Six key practice positions for engaging families
Narrator [00:00:02] Welcome to the Emerging Minds podcast.
Sophie Guy [00:00:07] You’re with Sophie Guy, and today, I’m speaking with Dan Moss about a set of practice positions that have been developed by the Emerging Minds National Workforce Centre for Child Mental Health. Dan is the Workforce Development Manager at Emerging Minds and has previously worked as Assistant Director of Performance Reporting and Evaluation at the Department for Child Protection, as well as working for fifteen years as a practitioner, supervisor and senior manager across a range of services at Uniting Communities. As a practitioner, Dan has a strong interest in narrative and strengths based engagement strategies for working with children, parents and families.
[00:00:44] Well, thank you very much, Dan, for coming and agreeing to have a conversation with me today. Really appreciate it.
Dan Moss [00:00:49] It’s a pleasure. Thank you for having me.
Sophie Guy [00:00:51] Could you start by just telling us a little bit about yourself and how you came to work at Emerging Minds?
Dan Moss [00:00:57] Yeah. So I had a long history of working both as a practitioner but also a manager and in senior management roles in NGO and child protection services. And the practice work that I’ve done has always been with the most disadvantaged children and their families. And the challenge for me in practice, I think for a long time was to work with people who have been affected by intergenerational disadvantage, violence and trauma, as well as poverty, who might come in and meet with me or meet with my team members with a view of themselves, which is not always particularly hopeful. Which often because of external or sociopolitical experiences has been negative or hopeless or feeling a lack of agency and being able to make changes for children or families. And so my challenge really in every role that I’ve ever had has been how to make plans with children and their families to kind of really create a sense of hopefulness and an alternative story for children and their families.
[00:02:11] And so, just over twelve months ago, the Workforce Development Manager role came up at Emerging Minds and really instantly resonated with me because of the strong values that the project has around children’s mental health. And more broadly than that, children’s and families, social and emotional wellbeing. I was really impressed looking at some of the products that have been developed in the organisations past around, how they were able to see mental health as more than just a individual deficit example and to see the child’s ecology and all of the things that affect, particularly disadvantaged children and their families. I really like the way that they began to build products which helped practitioners to keep the child visible in really practical and easy to follow ways, and also that they didn’t stigmatise or shame the parent unnecessarily. That understood that if we were going to make changes to children’s long term mental health and social and emotional wellbeing, we really had to make changes to the family environment and really help and support parents and extended family.
Sophie Guy [00:03:27] Great. And we’ve met today to discuss the National Workforce Centre for Child Mental Health practice positions that have been developed. Can you tell me why it seemed important or necessary to develop these practice positions?
Dan Moss [00:03:44] So when I first came to Emerging Minds, a lot of work had been done both at Emerging Minds and previously through the organisation’s predecessor, which was Children of Parents with a Mental Illness, collaboratively with both researchers, practitioners and people with lived experience, around the particular practices that helped keep the child front and centre in any, either adult focussed or child focussed service. Now what I understand, and what I’ve since experienced came back from all three segments, including research, practice and people with lived experience was the same, basic principles just supported in evidence are so important to practice. So curiosity, if we take that as an example, it’s such an important thing for anyone that works, walks into a professional service. You look at a parent who is disadvantaged. Often facing adversity, is not always as confident as they would like to be in supporting their child in the right way. The ability of a practitioner to be able to extend a sense of curiosity and goodwill to them, in those first moments of practice is something that we regularly hear in our service. So really, even though the practice positions by themselves are not rocket science, in a sense. They are the building blocks that inform all of the work that we do.
[00:05:20] So we do a lot of work with Artists Made Productions, who is, we’ve developed a partnership with, who develop much of the e-learning and creative work that we do. And working with them we wanted to devise a way which provided a framework for all of the products that we produced within the National Workforce Centre for Children’s Mental Health. And so that, not only we could have this internal organising mechanism, but also that we could stand for something. That we could be very upfront with all sorts of practitioners, around what we stand for as an organisation. Not just because we’ve plucked these positions out of the sky, but because they’re what people tell us. They’re what practitioners tell us that they’re challenged by every day to remember these six positions. They want people who walk into services tell us that they most want professionals to be able to remember. And they’re also what research is telling us works to engage families.
Sophie Guy [00:06:18] Rather than go into a description of all the practice principles, I wonder if you could just list them and perhaps, reflecting on your own practice experience, talk a bit about one of them? Perhaps? One or two that, from your perspective are the most important or the most challenging?
