Sub-theme 3.1 Being with

The sub-theme ‘being with’ captures a trajectory of connecting with parents and children, in which nine participants emphasized the interpersonal context of the work and importance of being alongside and with parents and infants.

For six participants there was an awareness of parental ambivalence towards services and the low currency of professional help, setting an initial backdrop to the work.

It’s just another appointment, the currency of people going in to help is low because she’s (parent) had so much of it […] anything is like well you can come in but who are you and yeah yeah and it’s very much like this line of work whereby they just have so much intervention these parents. P1

Against the backdrop of ambivalence, a “dance of engagement” (P6) would ensue, which seven participants spoke of as an essential aspect of the work, “without it you’ve nothing” (P3). Establishing engagement required a presence and acceptance of the parent in the moment, bracketing professional agendas, and being persistent.

Accepting them (parents) in the moment at the time because you never know

what you’re gonna get when you get through that door but it’s about accepting them as they are in that moment and taking a step back and saying ok well what shall we do now. P4

If you can set up something fun and they (families) can meet you on that level and if they can’t but you have to adjust to meet them. P6

The persistency, the way the workers keep knocking on doors, keep getting those appointments established in the beginning bears fruit. P8

Connecting with the infant in the presence of the parent could be a way of joining with the family. Here, engaging in play could establish trust and seemed to hold the potential of relaxing vigilance and guardedness of the families.

With mothers particularly under child protection they view mental health as a potential barrier to the parenthood, something that’s being scrutinized […] so having that external little infant that tells no lies helped opened up conversations. P2

She (infant) wasn’t sure about me, she was trying to suss me out […] there was one time we did a jigsaw […] her mum was watching and I enjoyed the fact her mum could see I was attending to her in a playful way cos I thought this is about building trust. P1

It’s the same for the parent as the child, bringing their barriers down, taking down the concerns, taking down the anxieties allowing them to be free and playful. P6

For six participants, being pragmatic and responsive to parents in-the-moment-needs, conveyed a message of really caring, again highlighting a bracketing of professional agendas to centre the parent and relate person-to-person.

Just a real act of kindness […] I’m gonna take your children out for a couple of hours I’ll be back on time, you can have a bath and make yourself feel more comfortable […] this mother just needs some comfort, she just needs a space just to get herself up and dressed and little things that actually make the client feel this person really cares. P3

Simple things like making someone a cup of tea and saying actually I’m gonna make you a cup of- you know when actually I’m just being a person is really important. P9

Participants used the interpersonal context for acknowledging and witnessing moments of parent-infant connection and parental insights, using their knowledge of the parent across time to share in moments of change and love.

She enjoyed looking at the positive things that were happening between her and her baby and having someone acknowledge those with her […] so she would say something and I would say that’s quite insightful and she would always have this huge grin. P7

When she had her baby I saw her in the hospital, she goes I fell in love instantly and thinking about how ambivalent she was during the pregnancy […] she had never been sure if she’d really experienced love or what it would feel like and if she’d be able to recognize it so when she used that word yeah you had to swallow and breath and talk and explore it. P2

There was a sense these moments were also important for participants to hold onto, linking with the idea of proving expectations wrong and overcoming the child protection context:

This mum’s always enjoyed me witnessing the lovely moments, there was another beautiful moment they were just totally attuned in their own little world and I took this amazing photograph that captures that and I hold onto that because it was an important moment. P10

From a connected position with parents, noticing moments of fear or misattunement between parents and infants could also be held and shared.

He’s (infant) seeking her out then there’s this one moment and you have to pause to even notice it but she (parent) just lifts her head away to one side and I felt it was really significant and she said well there’s times I feel like whenever they’re (children) all there and all needing me I just feel like this big black hole opens up inside me and I feel like I’m going to fall in and that was the real centre point, that symbolic statement. P1

For six participants, modelling an openness in communication and keeping consistent boundaries was an important process in the work to foster containment. This was hypothesised to have been missing from the parents own experiences of being parented and formed a basis for a re-working and re-experiencing of relational templates.

It’s really important to be really honest and not bottle it up because I guess the whole point of successful therapy is being able to model. P5

It’s that consistency, that parenting bit that even if they (parents) behave really badly, they’re really horrible, all the rest of it, we’re still there the next day and we’re still there the day after that. P9

The level of honesty that you can offer them some level of challenge, it’s safe to challenge them and there’s reason behind it, almost working as that internal working model of a parent, it’s safe to be understood […] with children and it’s the same with these parents who also need that too. P6

For three participants, this developmental process between clinician and parent could then parallel an equivalent process between parent and infant.

Being part of the development of a trusting, reciprocal, containing relationship so that they (parents) in turn can parent their babies. P10