Inside the black box of a successful parent-infant intervention in a South African informal settlement : mothers' and counsellors’ accounts of the process

Landman, Mireille (Stellenbosch : University of Stellenbosch, 2009-12)

Thesis (DPhil (Psychology))—University of Stellenbosch, 2009.

Thesis

ENGLISH ABSTRACT: Extensive research over the past 30 years has shown that reliable, sensitive, responsive and empathic care of the infant by the mother or mother-substitute in the early months facilitates the development of secure attachments in infants, and ultimately their healthy development towards competent adulthood and future relationships with others. This study analyses interviews with 17 mothers selected from an intervention proven successful by means of a randomized controlled trial. The intervention took place in Khayelitsha, a peri-urban settlement close to Cape Town, South Africa, and was delivered by previously untrained lay counsellors to at risk mothers and infants. Supervision and training of the counsellors was provided by the author. Mothers were purposively selected on the basis of being experienced by counsellors as easy, difficult to reach, young/immature mothers and HIV-positive mothers, and were interviewed by a clinically trained interviewer not involved in the project individually and in groups. Counsellors’ process notes, exploring the impact, relevance and meaning that the intervention had for the recipient mothers, as well as the supervisor’s notes were also used as data. The findings identify what changes mothers reported, their experiences of the intervention, cultural issues in the intervention, and mothers’ suggestions for modifications to the programme. The results are discussed in light of theories of change emerging from the literature on psychotherapy change research and research on community-based interventions. The study shows that though results of randomized controlled trials are necessary for policy planning, in-depth interrogation of the design and process issues at stake in complex community-based studies yield complementary data which are also important to consider. Finally, the study considers the implications of this understanding of process for the future dissemination of the training and application of this programme, as well as policy, research and funding challenges.

AFRIKAANSE OPSOMMING: Wydstrekkende, uitgebreide navorsing van die afgelope 30 jaar toon dat betroubare, sensitiewe, aandagtige en empatiese sorg vir die peuter deur die moeder of moeder-plaasvervanger, die vorming van veilige bindings, sowel as die uiteindelike gesonde ontwikkeling van bevoegde volwassenheid en toekomstige verhoudings met andere fasiliteer. Hierdie studie analiseer onderhoude met 17 moeders, gekies uit 'n intervensie wat bewys is deur middel van 'n ewekansige kontrole toetsing. Die intervensie het plaasgevind in Khayelitsha, 'n peri-stedelike nedersetting naby Kaapstad, Suid-Afrika, en is uitgevoer deur voorheen onopgeleide vrywilliger beraders wat moeders en peuters wat blootgestel is aan risiko bedien. Supervisie en opleiding van die beraders is deur die outeur voorsien. Moeders is vooraf uitgekies deur die beraders, volgens die criteria: maklik en moeilik bereikbaar, jong/onvolwasse moeders, en HIV positiewe status. 'n Klinies opgeleide onderhoudvoerder wat onbetrokke is by die res van die projek het met die moeders individueel en in groepskonteks onderhoude gevoer. Beraders se prosesnotas wat die impak, relevansie en betekenis van wat die invervensie vir die moeders ingehou het, sowel as die supervisor se notas is ook gebruik as data. Die bevindings is bespreek in die lig van veranderingsteorieë wat uit die literatuur oor psigoterapie veranderingsnavorsing, sowel as navorsing oor gemeenskapsgebaseerde intervensies vorendag gekom het. Die studie toon dat hoewel bevindings van ewekansige kontrole toetsing nodig is vir beleidsbeplanning, in-diepte ondersoek van die proses en ontwerp kwessies ter sake in komplekse gemeenskapsgebaseerde studies komplimentêre data lewer wat ook belangrik is om in ag te neem. Ten laaste oorweeg die studie die implikasies van hierdie ondersoek van proses vir toekomstige disseminasie van die opleiding en toepassing van hierdie program, sowel as beleid, navorsing en befondsings uitdagings.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/1165
This item appears in the following collections: