Introduction
Method
Participants
Procedure
Design
Q Methodology Phase 1—Concourse and Q-Set Development
Q Methodology Phase 2—Administering Q-Sets and Obtaining the Q-Sorts
Data Analyses
Results
No | Statement | Factor 1 | Factor 2 |
---|---|---|---|
1 | The MBU provides time to take part in Baby TP | 1 | 2 |
2 | It is important that Baby TP fits nicely with the ethos of the unit | 0 | −1 |
3 | The skills taught in Baby TP need to generalise to environments other than the MBU | 3 | 6 |
4 | When mothers are unwell, Baby TP will be intolerable | −1 | −3 |
5 | Mental health issues prevent mothers from accessing Baby TP | −3 | −4 |
6 | Baby TP needs to fit with the mothers’ mental health | 4 | −1 |
7 | Baby TP should be flexible to the mothers mental health status | 2 | 3 |
8 | Baby TP will be fluid and flexible | −1 | 0 |
9 | Baby TP will be flexible to cope with unplanned events | 0 | 4 |
10* | The facilitator needs to be skilled in their explanation of Baby TP | 1 | 1 |
11 | Staff rolling out Baby TP need to have a thorough knowledge about mother and baby | 1 | −2 |
12 | Baby TP will make women’s anxieties about their ability to parent worse | −3 | −4 |
13 | It is important for staff to be able to answer questions about Baby TP | 4 | 2 |
14 | Baby TP is a reactive response from “anxious” professionals | −5 | −4 |
15 | Staff need to believe that Baby TP benefits the mother | 1 | 0 |
16 | The techniques of Baby TP flow through to the staff on the MBU | −2 | 1 |
17 | It is important that all staff know which mothers are using the Baby TP techniques | 2 | −1 |
18 | It is important that the mother thinks Baby TP is worthwhile | 4 | 1 |
19 | It is important that mothers are open to change | 2 | 4 |
20 | If the mother has unchangeable situations at home, Baby TP is not going to be helpful | −4 | −6 |
21 | Mothers want to be recognised for the work they are doing in Baby TP | 0 | 2 |
22 | Baby TP is “preachy” | −5 | −3 |
23 | People providing Baby TP should only suggest techniques | −1 | −3 |
24 | A trusting relationship with the Baby TP therapist is important | 5 | 3 |
25 | One-to-one work will make it easier for mothers to say when they find Baby TP difficult | 5 | 1 |
26 | If the relationship between the Baby TP facilitator and mother is not working, neither will Baby TP | −1 | 0 |
27* | It is important that Baby TP complements what staff already know | −1 | −1 |
28* | Doing Baby TP will make mothers feel like “bad parents” | −6 | −6 |
29 | Baby TP might make people feel like they are being unfairly judged or blamed | −4 | −3 |
30 | It is important that mothers doing Baby TP can gauge their progress | 4 | 2 |
31* | It is important for mothers to feel they have achieved something | 5 | 5 |
32 | Baby TP is an extra thing to engage in and will make mothers feel overwhelmed | −4 | −5 |
33 | It is OK for Baby TP to be challenging for mothers | 0 | 3 |
34 | Mothers should have ongoing support in doing Baby TP | 3 | 2 |
35 | It is important that the mother’s family are open to change | −1 | 0 |
36 | Baby TP will help develop skills that can help deal with family problems | −1 | 6 |
37* | It is important that Baby TP sessions do not interfere with family visits on the MBU | −2 | −2 |
38 | It is important that mothers feel in control and responsible for Baby TP | 2 | 0 |
39 | Well delivered Baby TP will maintain overall confidence in the MBU | 1 | 0 |
40 | Baby TP will be helpful for mothers to meet their parenting needs | 2 | 6 |
41 | If a mother is severely depressed, they will not have the motivation to do Baby TP | 1 | −2 |
42 | Whilst staying on the MBU it is easy for mothers to commit to Baby TP | −2 | 2 |
43* | In order to engage in Baby TP, staff expect mothers to be open to learning | 0 | 0 |
44 | Baby TP will use all the mothers energy and focus | −6 | −4 |
45 | It is important that the Baby TP therapist works with both mother and baby | 4 | −3 |
46 | Baby TP will address mothers feelings of uncertainty | 0 | 1 |
47 | It is important that Baby TP engages with the current situation and needs of the mother | 6 | 4 |
48 | It is important that mothers have a positive attitude towards recovery from illness | 2 | 1 |
49* | Taking part in Baby TP will be a positive experience | 1 | 1 |
50* | It is important that mothers discuss Baby TP with other like-minded people | −3 | −3 |
51* | There is no opportunity to practice the Baby TP skills on the MBU | −6 | −6 |
52* | It is important that Baby TP is easy for mothers to do | −1 | −1 |
53* | Baby TP will be about what has gone wrong for mother and baby | −5 | −5 |
54 | Baby TP needs to emphasise the positive so as not to make the mother’s mental illness worse | 2 | 3 |
55 | The way Baby TP is presented to mothers will be important | 3 | 0 |
