• The Benefits and Costs of Caring: A Mixed Methods Study of Early Head Start Home Visitors

      West, Allison L.; Berlin, Lisa J. (2015)
      Early Head Start (EHS) home visitors are the lynchpin connecting program goals with service outcomes, yet scant attention has been paid to issues concerning the home visiting workforce. In particular, the ways in which EHS home visitors are affected by prolonged relationships with low-income, high risk families are not well understood. Guided by a strengths-based, developmental-ecological framework, this mixed methods study examined the influence of individual, occupational, and organizational factors on compassion satisfaction, secondary traumatic stress, and burnout. Home visitor compassion satisfaction, secondary traumatic stress, and burnout were also examined as predictors of (a) home visitor turnover and (b) family engagement. In the quantitative phase of this study, 77 home visitors from Maryland and the District of Columbia completed pencil and paper surveys that assessed individual, occupational, and organizational characteristics that prior research and theory have shown are associated with compassion satisfaction, secondary traumatic stress, and burnout. Survey data from a subsample of 27 home visitors were linked with family-level data from the Partners for Parenting study in order to examine associations between home visitor compassion satisfaction, secondary traumatic stress, burnout, and EHS family demographic and psychological risk. Home visitor survey data were also linked to home visitor turnover at 6 months post-survey and with indicators of EHS family engagement. In the qualitative phase, seven home visitors from the larger sample completed semi-structured interviews addressing occupational stress. EHS home visitors in this sample evidenced moderate to high compassion satisfaction and low to moderate secondary traumatic stress. The quantitative and qualitative results supported an ecological approach to understanding compassion satisfaction, secondary traumatic stress, and burnout. Results from bivariate correlation analyses suggested that lower attachment avoidance and perceptions of low supervisor support were associated with six month turnover. Higher levels of compassion satisfaction, greater material hardship, greater perspective taking ability, larger caseloads, and higher levels of EHS family cumulative risk were associated with more positive home visitor ratings of working alliance. Results are discussed in terms of their implications for practice, policy, and research.
    • The Parent University Program: Factors Predicting Change in Responsive Parenting Behaviors

      Liggett-Creel, Kyla; Barth, Richard P., 1952-; Berlin, Lisa J. (2016)
      There are few evidence-based parenting programs for children under the age of three and even fewer have been rigorously evaluated in comparison to parenting programs for older children (Barth & Liggett-Creel, 2014). Parenting programs such as Child-Parent Psychotherapy, Circle of Security, Promoting First Relationships, Chicago Parent Program, and Attachment and Biobehavioral Catch-up have shown positive outcomes. Common components are beginning to be identified in successful parenting programs for families with children ages birth to three years old. The Parent University Program (PUP) integrates common components of five evidence-based interventions for children birth through three years old. Parent-child dyads (N=86) participated in the parenting program with the goal of increasing responsive parenting skills. This study aims to assess the changes that may occur in responsive parenting behaviors that promote social emotional growth, cognitive growth, sensitivity to cues, and responding to the distress of their child. Results will add to parenting program research on the use of common components, real world implementation and evaluation, and the use of peers as facilitators. Participants of the PUP showed a significant increase in responsive parenting behaviors. Participants who completed pre-test, post-test, and follow-up assessments showed a significant change from clinical to non-clinical status after attending the PUP. Neither the type of facilitator nor the number of hours attended showed an association with changing parenting behaviors. The age of the child was associated with the change in responsive parenting. Older children had higher scores at pre-test and showed less change over time. The results of this research suggest that further evaluation is warranted with more rigorous study design including a randomized clinical trial.