Child abuse prevention by home visitors: A study of outstanding home visitors using mixed methods.

摘要

Child abuse remains a serious health problem in the U.S. Yet, there are preventative programs that can significantly improve the parenting experienced by very young children and result in lower incidence of maltreatment. Home visitation is the most prevalent and successful form of primary prevention. These programs are staffed by home visitors who empower parents and are the lynchpin of home visitation programs. What makes some home visitors excel at this work is the focus of this research.;A small, non-random, purposive sample of excellent home visitors and their administrators was used to learn about the personal characteristics of outstanding home visitors. The mixed methods design of this research included qualitative interviews, home visiting situational vignettes, and quantitative tests of personality attributes.;The results indicated that this group of outstanding home visitors possessed important similarities. First, the home visitors were effective at forming and maintaining empathic relationships. The variables that facilitate the formation of the therapeutic relationships between home visitor and client include: (a) "good enough empathy" (need not be extraordinarily empathic but at least averagely so), (b) positive regard (showing respect to the families and recognizing that the parent is the expert on their child), and (c) congruence. Secondly, the home visitors possessed self-awareness allowing for reflective practice and forming and maintaining better client relationships. Thirdly, the excellent home visitors possessed an attitude of lifelong learning. Fourthly, the home visitors strongly believed in the ability of their clients to change. This was accomplished by focusing on client strengths. Finally, in order for the home visitors to assist parents in therapeutic change, they had a belief in and understanding of systems theory and the impact that the environment can or has had on those clients. Without an ecological approach, home visitors are likely to blame the families with which they work for their unfortunate situations such as poverty.;Each of the five characteristics can be taught and improved, but entrenched beliefs are less easily manipulated. The five characteristics are ordered with the first (effective at forming relationships) the most amenable to change and the last (an ecological approach) the least.