The PIP service has been using GBOs as part of their package of routine outcome measures for several years. We have found that setting goals with our parents at the outset of Parent Infant Psychotherapy can:
- Support the treatment alliance- they are the family's goals, not therapists' goals, but the therapist immediately is joining them in problem solving (they are no longer alone)
- Orient the parent towards the help that we can focus on: i.e. improving the relationship with the baby; rather than for example, focusing solely on mood improvement in the parent.
- Offer something quantitative and tangible that suggests at the outset that the "problem" can be verbalised/ outlined (thus is hopefully less overwhelming) and suggests it will be able to improve with support.
A parent described a goal 'to feel less resentful of her mother in law's "intrusive" offers of help'. This led to a discussion and working through of her loss of her own mother in adolescence (which she thought she had dealt with) and reliving this bereavement having made the transition to motherhood herself.
A parent states that their goal is 'to feel less anxious and happier', (i.e. is self-directed, when the PIP model is relational). We would probe about how - in relation to baby - they might achieve or know they had achieved an improvement in their state of mind and link this to aiming to gain a better ability in reading their baby’s mood/states and how both may impact one another.
Thus, we are already working in the goal setting, in a way that promotes an increased awareness of their own and their baby’s internal states, as well as increasing curiosity. We ask questions like:
- How will you know when you feel happier?
- What might be different in you, and in Baby?
- How do you think Baby feels about this- how can you tell?
We might further suggest that they might then be able to read their baby’s responses or cues more sensitively with support of PIP and receive further feedback from their baby. We would indicate through these reflections and questions that Baby is an active and independent participant in this shared treatment and goal of mood improvement for both.
Often parents feel they reach a goal after a few months and in reviewing these we would then ask if they felt this goal was still relevant and could then set further goals or set a date for the work to conclude if a goal had been achieved.
Find out more about PIP here.
The Child Outcomes Research Consortium (CORC) in partnership with experts in the field of perinatal mental health from the Anna Freud National Centre for Children and Families (AFNCCF) have been commissioned to provide guidance on best practice and how to overcome common barriers to implementation by producing an Outcome Measurement Implementation Manual and by disseminating the manual, case studies and learning via 12 regional training workshops in collaboration with Perinatal SCNs.