In-Home Approach Disrupting Adversity

In-Home Approach Disrupting Adversity


A study exploring the outcomes of a home visiting program for vulnerable babies, toddlers and parents has gathered rich evidence to support future at-risk families and life-changing interventions.

The program, Tweddle’s Home Parenting Education and Support (HoPES), is an intensive 8-week home-visiting intervention. The program supports the preservation and reunification of families with young children (aged 0–4 years) receiving child protection services.

The study was led by Associate Professor Rebecca Giallo from the Murdoch Children’s Research Institute in collaboration with Tweddle and The University of Melbourne.

Tweddle Director of Clinical Services and Nursing Kirsty Evans said that intensive home-based family preservation programs were crucial. “They are designed to improve parenting skills, reduce abuse, and address child and parent risk factors for child maltreatment and its recurrence.”

“Despite challenges experienced by families around complex social health issues, the study’s outcomes highlighted the benefits of tailoring interventions and the use of strengths-based approaches to meet the needs of families.” she said.

Recent Australian data has shown that infants (aged 0–12 months) were more likely (16 per 1000 children) to be the subjects of child maltreatment substantiations than older children (AIHW, 2020), highlighting the need for specific interventions for families caring for infants and toddlers.

Ms Evans said that shorter interventions were also needed given the well-documented challenges of attendance and retaining families in long-term interventions.

The HoPES program is underpinned by trauma-informed care. “The long-history of adversity often experienced by families receiving child protection services means that a different approach is required. Social learning and behavioural principles like modelling, goal setting, behavioural rehearsal and feedback form a vital part of the education.” said Tweddle Nurse Unit Manager Catherine Fisher, who was also involved in the study. “A vital part of the program is the therapeutic play activity in each session. Play is an important tool in building secure attachment, and this helps to disrupt intergenerational trauma, and build positive relationships for the future.”

HoPES is delivered by Tweddle practitioners with qualifications in social work, community welfare and/or early childhood education. Many strategies to facilitate parent engagement are utilised, including taking the time to build rapport and trust; actively engaging fathers, using a strengths-based approach, flexible meeting times and providing lots of positive feedback.

As part of the study, a common goal was for parents to better identify and respond to their baby’s cues for tiredness and hunger, and support was provided via direct instruction and modelling. The practitioners capitalised on moments for incidental teaching when parents raised concerns or specific observations were made.

The study, published in the Journal of Reproductive and Infant Psychology, found that a longer-term follow-up of families was recommended, particularly in regards to recurrence of neglect or abuse and the preservation and/or reunification outcomes for families.

The next stage of research will seek to capture the voices of families who have participated in HoPES, in particular, Aboriginal and culturally diverse families.  Ms Evans concluded that the ongoing development of trauma informed and culturally sensitive interventions to support families experiencing extreme adversity will continue to be a priority for Tweddle.

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