Monday, April 9, 2012

I Am Public Health: Health Department shares stories from ...

To commemorate Public Health Week, the Tacoma-Pierce County Health Department is sharing some stories of its?work. These stories are written by staff and give a glimpse into the work of the Health Department.By Connie Arias, Family Support Worker

I have been a Family Support Worker (FSW) for 12 years at the Sumner/Bonney Lake Family Support Center. The Family Support Partnership operates 12 Family Support Centers where all FSWs work. All FSWs are employees of other agencies; I am employed by Pierce County Community Connections. Hired as a bilingual FSW, at the beginning I mainly worked with Spanish-speaking families, sharing parenting tips, advocating for them and connecting them to a variety of community resources.

As the Family Support Partnership evolved, three other FSWs and myself became trainers in the evidence based home visiting program called Promoting First Relationships, or PFR. We receive referrals from a variety of social service providers, clinics and public health nurses.

We also receive low risk Child Protective Services referrals from the Washington State Department of Social and Health Services/Children?s ?Administration. All families are offered evidence based home visiting ?programs.

When a referral comes in, I contact the family by phone or make a cold-call visit to their home. Recently I visited with a young, 20-year old couple and their three month old baby girl. This couple is living with the dad?s parents because they cannot afford their own housing. Both parents are participating in PFR, and this was their fifth session with me.

Although we make scheduled visits, many families are not ready for us when we arrive, as was the case this day. Building ?appointment keeping skills? is often part of the work we do. So I waited outside for about 10 minutes while the grandmother corralled the seven puppies she is raising, and while mom woke up. Once inside, we met at the kitchen island because there is no other space in the house where we can meet. The home is extremely cluttered and dirty, which was part of the reason for the original referral.

Once mom and dad were finally ready, we started by talking about how they are doing and feeling. This is part of the curriculum is called ?joining.? Joining is designed to develop trust between the family and their FSW. During joining, mom told me about a toothache she has and said she didn?t have a dentist to turn to for help. I referred mom to SeaMar Dental Clinic and Community Health Care.

Next we reviewed our conversation from last week and talked about how they can apply it to their relationship with their daughter. Our conversation was often diverted by the father, who was more interested in talking about his recent purchases and dirt biking adventures than his baby. This is a frequent occurrence in this family, and it?s my job to gently bring the conversation back to the topic. At one point, dad showed me a picture of his (unloaded) shotgun straddling the baby in the car seat? so we had an extensive talk about gun safety. After dad agreed to keep firearms unloaded and in grandfather?s room, we moved on.

The previous week, we had videotaped dad playing with the baby. Videotaping is a part of the curriculum that gives the family the opportunity to see how they interact with their child and lets us as FSWs encourage good parenting. Dad smiled when I commented that he is doing a nice job and how gentle he is with his young daughter. As part of the program, we also help parents understand their own childhood experiences to illustrate how family dynamics and incidents impact their own parenting.

It helps them come to a greater understanding of their child?s social and emotional needs and how to respond to them. I asked the two to share about a difficult memory from their childhood. Dad discussed a bicycle accident when he was about five years old. He remembered his mom comforting him and providing care for his injured knee; he felt safe with his mom. Through this exercise, Dad realized his need to be understood by his parents and recognized that he wants to provide for his daughter in this way.

I returned to the Family Support Center after the visit and talked with a co-worker about ways to more ?effectively work with this father and keep his attention focused on parenting. This family is proving to be quite a challenge, but my history with Promoting First Relationships tells me that after participating in the course, this mom and dad will be better parents to this baby than they could have been without this intervention. We know that this will lead to better outcomes for this little girl in school and in her future
relationships.

Family Support?Partnership?by the numbers
1,287 (# of families who?received home visits in?2011)
20 (# of TPCHD FSWs?today)
12 (# of TPCHD Family?Support Centers)

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