‘Comfortable, safe and valued’: an analysis of the impact of COVID-19 on Hertfordshire's Community Perinatal Team

AimsThis study aimed to assess the impact that the COVID-19 pandemic has had on the Hertfordshire Community Perinatal Team (CPT) group interventions and the innovations made.BackgroundThe CPT is a multidisciplinary mental health service that runs three groups: Circle of Security (CoS), Emotional Coping Skills (ECS) and a peer support group - Wellbeing and Lifestyle. The service has received an increase in referrals during the COVID-19 pandemic.MethodMethods: Team member and client semi structured interviews were conducted with answers transcribed in real time and analysed. Patient clinical records were accessed via PARIS and analysed in order to identify patient demographics within each group and whether these had changed during the pandemic. Clinical outcome measures and client feedback were evaluated to see whether the change in groups is impacting their clinical effectiveness.ResultResults: Innovations made by the CPT include: groups becoming virtual, launching of the new Circle of Security Group which helps women tackle the ‘Ghosts in the Nursery’ and strengthen maternal bonds, restructuring existing groups, breakout room forums and incorporating communication platform apps such as Whatsapp. The Wellbeing and Lifestyle Group increased in size and reach (7 women from 7 areas in 2019 vs 12 women from 12 areas in 2021) with an increased retention rate (71% in 2019 vs 100% in 2021) and a decreased attrition rate (29% in 2019 to 0% in 2021). The Emotional Coping Skills group experienced similar changes (10 areas represented in 2019 vs 15 different areas in 2021) with an increased retention rate (58% in 2019 vs 100% in 2021) and decreased attrition rate (42% in 2019 vs 0% in 2021).ConclusionThe Hertfordshire Community Perinatal Team has responded to the pandemic by innovating existing groups and creating new forums; many of which will continue on even after the pandemic ceases. The groups have acted as a lifeline for women breaking up the monotony and isolation of lockdown life and providing an invaluable space for women to be heard.

A Mixed-Methods Study of Two Modes of the Circle of Security

Purpose: This study compared the impact, challenges, and benefits of the Circle of Security-Parenting (COS-P) intervention across two delivery modes: group center-based (GCCOS-P) and individual home-based (IHCOS-P). Methods: This mixed-methods study compared the impact of the COS-P on parental reflective functioning and parental stress across two delivery modes: GCCOS-P ( n = 7) and IHCOS-P ( n = 7). It compared the challenges and benefits of each, from the qualitative perspectives of participants ( n = 2 IHCOS-P; n = 3 GCCOS-P) and facilitators ( n = 4). Results: Quantitative statistical analysis comparing pre- and postintervention measures suggest that each delivery mode was equally effective in reducing parental stress and generally noneffective with respect to parental reflective functioning. Challenges and benefits of each mode, inherent in the peer/shared learning environment of the GCOS-P and the individualized, flexible delivery of the IHCOS-P, were identified. Discussion: This study adds to knowledge about the widely utilized COS-P, highlighting challenges and benefits of two modes of delivery.

Circle of Security - Parenting: A Systematic review on Effectiveness of use of the parent training program within Multi-problem Families

Introduction: Circle of Security-parenting (COS-p) is a simplified, relationship-based programme with the intention of developing parents’ observation and inferential skills related to understanding their child’s needs, increasing sensitivity to their child, aiding in emotional regulation, as well as decreasing any of their negative attributions to their child. COS-p is a widely used parenting programme that is gaining global popularity, as it is currently being delivered across several continents. Despite being one of the most frequently used interventions in Norwegian child protective services (CPS), no research has been conducted on this programme’s effectiveness when used in the CPS context. This study therefore aims to establish a systematic overview of the programme’s effectiveness for families within the CPS system, regarding both caregivers and benefits for the children. Method: The database searches were originally conducted in June 2018 and updated in April 2020, encompassing 13 international bibliographical databases. The search for grey literature was conducted, and the generated articles these were then manually searched. A non-statistical narrative approach was used to analyse the studies due to the heterogeneity of the outcome measures. Research studies on the effectiveness of COS-p intervention, where the participants reported a minimum of two specifically defined risk factors, were included for further analysis. Results: Seven studies met the inclusion criteria. The studies included in the review focus on a diversity of separate and isolated factors concerning caregivers but not the effect of the accumulation of risk factors and how this may or may not influence the potential effectiveness of COS-p. The findings’ strengths include some improvements in reducing parental stress, increasing self-efficacy and parenting skills, and promoting an understanding of child behaviour. There is no conclusive evidence that COS-p assists in increasing the security of the parent-child attachment relationship. Discussion: Given the limited number of studies, further research is needed to examine if COS-p improves child behaviour, if its effects can be sustained over time and if it is more effective for particular populations.