Faith, religion, spirituality and care

Regrettably, I am still a reader of the Daily Mail online. Whilst often infuriating, it does occasionally have its good points. Recently, an article on a new book about ‘mind over body’ – ‘The cancer patient cured by a broken radiotherapy machine and the paralysed man who walked again after visiting Lourdes: New book shows incredible influence of the mind over the body’ reminded me of Louise Hay’s excellent ‘You Can Heal Your Life.’ Hay considers the psychological/emotional/spiritual meanings and connections of physical illness, and offers those dimensions as spaces to support healing. All of this, in turn, got me thinking about faith, religion and spirituality as sites of care practices, sources and resources of care, and, then, their relationship(s) with care ethics. I realised that we have not as yet tapped this seam in our critique of care, and so wanted to raise this as a topic, perhaps for further discussion/contributions. Here is a brief bibliography to help get us started:

Care to comment/ discuss?

 

A Darker Side to Care..?

It’s been great to read the diverse blogs on this site and the definite slant given by commentaries on issues of identity and sexuality to the challenge of revaluing care. Some time ago I attended a meeting with some of the other members of this network where we raised the question of what is ‘queer care’. And more specifically, how could we go about finding out how it was practised and what it meant to people? We were interested in the lived realities of care for LGBT people but also whether queer theory could offer a framework for making sense of this experience.
Of the still very limited research on care in the context of LGBT ageing there is every indication that helping relationships are organised rather differently to traditional binary notions of the care-giver and care-receiver. For instance, Ann Cronin and Andy King’s work suggests interdependence over dependence in lesbian and gay relationships.  Research with the trans community by Sally Hines also points to support clusters and collective ways of helping people rather than dyadic carer/caree encounters. While Margrit Shildrick and Janet Price’s joint work on intercorporeality and their notion of ‘two bodies becoming together…’ sheds a very different light on how we think about the body itself and its potential in helping situations. However, the closeness and intimacy signalled by these accounts stand in contrast to findings regarding care for older LGBT people of the more formal/paid variety.
Here, care is an uneasy term, and comes with baggage. This is why it has been all but bracketed off in critical disability studies, with the intention that this may lead to more novel ways of thinking about the helping relationships that evolve between people. Perhaps then a queer approach could also usefully begin by treating care with caution –  after all there’s no saying that ‘revaluing care’ might not lead us to decide it is a less useful term for future understandings of helping relationships rather than necessarily investing it with new worth. Many LGBT people’s experiences invite such a possibility because so much of what is badged as care can be experienced as very negative and damaging. This can range from the wholesale neglect of the individual supposed to be ‘in care’ to a diverse range of sometimes more subtle indicators of disapproval, disgust or rejection communicated verbally, behaviourally, emotionally, viscerally etc. and all of which are enfolded within care practices. To date, these experiences are not well documented, partly because LGBT people in the ‘Fourth Age’ are largely invisible and ignored by mainstream gerontology, as Ann Cronin has pointed out, and often are too concerned for their safety to identify themselves in the context of relying upon care services. Do the assumptions that underpin how we currently think and talk about care serve to perpetuate the cultural silence about this darker side?
Taken collectively, research to date tells us that many LGBT people are afraid of a time when they might require care. Findings in the UK and US have uncovered significant numbers who would rather take their life than be admitted to a care home and many more who report a fear of care that involves body work and the prospect of being exposed to and handled by a care worker (although much of this research has been conducted with fit and independent people being asked to anticipate the need for care rather than describe the experience of it). Ironically, older LGBT people are more likely to require formal care by virtue of being less likely to have children and more likely to live alone, but evidence suggests many delay or refuse altogether the uptake of services due to anticipation of negative treatment and its impact upon their lives. At the very least then, formal care has a serious reputation problem in certain quarters. But research with older LGBT people also suggests it has a dark side – one that is perhaps most visible from certain (queer) standpoints. In our efforts to debate and revalue care maybe we should begin with the perspectives of those who have a close-up on the under-side of care and its darker recesses. And perhaps the place to start in ‘queering’ care is to dispense with the term altogether in an effort to find alternative ways of capturing helping relationships and reconfiguring the terrain of help and support in later life in ways that might feel more acceptable to minoritised groups…?

