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| Dr. Rachel Haine-Schlagel adapted a toolkit for use in child welfare home visits. |
While pursuing her Ph.D. in clinical psychology, Dr. Rachel Haine-Schlagel worked with children and families as a full-time clinician. She remembers being particularly struck by parents who didn’t seem engaged in treatment sessions. Some would text on their phones or ask to wait in the lobby. And she remembers how powerless that made her feel.
“It felt like heating the house with the windows open,” said Haine-Schlagel, now an associate professor in the Department of Child and Family Development at San Diego State University. “I was there and I was working with them, but I didn't think anything was going to be any different after we left that room. And that's really what it's all about. It's not what happens in that one hour as a therapist that you're with that family. It's what happens in those other 23 hours, times seven, until you see them again."
A new study highlights Haine-Schlagel’s strides in what has since become her area of research focus — finding ways to help providers encourage parents and other primary caregivers to be more active participants in services provided for their children. In findings published in the Journal of Child and Family Studies, Haine-Schlagel showed encouraging results for a toolkit she created to empower parents receiving home visitation because of child neglect.
These parents often do not perceive themselves positively as a parent if they've been investigated by child welfare and they're at risk of losing their child. But they have strengths that need to be capitalized on in a program like this. We want them to have an empowering experience. —Dr. Rachel Haine-Schlagel
New toolkit
Working in collaboration with Dr. Danielle Fettes at UC San Diego and other colleagues at UCSD and the University of Southern California, Haine-Schlagel took the Parent And Caregiver Active Participation Toolkit (PACT) — initially developed for children with disruptive behavior problems — and adapted it for use as part of SafeCare, an evidence-based parenting program for families with young children that improves positive parenting and reduces and prevents child abuse and neglect. PACT was provided to parents during SafeCare home visits through partnership with the County of San Diego Child Welfare Services and South Bay Community Services.Generally, SafeCare home visits go like this: Once a week a home visitor comes into a family’s home to share important information on topics such as household safety, child health and parent-child interaction. Home visitors then assign parents homework — tasks such as childproofing a room — to be done before the next visit.
The idea behind PACT is to encourage parents to see themselves as active participants in this process. The toolkit includes strategies for home visitors to convey a sense of partnership, as well as organizational materials and worksheets for parents to help them complete their homework and provide feedback to their home visitor.
"It's positive reinforcement,” Haine-Schlagel said. “These parents often do not perceive themselves positively as a parent if they've been investigated by child welfare and they're at risk of losing their child. But they have strengths that need to be capitalized on in a program like this. We want them to have an empowering experience."
Promising results
Compared to a control group that did not receive PACT as part of their home visits, parents receiving the toolkit reported asking more questions, greater involvement in planning to complete homework and greater involvement generally during the sessions. PACT also made home visitors more likely to assign homework to their parents — an indication it helped visitors stick to their plan while on their visits.“Someone coming to your house once a week for an hour is not going to fix things,” Haine-Schlagel said. “Parents have so much expertise on their family, and providers need to be able to partner with parents to capitalize on their knowledge and strengths to help families make meaningful change.”