Dan Moss [00:06:38] Yeah, the practice positions child, child aware and parents sensitive practice they’re about holding contextual understanding of the child and family’s life. They’re about respect and they’re also about providing a strength and hopeful practice with children and families. And perhaps the over arching position within all of those is child aware and parents sensitive practice. Really, that is the primary concern that that National Workforce Centre for Child Mental Health is really all about. It’s about making sure that the child is visible. For example, if an adult comes into an adult and, an alcohol and other drugs service around that sense of previous adversity with addiction, it’s really our job to support that practitioner in every instance, to inquire through a curious framework about does that adult have any children.
[00:07:40] Well, what’s your relationship like with their child? Does the child still live with them? If so, what’s the relationship like? What are they most like about their their relationship with their child? What sort of influence does their current adversity have on that relationship? And most importantly, what can be done to actually improve their child’s outcomes? And specificly his or her social emotional well-being and ultimately their mental health. So for us, that’s really the primary target of our work that we’re wanting to attend to. And having that is our first practice position helps keep that priority front in mind. Not only in all of the content that we develop, but in all of the consultations that we have as a Workforce Centre with the many different professionals across many different sectors who we work with.
Sophie Guy [00:08:36] And would you say, is there one that stands out to you more personally in your professional experience? Or is that the one the parents sensitive and child aware?
Dan Moss [00:08:48] Yeah, I mean, I think they all get used really interchangeably. But if I had to think of one that stands out for me is a really significant challenge in parent and child work. It’s having contextual understandings of what’s happening in the child’s life and the family’s life. And while that is so, such a challenge, I think it’s because as the many different sectors who work both in a statutory and health responsiveness to parents and their children, it’s often our job to make really quick assessments. Assessments around whether a child safe, assessments around whether a parent is fit or unfit or we’re a very assessment based sector or sectors.
[00:09:30] And I think a practitioner or a professionals ability to be able to take the time to build a sense of context around what’s going on for a child and what’s going on for a parent, can be so significant in the long term outcomes for that family. Many of our child and family partners tell us of one example where they’ve walked in to see a psychiatrist or a GP or a counsellor or a social worker. And that contextual understanding has been uncovered, which has been able to uncover an ethic or a hope or a strength which has really kind of been the beginning of a plan, or a different, or an alternative sense of the family’s self and what they can achieve for the social and emotional wellbeing of their child. So I think that’s one that particularly resonates for me and one that I think we’ve got a continued amount of work to do when we’re kind of working with practitioners around the many different and immediate challenges they face in their particular contexts.
Sophie Guy [00:10:37] And what does it look like to explore the context of a child and their family?
Dan Moss [00:10:42] So there’s many different contexts. For example, at the moment, one of the big pieces of work that the National Workforce Centre is doing is looking at, it’s cultural contexts. So looking at the different beliefs or ethics that might affect families because of the history and the traditions of their cultures and what it might mean where practitioners make the space to be able to let that exist within a room, within all of the bussyness and the hustle and bustle of everything else that happens. What would it make if we could support practitioners to open space for those conversations, to have parents talk about what the history of that culture might mean and how that might be helpful for them in making changes in their relationships or their routines or their communication that they have with their children? How might that be used to kind of start to devise a plan for better outcomes for children? So I think at the moment that’s certainly a strong focus of our project, particularly in our work with Aboriginal communities, families and children.
[00:11:52] We recognise that as far as children’s mental health, there’s a lot of work to be done in being able to join with Aboriginal communities and professionals and experts, in being able to develop support mechanisms for mainstream practitioners within this space.
Sophie Guy [00:12:12] Okay. And I’m thinking from the perspective of someone working in a service, maybe a manager or a practitioner and probably what the reality is for them they feel very under pressure under the pump, perhaps, you know, funding pressures are greater at the moment, I don’t know. But, you know, everyone feels busy. Everyone’s got their client load, and there’s a lot of sort of different programs or, you know, new ways of working that come through the door. Why would a practitioner or service want to know that our principals, can you tell me bit more about why they’re relevant, why they’re important?
Dan Moss [00:12:49] Well, I think our experience is that organisations and services and practitioners want to get better at the work that they do. They want to feel that when they work with disadvantaged children and their families, that there’s a better chance that there are going to be good outcomes for that child. And so there’s a real, I think, first out there for the micro skills of ensuring that that happens or making the best chance for that family, that good outcomes will happen.