‘Gender Identity and Health Care Experiences in Australia’ by Dr Damien Riggs

In 2012 and 2013 Dr Clemence Due and I conducted two surveys, the first focusing on the health care experiences of Australian people who were female assigned at birth (FAAB) but who now identify with a different gender identity, and the second focusing on the healthcare experiences of Australian transgender women. Our analyses so far have adopted a comparative approach, primarily because most previous studies of transgender, transsexual or genderqueer people’s experiences of healthcare have not disaggregated findings by assigned sex. We thought that a comparative approach might thus be useful given that research suggests that transphobia is highly correlated with both homophobia and sexism amongst heterosexual, cisgender people (see Riggs, Webber & Fell 2009). These three forms of discrimination are related by the fact that the first two are about attitudes towards gender non-conformity, and the third measures how much an individual subscribes to social norms about (nominally cisgender) gender role conformity. Previous research suggests that transphobia (and cisgenderism more broadly) is gendered, not only in the sense that cisgender men are more likely to be transphobic than are cisgender women, but that people FAAB will experience transphobia or cisgenderism differently than will people male assigned at birth (MAAB). In undertaking a comparative approach, then, our hypothesis was that such differential discrimination would result in different experiences with healthcare providers between the two surveys.

In order to test if it was appropriate to group all responses from people MAAB together as one group, and to compare this with all responses from people FAAB, we first checked to see if there were any significant differences within each group in terms of current gender identity. In each study participants were asked to name their current gender identity. The three main categories used by participants within both of the studies were:

1. Affirmed gender (i.e., simply ‘male’ – used by people FAAB – or ‘female’ – used by people MAAB)
2. Transgender (this included terms such as trans woman, trans girl, trans boi, transgender man)
3. Genderqueer

Statistical testing indicated that both within the surveys, as well as when combining the two samples into a whole, there were no significant differences in between those people who identified themselves using either their affirmed gender, the term ‘transgender’, or the term ‘genderqueer’.

In order to further ensure that focusing on differences between people MAAB and people FAAB was a valid approach, we also looked at whether there were other notable differences across the two samples. We found that:

1. Participants who were older were more likely to have undertaken sex-affirming surgery than participants who were younger,
2. Participants who were older reported more positive levels of mental health than did participants who were younger, and
3. Participants who had undertaken sex-affirming surgery reported more positive levels of mental health than did participants who had not undertaken surgery (as we had already found when looking solely at the first study, see Riggs & Due, 2013).

These initial findings suggested to us that it was possible that the main issue at stake across the samples was age. What we did, then, was control for age in our subsequent statistical testing. This enabled us to examine whether assigned sex (MAAB or FAAB) was a significant predictor of experiences. The answer was yes:

• Participants who were MAAB were more satisfied overall with the support they received from counselors, psychologists and psychiatrists than were participants who were FAAB,
• Participants who were FAAB reported more positive levels of mental health than did participants who were MAAB,
• Participants who were MAAB reported more positive experiences of gender-affirming surgery than did participants who were FAAB,

In addition to differences between participants MAAB and participants FAAB, there were other interesting findings. Some of these highlight areas in need of improvement by (nominally, though not in all cases) cisgender mental and physical health care professionals:

• Participants who reported higher levels of discrimination from health care professionals reported less positive levels of mental health,
• Participants who reported feeling that they frequently had to educate health care professionals about issues related to their current gender identity reported higher levels of discrimination,
• Participants who reported feeling that they frequently had to educate health care professionals about issues related to their current gender identity reported that they felt less respected by the professionals.

So what do all of these findings suggest to us? We of course acknowledge that this was a modest sample (78 people FAAB and 100 people MAAB), though these numbers are similar to those of the pioneering TranZnation report (2007), and they include participants from all Australian states and territories. The findings suggest the importance of taking into account both age and natally assigned sex. These demographics may impact upon people’s experiences due to differing:

• Diagnosis rates of ‘gender dsyphoria’ between people MAAB (0.005% to 0.014% of the population) and people FAAB (0.002% to 0.003% of the population),
• Societal gender norms and expectations of people FAAB and people MAAB, such that experiences of discrimination from the general population, from transgender communities, and from health care professionals will likely differ according to cisgender (and transgender) people’s assumptions about gender norms,
• Degrees of availability and successful outcomes of surgery as perceived by people MAAB when compared to people FAAB (though this is slowly changing, see Cotten, 2012),
• Understandings of gender identity within non-gender normative communities.

