Practical examples of positive prevention

Let's be honest, attending psychology conferences can be pretty bleak in austere times. So many societal issues, so little time. Opening this BPS-organised symposium, Julia Faulconbridge said that prevention, health promotion and early intervention services have been hit hardest by cuts. Can psychologists genuinely be expected to 'lead the change and promote healthy child development'? What enables a parent to be a good one, in the face of a potential 'developmental cascade' of issues? Thankfully, just as I was feeling helpless and overwhelmed on behalf of psychologists everywhere, we heard striking examples of psychologists doing concrete work within unified, holistic services, created 'for people not for problems'. Michael Ungar's view of resilence was to the fore – as less an individual trait, more a quality of the child's social and physical ecology. 

The first success story was from Camilla Rosan in the field of perinatal mental health. Up to 20 per cent of women develop a mental health problem during pregnancy or within a year of giving birth; yet in 2015, fewer than 15 per cent of localities provided specialist services for women with complex or severe conditions at the full level recommended in NICE guidance, and more than 40 per cent provided no service at all. Now, every area of the country has money to set up an evidence-based perinatal mental health service. These cover five pathways – preconception advice, specialist assessment, emergency assessment, psychological interventions, urgent admission to an mother and baby unit. Services have been extended to preconception to 24 months after birth; and access expanded to include a whole family approach. 

Rosan called for still more to be done to support the resilience of family functioning during 'challenging times' around birth. 'We need to train practitioners to be "perinatal competent". We must prioritise antenatal and postnatal parents for assessment and intervention – babies can't wait.'

Next, Dr Jenny Taylor was fascinating on embedding psychological principles throughout services, and in casual conversations taking place in informal settings. She gave examples such as Pause, a programme focusing on women who have had more than two children removed by social services. It has been effective in reducing the number of pregnancies, saving millions of pounds per year. More broadly, Pause is helping women to understand what a positive relationship would look like. 

Similarly, the 'FAMILY' programme for children at risk of entering care has been teaching social workers to use collaborative formulation; and Music And Change-UK has engaged marginalised young people at risk of offending in 'streettherapy'. Such 'opportunities for purposeful conversations' might not labelled as therapy or conducted in a usual context or time slots. They are, however, showing that 'being a psychologist' can involve so much more than the traditional model of one-to-one therapy; and it can involve encouraging other professions to adopt our foundational principles. That might include looking beyond symptom clusters to the severity of difficulties in identity and self worth, family and peer relationships, and the ability to be productive and to learn. An end goal has to be nurturing a child's capacity to tackle developmental challenges and use cultural resources to maximise growth. 

Key source

Improving the psychological wellbeing of children and young people – edited book with examples.