56 | It is important that Baby TP does not go against what mothers already know | −1 | −4 |
57* | It is important for the mother to recognise what she has done well | 5 | 5 |
58* | It is important for the mother to recognise what she could have done differently | 2 | 2 |
59* | It is important for the mother to recognise what she has done wrong | −2 | −2 |
60 | Staff need to think about what parts of the Baby TP would be helpful for mothers | 3 | 0 |
61 | It is important to encourage staff to reflect | 0 | 3 |
62 | Staff need support and training to feel confident in delivering the Baby TP skills | 6 | 3 |
63 | All staff should have the same training in Baby TP | 1 | 0 |
64* | It is important that both staff and mothers will find Baby TP enjoyable | 1 | 1 |
65 | Staff have too much work to do to support Baby TP skills adequately | −4 | −5 |
66 | Baby TP will be easily incorporated into the workload of staff | −2 | −1 |
67 | Baby TP should not have too much paperwork for staff to do | −3 | 2 |
68* | It is important that Baby TP only takes a small amount of staff time | −3 | −3 |
69 | Baby TP should be a priority for the MBU | −2 | 2 |
70 | Baby TP should not get in the way of other MBU work | −3 | −2 |
71 | Baby TP is about learning new skills | 0 | 1 |
72 | Baby TP provides a safe place for mothers who have mental health issues | −2 | −1 |
73 | It is important Baby TP will highlight the importance of mothers looking after themselves | 0 | 5 |
74 | Engagement with mothers must be the priority in Baby TP | 3 | 5 |
75 | Doing Baby TP would make mother’s feel exposed or a bad mother | −4 | −5 |
76 | Staff attitude affects engagement on Baby TP | 1 | 4 |
77 | Mothers want factual information about parenting | 0 | 4 |
78 | Practical materials are essential | −2 | 3 |
79 | Baby TP comes at the wrong time | −5 | 0 |
80 | The Baby TP therapist needs to really sell the programme to mothers | −3 | −1 |
81 | It is important for all staff on the MBU to have a clear role within Baby TP | 3 | −2 |
82* | All staff should support what is done in Baby TP | −1 | −1 |
83 | It is important that mothers and Baby TP therapists work together to solve the mother’s problems | 2 | 1 |
84 | It is important that staff understand why Baby TP works | 6 | 0 |
85 | Mothers being able to make choices in Baby TP is important | 3 | −1 |
86 | Mothers should decide when they want to do Baby TP sessions | 0 | −2 |
87 | Mothers need to know what they can do and cannot do for Baby TP to work | 0 | −2 |
88* | Baby TP needs to be based on common-sense | −2 | −2 |
Factor loading | No. | Professional title | Experience (Years) | Previous knowledge of parenting interventions |
---|---|---|---|---|
1 | 2 | Nursery nurse | 17 | General knowledge and ward experience |
1 | 3 | Staff nurse | 14 | Degree in Psychology |
1 | 4 | Nursery nurse | 31 | General knowledge and ward experience |
1 | 5 | Assistant ward manager | 2.5 | General knowledge and ward experience |
1 | 6 | Staff nurse | 3 | General knowledge and ward experience |
1 | 9 | Nursery nurse | 23 | General knowledge and ward experience |
1 | 10 | Senior staff nurse | 32 | General knowledge and ward experience |
1 | 11 | Nursery nurse | 9 | General Knowledge and ward experience |
1 | 12 | Nursery nurse | 34 | Baby TP presentation and general knowledge |
1 | 14 | Staff nurse | 0.16 | General knowledge and ward experience |
2 | 1 | Psychiatry—specialist trainee | 7 | General knowledge and ward experience |
2 | 7 | Ward manager | 7 | General knowledge and ward experience |
2 | 8 | Support worker | 10 | General knowledge and ward experience |
2 | 13 | Staff nurse | 5.5 | General knowledge and ward experience |
2 | 15 | Psychiatry—specialist trainee | 6 | General knowledge and ward experience |
2 | 16 | Consultant psychiatrist | 22 | Webster Stratton, parent-child game |
Factor 1: Staff Qualified Acceptance
“I don’t know as much as I would like to know about Baby TP but my understanding is that it is driven from a needs-led perspective, from mums’ perspective and it is not about us, it is about helping people to be successful parents.” (Participant 3)“…We all need to be singing from the same song sheet although I think it should be done by one main person really, who is trained.” (Participant 11)
Factor 2: Systemic Approach/Systemic Results
“I think it is like with any talking or psychological therapy, if you can only do it in the session or in a particular situation and you can not translate it into your everyday life, it would not be very useful.” (Participant 16)“I think that you would be hoping that they would be able to take these skills and use them in the community so it is not just about coping whilst they are in hospital but also with life in general.” (Participant 15)