The report documenting the full findings is available at: http://www.genderidentityaustralia.com/?p=262

References

Cotten, T.T. (Ed.). (2012). Hung jury: Testimonies of genital surgery by transsexual men. Transgress Press.
Couch, M., Pitts, M., Mulcare, H., Croy, S., Mitchell, A., & Patel, S. (2007). TranZnation: A report on the health and wellbeing of transgender people in Australia and New Zealand. Melbourne: Australian Research Centre in Sex Health and Society.
Riggs, D.W. & Due, C. (2013). Mapping the health experiences of Australians who were female assigned at birth but who now identify with a different gender identity. Lambda Nordica, 5.
Riggs, D.W., Webber, K., & Fell, G.R. (2012). Australian undergraduate psychology students’ attitudes towards trans people. Gay and Lesbian Issues and Psychology Review, 8, 52-62.

Dr Damien Riggs
Senior Lecturer
Flinders University
GPO Box 2100
Adelaide 5001
South Australia

 

 

Key authorship on older LGB carers

Brotman, Shari, et al (2007) ‘Coming out to care: Caregivers of gay and lesbian seniors in Canada’, The Gerontologist, 47(4), pp. 490–503.

Conaghan Joanne and Grabham, Emily (2007) ‘Sexuality and the Citizen Carer’ Northern Ireland Legal Quarterly, 58: 325-341

Concannon, Liam (2009) ‘Developing Inclusive Health and Social Care Policies for Older LGB Citizens’, British Journal of Social Work, 39: 403-417.

Corden, Anne and Hirst , Michael (2011) ‘Partner care at the end-of-life : identity, language and characteristics’, Ageing & Society, 31:  217–242.

Cronin, Ann, et al (2011) ‘Categories and their consequences: Understanding and supporting the caring relationships of older lesbian, gay and bisexual people’, International Social Work 54(3): 421-435

Fenge, Lee-Ann, and Hicks, Christina (2011). “Hidden lives: the importance of recognising the needs and experiences of older lesbians and gay men within healthcare practice.” Diversity in Health and Care 8(3): 147-154.

Hughes, Mark, and Kentlyn, Sue (2011. “Older LGBT people’s care networks and communities of practice: A brief note.” International Social Work 54(3): 436-444.

Manthorpe, Jill and Price, Liz (2005) ‘Lesbian Carers: Personal Issues and Policy Responses’, Social Policy & Society 5(1): 15–26

Munro and Karen-Leigh Edward (2010) ‘The Burden of Care of Gay Male Carers Caring for Men Living With HIV/AIDS’, American Journal of Men’s Health, 4(4) 287-296

Munro and Karen-Leigh Edward (2010) ‘The Burden of Care of Gay Male Carers Caring for Men Living With HIV/AIDS’, American Journal of Men’s Health, 4(4) 287-296

Newman, Roger (2005). “Partners in care – Being equally different: lesbian and gay carers.” Psychiatric Bulletin 29(7): 266-267.

Price, Elizabeth (2008) ‘Pride or Prejudice? Gay men, lesbians and dementia’, British Journal of Social Work, 38: 1337-1352.

Price, Elizabeth. “Caring for mum and dad: lesbian women negotiating family and navigating care.” British Journal of Social Work 41.7 (2011): 1288-1303.

Roseneil, Sasha (2004) ‘Why we should Care about Friends: An Argument for Queering the Care Imaginary in Social Policy’, Social Policy & Society 3(4): 409–419

Rosenfeld, Dana, Bartlam, Bernadette and Smith, Ruth (2012) ‘Out of the Closet and Into the Trenches: Gay Male Baby Boomers, Aging, and HIV/AIDS’, The Gerontologist  Special Issue: Baby Boomers, Advance access 31st January 2012, doi:10.1093/geront/gnr138, 0(0):1–9.

Ward, Richard, et al (2005) A kiss is still a kiss? The construction of sexuality in dementia care. Dementia: the International Journal of Social Research and Practice, 4 (1): 49–72.

