文
共 19 条
  • [1] Ackerman SJ, 2003, CLIN PSYCHOL REV, V23, P1, DOI 10.1016/s0272-7358(02)00146-0
  • [2] Therapeutic Alliance, Cultural Competence and Minority Status in Premature Termination of Psychotherapy
    Anderson, Kristin N.
    Bautista, Chandra L.
    Hope, Debra A.
    [J]. AMERICAN JOURNAL OF ORTHOPSYCHIATRY, 2019, 89 (01) : 104 - 114
  • [3] Braun V., 2019, HDB RES METHODS HLTH, P843, DOI [DOI 10.1007/978-981-10-5251-4103, 10.1007/978-981-10-5251-4103]
  • [4] Racial/Ethnic Matching of Clients and Therapists in Mental Health Services: A Meta-Analytic Review of Preferences, Perceptions, and Outcomes
    Cabral, Raquel R.
    Smith, Timothy B.
    [J]. JOURNAL OF COUNSELING PSYCHOLOGY, 2011, 58 (04) : 537 - 554
  • [5] Invisibility syndrome and racial identity development in psychotherapy and counseling African American men
    Franklin, AJ
    [J]. COUNSELING PSYCHOLOGIST, 1999, 27 (06) : 761 - 793
  • [6] Rethinking Bias to Achieve Maternal Health Equity Changing Organizations, Not Just Individuals
    Green, Tiffany L.
    Zapata, Jasmine Y.
    Brown, Heidi W.
    Hagiwara, Nao
    [J]. OBSTETRICS AND GYNECOLOGY, 2021, 137 (05) : 935 - 940
  • [7] Beyond "patient-provider race matching." Black midwives clarify a vision for race-concordant care to achieve equity in Black perinatal health: A commentary on "Do Black birthing persons prefer a Black health care provider during birth? Race concordance in birth"
    Jeffers, Noelene K.
    Canty, Lucinda
    Drew, Michelle
    Grayson, Nikia
    Amani, Jamarah
    Marcelle, Ebony
    Amore, Alexis Dunn
    [J]. BIRTH-ISSUES IN PERINATAL CARE, 2023, 50 (02): : 267 - 272
  • [8] John St.M.S., 2012, Zero to Three Journal, V33, P13
  • [9] Developing a Model of Broaching and Bridging in Cross-Cultural Psychotherapy: Toward Fostering Epistemic and Social Justice
    Lee, Eunjung
    Greenblatt, Andrea
    Hu, Ran
    Johnstone, Marjorie
    Kourgiantakis, Toula
    [J]. AMERICAN JOURNAL OF ORTHOPSYCHIATRY, 2022, 92 (03) : 322 - 333
  • [10] Participation patterns in home-based family support programs: Ethnic variations
    McCurdy, K
    Gannon, RA
    Daro, D
    [J]. FAMILY RELATIONS, 2003, 52 (01) : 3 - 11