Can staff mindset encourage a positive working alliance with parents with mild learning disabilities and encourage them to seek help sooner?

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Parents with learning disabilities are likely to face a number of problems that make parenting more difficult. For example, they are more likely to struggle with financial and mental health issues.

They are also more likely to feel socially isolated; lacking positive role models and a supportive network of people to help them through hard times. It is also common for parents with learning disabilities to face stigma from other people who hold prejudicial views that they will not be successful parents.

The ‘functional-contextual’ approach to parenting suggests that all parents are able to develop and improve their parenting skills. The term ‘mindset’ is used to refer to beliefs around whether or not people can develop their skills as a parent.

There are two main types of mindset.The belief that parenting behaviours can change is referred to as an ‘incremental’ mindset, whereas the belief that parenting behaviours are fixed, and therefore cannot change, is referred to as an ‘entity’ mindset.

In the current study, the research team were interested in whether the mindset of staff affected two factors; the amount of time parents waited before asking for help and the quality of the alliance between the parents and support staff.

Method

Parents with mild learning disabilities and their support staff took part in the study

Parents with mild learning disabilities and their support staff took part in the study

Both parents with mild learning disabilities and their support staff took part in the study. Support staff completed questionnaires and parents took part in a two hour home visit, which included an interview and questionnaires that were adapted for people with learning disabilities. In total, 63 members of support staff and 76 parents took part in the study.

Staff completed a questionnaire to measure their ‘mindset’. In addition, both parents and staff completed a questionnaire to measure the quality of the working alliance between the two parties.

Parents were asked about the amount of time they would wait before seeking professional help.

Finally, the research team worked with the parents’ main Support Worker to gain a measure of each parent’s level of adaptive functioning, comprised of their communication skills, daily living skills and social skills.

Results

Initial analysis found that 35 members of support staff (55%) had a more ‘incremental’ mindset, believing that parenting skills can change over time.

Two members of staff had an equally entity-incremental mindset. A further 26 members of support staff (42%) had a more ‘entity’ mindset, believing that parenting skills of people with learning disabilities are static and cannot be changed.

Time taken to seek help

The study found that parents asked for help sooner when they were working with staff that have a more incremental mindset. This remained true even when the parents’ level of functioning was taken into account; therefore parents of all abilities asked for help sooner when staff believed their parenting skills could change and improve.

Mindset was associated with the amount of time parents waited before seeking professional help

Mindset was associated with the amount of time parents waited before seeking professional help

Working alliance between parents and support staff

The mindset of the support staff did not affect the quality of the alliance between parents and staff. Instead, it was found that both parents and staff were more likely to report a more positive alliance when the parents had higher levels of functioning.

To further explore the relationship between staff mindset, level of functioning and the quality of the working alliance, the research team separated support staff into two groups and examined results for staff with an ‘entity’ and ‘incremental’ mindset separately. The researchers found an association between the quality of the working alliance and parents’ level of functioning only in the group of staff identified as having an ‘entity’ mindset.

Staff with an ‘entity’ mindset were more likely to report a better alliance when parents had a higher level of functioning, whereas staff with an ‘incremental’ mindset were more likely to report a positive alliance regardless of the parents’ level of functioning.

The authors use two line graphs to clearly demonstrate the interaction between the variables.

Conclusion

Although a small majority of support staff believed in the parents’ ability to develop their parenting skills, there were some staff members who did not believe this would be possible. This is important as the mindset of support staff can have consequences for service users. For example, this study found parents were likely to ask for help sooner from staff with a more incremental mindset.

The association between a parent’s level of functioning and the quality of the alliance between staff and parents may suggest that it is harder to form a positive working relationship when parents have lower levels of functioning.

However, the parents’ level of functioning was only an important factor when the support worker believed less in the parent’s ability to develop their parenting skills. When staff believed parents could improve their skills, level of functioning had no effect on the perceived working alliance between staff and parents. This could be due to people with a more ‘incremental mindset’ approaching parents with lower levels of functioning more positively.

Strengths and Limitations

The study sample consisted of mainly mothers and female support staff. Therefore it would be interesting to examine the effect of mindset in a group of male support workers and fathers. In addition the study demonstrates the effect of mindset through correlational associations. This does not allow the authors to demonstrate that a more incremental mindset causes parents to ask for help quicker.

It may also be true that when parents ask for help more quickly, staff change their perception and develop a more incremental mindset.

The study originally invited 123 members of staff and 131 parents to take part in the study and received a response rate of approximately 51% for parents and 58% for support staff. It may be true that a self-selection bias occurred, with those who chose to take part in the study feeling more strongly about the topics raised in the questionnaires, such as mindset or working alliance.

Although a larger sample size would help to further validate the findings, the final sample is large enough to be confident in the study’s conclusions.

Summary

The study demonstrates an important gap in the literature and highlights the need to consider the impact that the attitudes of support staff can have on parents with learning disabilities.

Organisations that provide support for parents with learning disabilities should look to foster a more incremental mindset amongst staff, suggesting that parenting skills can improve. However more research into effective ways to cultivate a more incremental mindset may be required.

Organisations should look for ways to foster a more incremental mindset amongst staff

Organisations should look for ways to foster a more incremental mindset amongst staff

Links

Meppelder, M., Hodes, M.W., Kef, S., & Schuengel, C. (2014). Expecting change: Mindset of staff supporting parents with mild intellectual disabilities, Research in Developmental Disabilities, 35, 3260 – 3268 [abstract]

References

Aunos, M., & Fieldman, A.A. (2002). Attitudes towards sexuality, sterilization and parenting rights of persons with intellectual disabilities, Journal of Applied Research in Intellectual Disabilities, 15, 285-296

Benjet, C., Azar, S.T., & Kruersten-Hogan, R. (2003). Evaluating the parental fitness of psychiatrically diagnosed individuals: Advocating a functional-contextual analysis of parenting, Journal of Family Psychology, 17, 238-251

McConnell, D., & LLewellyn, G. (2002). Stereotypes, parents with intellectual disabilities and child protection, Journal of Social Welfare and Family Law, 24, 297-317

Darbyshire, L., & Kroese, B.S. (2010). Psychological well-being and social support for parents with intellectual disabilities: Risk factors and interventions, Journal of Policy and Practice in Intellectual Disabilities, 9, 40–52

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Fawn Harrad

Fawn has a background in both healthcare research and front-line health and social care roles. After graduating with a BSc Psychology with Sociology degree, Fawn spent 3 years worked at the University of Leicester. Based in the Department of Health Sciences, Fawn provided support to a number of research studies and evaluation projects that sought to improve local healthcare services. During this time Fawn also worked part-time as a Support Worker for adults with learning disabilities and as a Mental Health Recovery Worker. More recently, between, Fawn spent 18 months working on an NHS male dementia assessment and treatment inpatient ward. Alongside this Fawn has joined the ENRICH (Enabling Research in Care Homes) project, a national project that aims to increase the amount of research delivered in care homes. In September 2017 Fawn started a PhD project, focusing on understanding admissions from care homes.

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