11.3 Challenges

What Is It?

Relationships 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, 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 could 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 by:

  • showing up regularly for home visits, demonstrating that you can be trusted.

  • calling or texting the day before the visit to remind families that you are still planning to come.

  • diligently showing 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) writing 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.

  • defining roles. Make a verbal contract with the family initially, and revisit the roles periodically as appropriate. Families may be excited about the program but unsure of exactly what you will be doing with them. Let families 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. You just want to support and encourage them as they learn new skills, learn about child development, and learn about community resources.

  • checking 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, and assuring that the parents understand the information.

  • assuring families that you want to partner with them to support the child’s development.

  • listening 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.” You might ask the parent if it would be comfortable or if she believes it might be helpful for her to hold the baby (“It might give you both some comfort”).

  • knowing the signs of depression, being able to help the mother understand the effects of depression on herself and her child, and knowing community resources the mother can access for treatment.

  • addressing the need for the parents to participate in the visit; for example, “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.”

  • providing case management services to help parents find and use health care, including oral health care services.

Experience It

Building Rapport

Learn More

Early Head Start's goal is promoting the development of the whole child. The staff’s main strategy for addressing the child’s emotional needs is to enhance the parent–child relationship. Supporting the parent and ensuring his/her well-being is an important part of this strategy. Infant mental health services are designed to help accomplish this in the home setting through the practice of “kitchen therapy.”