Journal o f Clinical Psychology in Medical Settings, VoL 1, No. 3, 1994
Training Program in Psychosocial Intervention for High-Risk Infants and Their Families Barry M. Lester 1,3 and Elaine C. Meyer 2
A multidisciplinary training program for psychosocial intervention in the Neonatal Intensive Care Unit (NICU) was developed. The purpose of the program was to train mental health and health care professionals in a psychosocial preventive intervention model for high-risk infants and their families throughout the infants' hospital course in the NICU. The program was divided into modules that include assessment and intervention with the infant, parents, family, and larger caregiving environment. Over a 3-year period 40 trainees from 9 disciplines were trained. A randomized clinical trial was conducted which showed the positive effects of the intervention. A clinical service including inpatient and outpatient follow-up has been established in the NICU based on the psychosocial model developed from the training program. KEY WORDS: training; family-based; psychosocial; Neonatal Intensive Care Unit; preterm; high-risk infant; multidisciplinary.
INTRODUCTION
The concept of family-based psychosocial intervention as part of standard clinical care in the Neonatal Intensive Care Unit (NICU) has received increased attention (Harrison, 1993) and will require specialized training. The purpose of this article is to describe a psychosocial training program 1Brown University School of Medicine, Women & Infants' Hospital, and E. P. Bradley Hospital, Providence, Rhode Island. 2Brown University School of Medicine, Women & Infants' Hospital, Providence, Rhode Island. 3To whom correspondence should be addressed at Women and Infants' Hospital, 101 Dudley Street, Providence, Rhode Island 02905-2499. 217 1068-9583/94/0900-0217507.00/0© 1994PlenumPublishingCorporation
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developed for the National Institute of Mental Health (NIMH). The program was conducted over a 3-year period to develop a curriculum and training model. Videotapes and training materials are available as are trainers to provide on-site clinical training and supervision as necessary. In our own institution, following the completion of the training program, we conducted a study (Meyer et aL, 1994) in which families in the NICU were randomly assigned to a psychosocial intervention group or a standard care control group. This study showed positive effects of the intervention both on infant behavior and on parental attitudes and feelings. Following the documentation of significant intervention effects, the Women and Infants' Hospital adapted the psychosocial procedures into a new clinical service in the NICU. This service, called the Infant Development Unit, provides psychosocial services for infants in the NICU and their families. Thus, we have gone from the development of a model through the training program to the documentation of the program's effectiveness through an experimental study to the establishment of a clinical service. In this article we describe the training program so that others may take advantage of what we have learned. The purpose of this program is to train health care professionals in a psychosocial preventive intervention model with high-risk infants and their families. Preterm infants (born
Training Program in Psychosocial Intervention for High-Risk Infants and Their Families Barry M. Lester 1,3 and Elaine C. Meyer 2
A multidisciplinary training program for psychosocial intervention in the Neonatal Intensive Care Unit (NICU) was developed. The purpose of the program was to train mental health and health care professionals in a psychosocial preventive intervention model for high-risk infants and their families throughout the infants' hospital course in the NICU. The program was divided into modules that include assessment and intervention with the infant, parents, family, and larger caregiving environment. Over a 3-year period 40 trainees from 9 disciplines were trained. A randomized clinical trial was conducted which showed the positive effects of the intervention. A clinical service including inpatient and outpatient follow-up has been established in the NICU based on the psychosocial model developed from the training program. KEY WORDS: training; family-based; psychosocial; Neonatal Intensive Care Unit; preterm; high-risk infant; multidisciplinary.
INTRODUCTION
The concept of family-based psychosocial intervention as part of standard clinical care in the Neonatal Intensive Care Unit (NICU) has received increased attention (Harrison, 1993) and will require specialized training. The purpose of this article is to describe a psychosocial training program 1Brown University School of Medicine, Women & Infants' Hospital, and E. P. Bradley Hospital, Providence, Rhode Island. 2Brown University School of Medicine, Women & Infants' Hospital, Providence, Rhode Island. 3To whom correspondence should be addressed at Women and Infants' Hospital, 101 Dudley Street, Providence, Rhode Island 02905-2499. 217 1068-9583/94/0900-0217507.00/0© 1994PlenumPublishingCorporation
218
Lester and Meyer
developed for the National Institute of Mental Health (NIMH). The program was conducted over a 3-year period to develop a curriculum and training model. Videotapes and training materials are available as are trainers to provide on-site clinical training and supervision as necessary. In our own institution, following the completion of the training program, we conducted a study (Meyer et aL, 1994) in which families in the NICU were randomly assigned to a psychosocial intervention group or a standard care control group. This study showed positive effects of the intervention both on infant behavior and on parental attitudes and feelings. Following the documentation of significant intervention effects, the Women and Infants' Hospital adapted the psychosocial procedures into a new clinical service in the NICU. This service, called the Infant Development Unit, provides psychosocial services for infants in the NICU and their families. Thus, we have gone from the development of a model through the training program to the documentation of the program's effectiveness through an experimental study to the establishment of a clinical service. In this article we describe the training program so that others may take advantage of what we have learned. The purpose of this program is to train health care professionals in a psychosocial preventive intervention model with high-risk infants and their families. Preterm infants (born