Willis, Paul, Ward, Nickie and Fish, Julie (2011) ‘Searching for LGBT Carers: Mapping a Research Agenda in Social Work and Social Care’, British Journal of Social Work, 41: 1304–1320

‘Older carers: invisible but invaluable’ by Antony Smith

  • There are 2.8 million people aged 50 and over providing unpaid care in the UK, including 5% of people aged 85 and over.
  • A quarter of all carers aged 75 and over provide 50 or more hours of informal care each week.
  • Carers save the UK economy an estimated £87 billion a year.

At Age UK we hear from many people in later life who are caring for a spouse, partner, relative or friend. Although many find caring rewarding and an expression of their relationship, carers also tell us that they feel invisible and undervalued. Many are stressed and exhausted. Here is an excerpt from one of those personal stories.

Jenny and James

“James and myself were both looking forward to spending our retirement together, but four months after I retired, James became ill and was diagnosed with memory loss caused by depression. Five months later he became ill again, almost overnight, and was hospitalised. He was 71.

“Eventually I was told, because James had Lewy Body dementia, I’d never be able to look after him and that he had to go into residential care. With a nursing background, I thought I could care for James at our home and believed this would be better for his mental wellbeing, but no one listened.

“Once a social worker was assigned to our case, he said he would try and enable a care package where James could live at home with me. However once our financial assessment was done, and we weren’t eligible for funding support, we were left to get on with things ourselves. I set about arranging a care package, but it was a complicated task to do with no guidance. Luckily, I’m able to use the internet, but I dread to think how I would have sorted anything without it.

“After nearly three months in hospital, James finally came home in Feb 2011.

“Being a carer is exhausting – from the moment James wakes up he needs help with everything from moving and getting dressed to washing and going to the toilet. When I don’t have night cover I’m up about four times a night and can’t sleep during the day as James needs someone with him all the time. Because we hired support workers independently we have the same ones nearly every time. I think that’s really beneficial to James, as changing faces can be particularly disorientating for someone with dementia and they perform very personal tasks.

“I take James to a day centre twice a week and this is welcome relief for me. Unfortunately we’ve just been informed that because of local authority funding cuts the centre will close next year. There are about 20 of us who use the centre, and James really enjoys his time there.

“Every six weeks I also put James in respite care for a week, to give me a complete break. Unfortunately on his most recent trip when I went to collect him he had no shoes on, his glasses were missing and he was wearing someone else’s clothes. I could tell he was frightened and he had bruises on his body. When I got him home I discovered he’d lost 8lbs in seven days. I’ve made a formal complaint and am waiting to discover the outcome, but things like that shouldn’t be acceptable and obviously I haven’t felt like I could put him in that respite home since.

“I feel I have managed to come to terms with my feelings of loss and bereavement concerning James, which were overwhelming at the start, and I just have to get on with things. I try not to think about the future. James is getting weaker, and I’m getting older so I don’t know how long I’ll be able to manage and I don’t know what will happen when our money runs out.”

Age UK Is calling for more support for older carers – from government, local authorities and health professionals – such as a Carer’s Allowance for pensioners, a choice of appropriate services and regular carers’ health checks. You can find out more about our work to highlight the support older carers need, as well as the recognition they richly deserve, on Age UK’s website.

Antony Smith is Development Officer for Equalities and Human Rights at Age UK Antony.Smith@ageuk.org.uk

Older lesbians in residential and nursing care

A central feature of care in the fourth age is the medicalisation of ageing bodies, the emphasis on collective bodily care and the power dynamics involved in that care1. An aspect of these dynamics that has not yet been explored is the intersection of age, gender and sexuality in the provision of personal care in residential settings for older people. Single, childless, older women are most likely to populate these settings2. These women are also more likely to be lesbians, both because older lesbians and gay men are earlier and disproportionate users of formal social care, and because older lesbians are more likely than older heterosexual women to be single and childless3. Lesbians have often found the processes of self-disclosure in health contexts a treacherous terrain to navigate in earlier life, many avoiding screening/treatment and/or choosing not to disclose their sexual identities to medical professionals, particularly during intimate physical examinations4. Some younger(er) lesbians also report feeling vulnerable to the heteronormative gaze in those gay commercial contexts frequented by heterosexual women5.

