Home Visitor's Online Handbook


Woman trying to move a boulderRelationships are the heart of the home visitor's work! Through your relationships with families, you support their relationships with their children; but relationships are not simple. There can be many celebrations and joys in partnering with families, but in some cases, you may experience challenges. Many home visitors observe serious challenges that affect relationships and require immediate action. They may witness or hear reports of child abuse or neglect, domestic violence, or sales or use of illegal substances. The family may become homeless, disappear for a while and suddenly show up again. A family may experience a crisis, such as having no money for rent, food, diapers, or oral health or medical care. Your program should have policies in place for these kinds of challenges.

Many families with whom home visitors work are well-functioning families invested in receiving enrichment services for their children. However, some home visitors report serious challenges in developing and maintaining their relationships with parents. Families may habitually miss visits or choose not to open the door when you arrive. Mothers in Early Head Start may be suffering with postpartum depression. There could be other family members dealing with depression and other mental illness issues that adversely affect the enrolled child or family. Sometimes, parents want to focus on their own lives and hold your attention. Some parents have never had a nurturing relationship themselves and don't know how to provide nurturing care to their child.

Home visitors sometimes find it difficult to actively engage the parents during the visit. Some families have had only unpleasant experiences with social services and don't know how to react to you. Some parents are distracted throughout the home visit or simply ignore the home visitor.

Working through these challenges is a normal part of the home visiting process and can ultimately serve and strengthen your relationship with the family.

How To

You can work to overcome these challenges if you:

  • Show up regularly for home visits, demonstrating that you can be trusted
  • Call or text the day before the visit to remind families that you are still planning to come
  • Diligently show up at the appointed time week after week, calling between visits to check in, and saying during the visit, "I was thinking about you this week."
  • After multiple attempts to contact them, write a short note asking the family to let you know if they still want to participate in the program
    • If they contact you wanting to continue, try to establish how the family sees the work proceeding
  • Define roles; families may be excited about the program but unsure of exactly what you will be doing with them
    • Make a verbal contract with the family initially, and revisit the roles periodically as appropriate
    • Let them know what your role is in the program and how you hope to partner with them
    • Emphasize how important their role is in their children's lives, that you recognize that they are their children's primary caregivers and teachers
    • Explain that you just want to support and encourage them as they learn new skills, learn about child development, and learn about community resources
  • Check in with the family to clarify any questions they might have about the information they received during the intake process and in the parent handbook about mandated reporting of child abuse and neglect, assuring that the parents understand the information
  • Assure families that you want to partner with them to support the child's development
  • Listen to the parent as she shares her experiences, responding empathically, and bringing the child into the conversation
    • You might say, "You sound so sad and angry. I am concerned that you have so much going on. I don't think I'm the only one who's concerned, either. Alex has been watching you so intently. He has a really worried look on his face, too. It's kind of amazing to realize how much babies care about our feelings."
  • Know the signs of depression, helping the mother understand the effects of depression on herself and her child, and share community resources the mother can access for treatment
  • Address the need for the parents to participate in the visit (e.g., "The time we spend together during the home visit is a partnership. I am here to support you as you engage with Johnny in his experiences.")
  • Provide case management services to help parents find and use health care, including oral health care services

Experience It

An Early Head Start parent describes the actions her home visitor took to build rapport and get past her resistance to participate.