[00:13:19] And the thing about the practice positions is that we are not asking practitioners to substitute what they’re currently doing with these positions. So, for example, we use the example of an AOD practitioner before who might use motivational interviewing or CBT. We’re not asking them to discard those practice modalities. What we’re asking them to do is use the six practice positions in a way which helps to support consistent practice, that keeps the child visible within their service delivery. So we kind of feel like that’s not an over burdensome thing to do. It might mean thinking about an assessment process and changing a couple of the questions. It might be having some processes in reflective supervision which ensures that practitioners are regularly attending to the relationship between children and their parents, and maybe looking at the processes that practitioners use around motivational interviewing to ensure that there’s always an opportunity for parents to talk about how their relationship with their child is a primary motivating factor in them wanting to make some changes in their lives.
Narrator [00:14:41] You’re listening to an Emerging Minds podcast.
Sophie Guy [00:14:47] In the day to day business of sitting down with family, parents, children, what do you think gets in the way for practitioners of a plan? Because these are going to be familiar I imagine to the majority of practitioners and they probably will recognise that there are important ways of practicing. But obviously there’s things that get in the way of them being able to do that. What are some of these challenges, do you think?
Dan Moss [00:15:12] Yeah, that’s a really good question. And we’ve, in the National Workforce Centre, have done some needs analysis with a whole lot of different sectors around what does get in the way. And we get really common responses around busyness, around the sense that children and families now we’ve come to services with many more coexisting needs than they ever had before.
[00:15:37] We also get reports that there’s not always the time for reflective supervision or training and development, and just the time limited and busy aspect of professionals lives. So these are the things that that can really get in the way of child aware and parents sensitive practice. The other thing that professionals across the board have told us really honestly is that there can be a confidence gap where children’s work is not a specialty for a particular practitioner. So there’s a sense that they might not want to ask a particular question. They might not want to open a particular can of worms for the fear that they’re not going to respond to that as effectively as they might like. So really, it’s incumbent on our Centre to be able to work with those practitioners to uncover those confidence gaps. And practitioners have certainly asked us if we can be supporting them through, through particular questions, examples of questions and examples of micro skills, which will allow for conversations with parents in particular, which are non stigmatising and non-judgemental. But at the same time, they do attend to the social emotional wellbeing of their children.
Sophie Guy [00:16:51] So what does help practitioners feel more confident to have these conversations and apply these principles, do you think?
Dan Moss [00:17:00] Yeah. So from the information that we get from many different practitioners, it’s often about being able to take a step back from the expert role that practitioners are most often thrust into. And child and family partners tell us this. It’s not the immense skill or immense ability to diagnose that they talk to us about. It’s the ability to provide an opportunity for human connection. To step away from that expertness for a second, for example, and have a really curious conversation around the difficulties that someone might be having with children or the hopes and the strengths that are relevant in a particular family. How might every member of the family know about this?
[00:17:50] So often practitioners, when they’re thinking really heavily about these six practice positions, they would tell us that they’re able to develop a framework where they are able to, to step out of that kind of expert or more centred understanding of their work, towards an understanding where this family are the best people to talk about what works for them. They’re the best people to talk about what are the challenges for them, what gets in the way of children’s positive outcomes. And it’s through these really human connections and generative conversations that these stories come to the fore. That they expertness of of the family comes to the fore in ways which make a huge difference. Not only to the children and the families that go to services, but also to the professionals themselves. These conversations are motivating, deeply motivating and inspirational and very hopeful for practitioners.
Sophie Guy [00:18:52] I also wanted to ask you about how the practice positions are currently being used in Emerging Minds work at the moment? Can you talk a little bit about that?
Dan Moss [00:19:01] Yes, I touched on a little bit before, we wanted to really build a scaffold for practitioners, both at the very entry point of their careers or their practice where they might be really interested in some more fundamental content or products, right up to practitioners who have been working for a long time or who are very confident in their practice. But just want to extend upon their their practice want to extend, for example, on how to have curious conversations through a particularly evidence based framework.
[00:19:35] And so within the Workforce Development Team, these practice positions have really been a strong organising principle for us to scaffold content. Whether that be e-learning, whether that be toolkits, whether that be practice papers, through fundamental kind of basic understandings of children’s mental health. To much more developed conversations, for example, in a family violence setting, where you might be working with with a father who’s perpetrated violence and wanting to have curious conversations around his understandings of what that’s meant for his children.
[00:20:11] So I think it’s allowed us to work with a broad range of professionals across a broad range of skills, confidences and competencies. For the National to Local team. I think these practice positions are what they live and breathe, not only for what they’re looking for from, from practitioners, but what they expect of themselves. So these ideas around curiosity and collaboration and contextual understandings, for example, these are what National Local team and our Consultants take with them in any consultancy, with any professional, because they wanting to come from a sense of curiosity and not knowing. It’s not like that we have all the answers and we go into services and we tell them this information and then they just change and things are better. It’s a much more intricate and co-design type process than that. And I think that these practice positions are important and supportive of our Consultants in working in the way that supports their own worldviews.