Residential care for older people – heteronormative at best, homophobic at worst6, is situated at the intersection between these two sites of vulnerability. It is also a site of social exclusion where ageing bodies are hidden away and where dependency can mean it is less likely someone will complain about their care or otherwise assert their rights, especially people from minority communities7.

Care spaces in the home or in sheltered accommodation or residential care have long been recognised as complicating the notion of the public-private divide, being both public work spaces and private home spaces. For an older lesbian this becomes even more complicated. Home care which goes public no longer affords the sanctuary of private identity performance and management. Yet at the same time, because it is home care, often in care spaces where the very old older person is hidden away from the public eye, some of the legal protections which she might have been able to mobilise for herself also do not apply, when the disciplinary norms of social relationships dominate. In this way an older lesbian can be disadvantaged in multiple ways by a home that has gone public and a public space that operates on private, heteronormative, lines.

(1)  Twigg, Julia. (2004) ‘The body, gender, and age: Feminist insights in social gerontology.’ Journal of Aging Studies 1891): 59-73.

(2)  Arber, Sara (2006) ‘Gender and Later Life: Change, Choice and Constraints’. In J. Vincent, C. Phillipson and M. Downs (eds) The Futures of Old Age, pp. 54-61, London: Sage.

(3)  Heaphy, Brian Yip, Andrew and Thompson, Debbie (2004) ‘Ageing In A Non-Heterosexual Context’, Ageing & Society, 24(6): 881-902; Stonewall (2011) Lesbian, Gay Bisexual People in Later Life, London: Stonewall.

(4)  Hunt, Ruth, and Julie Fish. “Prescription for Change: Lesbian and bisexual women’s health check 2008.” Stonewall and De Montford University (2008).

(5)  Casey, Mark (2004) ‘ De-dyking Queer Space(s): Heterosexual Female Visibility in Gay and Lesbian Spaces’, Sexualities, 7(4): 446-461

(6)  Ward, Richard, Pugh, Stephen and Price, Elizabeth (2011) Don’t look back? Improving health and social care service delivery for older LGB users, London: Equality and Human Rights Commission.

(7)  Aronson, Jane and Neysmith, Sheila M. (2001) ‘Manufacturing Social Exclusion in the Home Care Market’, Canadian Public Policy – Analyse De Politiques, 27(2): 154-165

‘Defining and exploring “care practices”‘ by Kathryn Almack

With my colleague Andrew King (University of Surrey), I’m starting work on a paper which aims to explore informal care practices within the lives of older lesbian, gay and bisexual (LGB) people. This will problematize the framing of ‘informal care’ within policy that most often assumes that these forms of care take place either within assumed heteronormative familial relationships and/or within a dyadic relationship, with one person the ‘carer’ and one the ‘cared for’. We are drawing on ‘case stories’ which we’ve developed from our research with older LGB respondents, selected to represent wider issues within LGB communities and illustrative of a range of care practices, including care provided by friends and strangers, reciprocal care and other expressions of care within LGB communities. We anticipate our paper will also contribute to wider debates about the increasingly diverse range of family forms and social relationships that are not easy to name or recognize.

In developing this paper, we are also searching for our theoretical framework within which to situate this; the thoughts on this below are my own, although it will be something that I work on in collaboration and further feedback from members of the networks are welcome.

I’m leaning towards defining and exploring ‘care practices’ –  akin to Morgan’s (1999, 2011) concept of family practices – as a way to investigate and interrogate care and caring relationship and practices and in particular, unpack the meanings of such practices – emotional, relational, moral, and symbolic. The concept of family practices seeks to shifts the focus towards what families do rather than a focus on family structures; but nevertheless also recognising that at everyday levels the ‘family’ is still a term used by individuals to describe their most meaningful relationships. Morgan suggests that this perspective offers the possibility to see the family as ‘less of a noun and more of an adjective or, possibly, a verb’ (1999:16).

Care practices could encompass a whole range of practices that bind people together, that may include conflicts, tensions and ambivalence as well as affection and love. Thus addressing some of the complexities of care – interdependence, reciprocity, conflicts (workings of power/imbalance), resources, identities, moral deliberations, emotions, labour, working across time and space, involving networks as well as individuals and dyadic relationships.

