TECHNOLOGY FEATURE
showing how we communicate with our mums and set up and
record the group process in a standardised way, following our trust’s
policies.
Group delivery
The usual face-to face-group size was up to 12 mums and their
babies in a 90-minute drop in group session, which was very
informal and unstructured. Following our mums’ feedback regarding
other groups, we decided to trial smaller groups of four mums and
30-minute sessions.
The rationale being we only had access to view four participants
at a time using MS Teams and initially could not select who you
could see, so often you could see co-facilitators as they were
talking, but not the mums.
Later, MS Teams developed a Pin function, whereby you could
select who you viewed, which made the process easier.
The groups were allocated based on the age of baby for
development milestones, the functional needs of mums, and
whether they already had good cohesion
together in our face-to-face sessions.
The structure of the sessions
remained the same for each group; an
activity that engaged mum with her baby,
such as a story, songs and nursery rhymes,
questions and feedback about baby
development, discussion about mental
health and functioning, and they closed
with goal setting for the forthcoming week.
The screen sharing function allowed the
facilitators to share YouTube clips, websites
and documents in real time to aid the
sessions. Following the sessions, the facilitators
sent out an email containing any useful material that
the facilitators used or the mums shared together as
peers.
Initial findings
After six weeks, 26 sessions have been facilitated for 18 mums and
evaluations have been sent by email. Although not all evaluations
have yet been collected, early feedback indicates that the group
sessions seem to be the right length, attendees are happy with a
smaller group, and they have found the sessions beneficial to their
baby and their own mental health.
Mums say the best parts of the group are: ‘Talking with staff and
other mums and being able to discuss how I am feeling due to the
current situation’; ‘Hearing what everyone had achieved during the
week and being able to have a laugh and a general chat like when
we would meet in person’; [It is a] great way to get new ideas for
activities/videos to watch, liked having the weekly goal/homework’;
‘Regular contact with perinatal staff members who are so positive
and supportive especially in times of lockdown, it gives you a focal
point to the day’; ‘Chatting to other mums in the same boat and
realising that, although what I am going through is not nice, it is
more common than you think’; and ‘It’s nice to keep in contact with
staff and the other mums in the group, considering everything in our
normal lives has come to a halt’.
From a facilitator’s point of view, observing mum and baby on
screen is quite demanding, so despite the option to see more
screens at once becoming available, it is likely that the smaller
groups will stay to maintain quality of session delivery.
Part way through the group it was agreed that we needed to
over-subscribe to the sessions and invite up to five mums to each
session, to ensure there was always peer support.
Due to the demands of the client group and the lockdown
environment, whereby most families are at home together, mums
often did not attend if they had had an unsettled night with their
baby, if their baby was asleep, or if their baby was fractious that
day, and arrived late or left sessions early to maintain other family
commitments.
next step
will be to [look at]
whether this digitally
enabled service
transformation has
demonstrated quality
‘‘The
improvement and is
here to stay.
On other occasions, mums attended the session alone, without
their baby who was sleeping, or with another family
member, which allowed the space for more in-depth
conversation about their mental health, which
they would not otherwise have.
As the sessions moved away from
a drop-in style and became more
structured, with themes each week,
there was a noticeable improvement
in attendance and time-keeping in
sessions.
Six weeks on, every mum who
would have attended face-to-face Stay
and Play attended at least two sessions
online. The initial assumption that they
would be put off by the technology, or that
new mums would not join the group, have
been dispelled, as has our assumption that we
would not have the skills to learn to use technology and
adapt our practice to successfully deliver online therapy.
It certainly gives mums who are geographically isolated or who
have no access to transport a new way to access to groups, rather
than being excluded, and the time facilitators would have spent on
travel is now spent on the planning of sessions.
At the time of writing, another six week block of groups was due
to start in June, with recognition that social distancing measures
might have been eased by the time these are complete.
The next step of the journey will be to further evaluate the
patient experience and whether group members want to go back
to the traditional way of offering group therapy, or whether this
digitally enabled service transformation has demonstrated quality
improvement and is here to stay.
Madeline Warwick, specialist perinatal occupational therapist
at Northamptonshire Healthcare NHS Foundation Trust. For more
information contact: [email protected] or follow on
Twitter: @madelinewarwick
OTnews August 2020 21