Sophie Guy [00:21:19] For practitioners or people working in services who are interested to read these practice positions and familiarise themselves with them or perhaps access some of our resources that have used them. Why can people go? What what do we have to offer?
Dan Moss [00:21:32] Yeah. So our website Emerging Minds has a broad range of products at the moment, from e-learning products, to as we said and toolkits, practice positions, podcasts such as this and webinars. And so, we’ve reached out to a large number of professionals across the nation because of that and are regularly looking for their feedback. So really we’re looking for any professional who’s interested either in the practice positions or any other aspect of our work to give us a call or send us an email and engage in a conversation around children’s mental health.
[00:22:10] One of the things that we’re really keen to do is have this be an open dialogue and even the practice positions being open dialogue. It may be that they become a dynamic resource over time. One of the things that we’re doing currently with all of our pieces of work is running focus groups and intensive evaluations after they’ve finished. So for us, it’s not just producing, for example, an e-learning course and putting it out there and see what happens. It’s ensuring that that course is being useful and supportive in child aware and parent sensitive practice. For lots of our products there’s there’s really good examples of the way that is being used. But there are also ways that practitioners tell us that that we could improve. That things could be a little bit more accessible for them, and we’re certainly trying to be as reactive to that as as possible.
[00:23:05] The other thing that we’re really trying to do, as we mentioned, is really extend upon that really rich tradition of COPMI in having child and family partners, people with lived experience of adversity and service provision as being front and centre in the work that we do. And this certainly means that there is a group, a really strong group of those who we work with really intensively, to ensure that they’re involved in the planning, the design and the review of our processes and our products. But we’re also, always looking to extend that network and we continue to extend that network as we go into new sectors and think about new issues. But we’re really keen always to have people with with lived experience of adversity, the children, families, parents to get in contact with us and for us to continue this conversation. Because, as I mentioned, we don’t know everything we need to know about children’s mental health yet. We’re a long way off that. We know a lot more than we used to and we’re applying that knowledge in really innovative and creative ways, we think, but there’s lots of work to do in that space. And the only way we can get better is is to ask both the people that are receiving those services and also the people that provide those services for their advice.
Sophie Guy [00:24:30] And what resources are available on our website right now, that have these practice positions that practitioners could access? Is there anything, any go to resources?
Dan Moss [00:24:41] Yeah. So the last two e-learning resources that we’ve produced feature the practice positions really strongly. So the first one of those is Engaging Parents an Introduction. And that really looks at any practitioner who’s working in an adult focussed service, really supports them to use the six practice positions to have introductory conversations with an adult in an adult focussed service, around firstly, are they a parent? And then if they are a parent, having some really useful and proactive conversations around how their their story of adversity might be affecting their relationship with their parent or with their child or might be affecting what they hope or what they want for their child. And so, that’s about a two hour course, which will be followed up early this year by a subsequent engaging parents course called Engaging Parents in Context.
[00:25:43] And the second course, which is heavily featured the practice positions, has been Supporting Children’s Resilience in General Practice. And that was, a course, which is a culmination of many years of work really with GPs, including focus groups, working with with particular GPs around what was currently the reality in their practice and how practice positions might help them take a very strong preventative stance with every parent who came into their their rooms. And we used the practice positions to come up with a series of resources for GPs which they could use in a practical sense to start to discuss with parents who come into consults with their own physical or mental adversity and really start to focus on some of the things that they might be able to do. Where children were being affected by that adversity.
[00:26:44] So that is another course that has also been strongly influenced by the voices of service providers who have been to see GPs and both those those people with lived experiences who’ve had really positive child focussed experiences with GPs. But also those those people who have some kind of critical feedback around their experience, who have felt that maybe there are opportunities to be asked more questions around the social emotional wellbeing of their child within a GP consult. So we’re really we’re really proud of where that that course has got to. And we’re certainly hopeful that starts to get used in a number of GP practices. And we’ll be continuing to monitor the effectiveness of the resources that we’ve developed.
Sophie Guy [00:27:37] OK great, we’ll leave it there for today. Thank you very much Dan, for coming in and having conversation with me.
Dan Moss [00:27:41] Thanks Sophie.
Narrator [00:27:43] Visit our website at www.emergingminds.com.au to access a range of resources to assist your practice. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The National Workforce Centre for Child Mental Health is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.