There are of course other ways of theorising care, including carescapes and an ethics of care framework. Carescapes (Mckie et al 2002) seeks to add a dimension to thinking about care across time and space – the concept developed out of concerns focused on the changing yet gendered nature of caring for children and time-space relations implicit in combining caring and working and shifting roles as children grow (but that may have wider application to other relationships of care):

Mapping routes through the shifting and changing multi-dimensional terrain that comprises their vision of caring possibilities and obligations: routes that are influenced by everyday scheduling and by combining caring work through paid work and the paid work of carers (McKie et al 2002: 904)

And of course, an ethics of care framework has been developed and drawn upon to theorise values of care (key references include Tronto, 1993 and more recently Barnes, 2012) – involving both thought and action and placing value on notions of responsibilities of providing good care; valuing connectedness, incorporating values of dignity and respect. It seems to suggest and encompass a moral framework – though not prescriptive – about the delivery of care and how it is delivered. Is that distinct from or similar to the meanings ascribed to relationships through the doing of care?

I’m left with questions that I don’t yet have answers to. Are there overlaps between the three – care practices, carescapes and ethics of care? Is it that they have developed within different spheres and that they do say the same things in different ways or do they offer distinct contributions to debates on care?  All thoughts and ideas most welcome in taking these reflections forward.

 

Name, address, contact details.

Dr Kathryn Almack

Senior Research Fellow

B Floor, QMC

School of Health Sciences

University of Nottingham

Nottingham

NG7 2HA

 

Tel: +44 (0)115 8231204

Email: k.almack@nottingham.ac.uk

 

References:

Barnes, M. (2012) Care in Everyday Life: an ethic of care in practice. Bristol: Policy Press

McKie, L., Gregory, S. and Bowlby, S. (2002) Shadow Times: The temporal and spatial frameworks and experiences of caring and working. Sociology, 36,4:  897-924

Morgan, D. H. J. (1999) “Risk and family practices ” in Silva, Elisabeth B. and Smart, Carol (Eds.) The New Family? London: Sage Publications, pp. 13-30

Morgan, D. H.J. (2011) Rethinking Family Practices. London: Palgrave Macmillan

Tronto, J. (1993) Moral Boundaries: a political argument for an ethic of care. London: Routledge

Children and Families Bill 2013: Helping Parents to Reconcile Paid Work and Care?

The Children and Families Bill 2013 has just had its second reading in the House of Lords. One of the aims is to encourage fathers involvement in childcare and accordingly, fifty weeks of the twelve months maternity leave is to become available as parental leave to eligible parents (see the Bill 032 2013-14 as bought from the Commons, http://www.publications.parliament.uk/pa/bills/lbill/2013-2014/0032/14032.pdf, s89(1)). Increasing flexibility for parents may seem positive, but it is unlikely to result in a huge increase in fathers’ involvement in childcare. Indeed, it has been predicted that only 2% of eligible fathers will use any of the parental leave (http://www.publications.parliament.uk/pa/cm201213/cmpublic/childrenandfamilies/130307/pm/130307s01.htm, column 137).

With such small predicted uptake, it is questionable if the Bill could approach the reconciliation of work and care differently to better encourage fathers’ participation in childcare. The legislation currently considers care as something that needs to be accommodated in the workplace only occasionally, mainly during pregnancy and childbirth, and then fleetingly throughout the rest of childhood. However, these are obviously not the only times when people will need to combine paid work and their caring responsibilities. As has often been noted in the care literature, caring is an everyday and universal occurrence (see for example, M. Fineman The Autonomy Myth: A Theory of Dependency (The New Press, 2004)). Acknowledging this may allow and encourage fathers and others to become more involved in providing care. Therefore, an overarching change to the regulation of employment which would better accommodate caring responsibilities may have been more beneficial for fathers and all carers.

Recognising the universal nature of care may ensure that its importance is acknowledged. Generally, paid work is seen as the priority and any caring responsibilities are considered obstacles to this. Indeed, although much work has been done in regards to the reconciliation of paid work and caring responsibilities, most of it comes from an employment centric vantage. If the workplace is to better accommodate carers, the importance of care must be recognised. Caring can no longer be seen as an obstacle to employment, but as an everyday occurrence that will inevitably affect the workforce. Nicole Busby’s A Right to Care? Unpaid Care Work in European Employment Law (Oxford University Press, 2011) has been a vital contribution in this regard. She advocates a right to provide care alongside paid employment. Accordingly, rather than begrudgingly accommodating care when it cannot be avoided, it would be recognised as vitally important work which will regularly impact upon all people’s lives.

Better accommodating care and acknowledging its impact upon paid work may encourage more men, including fathers to increase their involvement in care. If caring is rightly acknowledged as an unavoidable part of normal life, the penalties associated with taking time out of employment will have to be removed. Accordingly, all people would feel more able to take leave from paid work. After all, leave will only be helpful if people feel that they can actually use it (S. Eaton ‘If You Can Use Them: Flexibility Policies, Organizational Commitment, and Perceived Performance’ (2003) 42 Industrial Relations 145). Therefore, a re-evaluation of paid work and the workforce is vital. If labour law is to better accommodate carers and challenge gender stereotypes regarding care, rather than introducing more sound-bite legislation, the acknowledgement of the importance and universality of care must fundamentally change the nature of paid work.

Care in the first two years of life: OXPIP and the emerging discipline of parent-infant psychotherapy

By Adrian Sell, Executive Director, OXPIP: The Oxford Parent Infant Project

OXPIP is one of the organisations pioneering parent-infant psychotherapy. Founded in 1998 we have been working in Oxfordshire to provide support to parents who are struggling to form a secure attachment to their baby. In the last three years we have worked with over 900 families and consistently improved mental health and the quality of the parent-infant relationship[1]. We work with babies up to the age of two and their parents, normally the mother but we have worked with many fathers as well.

Parent-infant psychotherapy is distinguished by the attention it brings to the mother’s mental health, the baby’s mental health and, crucially, to the quality of the relationship between parent and baby. This focus on the quality of the care that comes from this early experience is critical to our success in addressing intergenerational cycles of disadvantage. We all have a tendency to default to parenting our children as we were parented, even if those relationships were withdrawn, unpredictable or harmful.

Our clinicians are skilled at enabling parents to build and sustain closer relationships with their children. One of the therapeutic tools for achieving this is through modelling thoughtful, empathic ways of relating within the therapeutic relationship. For some of the parents we work with this is the first time they have really experienced being thought about and related to in this way; it can be a powerful tool for change, opening up new possibilities for how they in turn can relate to their babies.

Our team of psychotherapists come from a range of backgrounds including Child Psychotherapy, Adult Psychotherapy and Clinical Psychology as well as including prior qualifications in Health Visiting, Nursing, Midwifery, Social Work and Teaching. All have undergone Infant Observation training, and are trained in the use of video through the (NICE approved) Video Interaction Guidance approach. This mix of backgrounds and approaches gives our work a strength and rigour that forces us to constantly challenge our own preconceptions and viewpoints.

We are part of a growing national movement of people and organisations who are bringing greater focus to the first years of life. Our Executive Director, Adrian Sell is a trustee of PIP-UK a new national charity seeking to support similar services to develop elsewhere. We have backing from Impetus – The Private Equity Foundation where we are one of twenty-five organisations they see as critical social game-changers supporting disadvantaged children to develop to their full potential. We are a member of the Centre for Social Justice Alliance where we are recognised for our effectiveness in tackling the root causes of poverty and disadvantage. We are supporters of the All Party Parliamentary Group for Conception to Age 2 – the first 1001 days

We all instinctively know that the first few years of our life are formative. There is also considerable neuroscientific evidence that has emerged to support this. OXPIP are now at the forefront of developing an evidence base for the positive impact that parent-infant psychotherapy can have. If you want to find out more then please look at our website, get in touch or leave a comment below.

OXPIP: The Oxford Parent Infant Project
Suite J
The Kidlington Centre
Kidlington
OX5 2DL
T: 01865 371080 or 01865 778034
info@oxpip.org.uk
www.oxpip.org.uk

 

Mark Neary’s Tribunal: Unequal access to justice

Read Mark’s blog on trying to self-advocate in a housing battle on behalf of Mark and his disabled son, with no Legal Aid (since cuts), and so no legal representative, up against a powerful local authority’s barrister. Appalling. Shows vividly the power imbalance created by lack of funding for Legal Aid in social welfare disputes. The disempowered are further disempowered by a judicial process to which they do not have equal access.