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Attachment 1: Father-inclusive practice, an inspirational case study

DEVELOPMENT OF A FATHER’S GROUP IN A NEONATAL INTENSIVE CARE UNIT (NICU)

Richard Fletcher Father’s Role in Family Services: The Engaging Father’s Project [online]. In: Focus on Fathering; pages: 125-141. Sullivan, Robin (Editor). Camberwell, Vic.: ACER Press, 2003.

The idea of the fathers’ group had arisen from an incident in the unit where a father of a long-stay baby reacted angrily to a perceived variation in the baby’s care and exploded into an angry outburst. The police were called and staff were understandably upset, especially since many had come to know (and like) the father concerned. In the following weeks, discussion of the situation of fathers in the unit led to the Engaging Fathers Project being contacted. After some discussion, a NICU Fathers’ Group was established.

The group was advertised (with an emphasis on the benefits to their baby) with three core information/skills topics: Cardio Pulmonary Resuscitation (CPR) training, Home Safety and Baby Positioning. A letter from the Director explaining why the group was being established was given to all mothers in the Unit. The first group started with a 30 minute CPR demonstration and then practice on an infant dummy conducted by male nursing staff. The discussion of fathering issues was facilitated by the male nurses and the father worker (Richard Fletcher). Fathers did attend, but only in small numbers. On many nights when the group was scheduled, there were only three or four fathers in the unit so that the potential pool of fathers was small.

Once the discussion of fathers’ experiences commenced, most participants were willing to contribute and on several evenings the facilitators had to insist on finishing the sessions after two hours of discussion. Topics ranged from recounting stories of birth and entry to the NICU to discussion of coping strategies and relationship difficulties. In general, the men were complimentary about the medical and nursing staff and appreciated the chance to learn skills such as CPR. We directed the discussion from ‘safe’ to ‘challenging’ topics. For example Home Safety flowed from door clips and hot water settings to ‘Shaken Baby Syndrome’ and anger management. For all the men attending the experience of arriving at the unit was disorienting and stressful. While they could see that their partners made numerous contacts with other mothers at the unit, they did not approach other fathers (other fathers, if asked ‘how is it going?’ might be emotionally upset).

Comments from the fathers as they left indicated that they appreciated the chance to talk about their experiences and feedback from nursing staff confirmed fathers’ appreciation of the group. Nursing staff also reported that young fathers seemed more involved and more confident after the groups. Staff were willing to recommend the group to parents who they encountered in the unit.

An important factor in the senior nursing staff commitment to fathers’ involvement came through the documentation of fathers’ lack of involvement. The Partnerships in Care sheets used in the unit to record parents’ intention to visit and participate were reviewed. Only two instances were found where fathers’ intention to come in to the unit was recorded. Since many fathers were known to attend, it was clear that the current recording system did not provide an accurate record of fathers’ attendance and needed to be modified. The relevant column on the form was split into two and changed from ‘Parent’ to Mother and Father/Partner.

The numbers of mothers and fathers attending educational sessions was also tallied. For the ‘Handling Your Baby’ educational sessions delivered by a physiotherapist attendance was recorded as:

June – December 2001 January – August 2002
Female Male Female Male
29 9 85 23

For the CPR sessions conducted by nursing staff the attendance was recorded as:

September – December 2001 January – August 2002
Female Male Female Male
34 11 99 29

Although not surprising, the presentation of these results provided additional impetus for the staff to address fathers’ participation in the care of their babies and provoked discussion of alternative arrangements for delivering these sessions.

Attachment 2: Evaluation of the father-inclusive practice guide pilot project– participant’s service profiles

Urbis Pty Ltd, June 2008

A pilot project of the father-inclusive practice guide, which was conducted by Urbis Pty Ltd, commenced in May 2007 and ran until March 2008. The pilot aimed to build on the knowledge and skills of Family Relationship Services Program and Early Childhood Program service providers. Participants in the pilot project have provided the following service profiles. These are intended to assist organisations who use the guide in the future to develop a sense of what types of organisations were involved in the pilot project and how father-inclusive practices can be applied in the workplace.

Sing & Grow, Playgroup Association of QLD, Enoggera, QLD

Sing & Grow is an early intervention project, funded to provide disadvantaged communities with free access to short-term music therapy in a community setting. Australian Government funding from their ‘Invest to Grow’ initiative enabled the program to expand nationally in 2005. Since then more than 320 programs have been conducted around Australia.

Programs involve weekly music sessions (usually 10 weeks) that allow families to participate in hands-on activities designed to assist children with developmental skills and encourage parents to learn new and different ways to use music as a way of interacting and playing with their children. Music is also used as a way to stimulate, develop and nurture family relationships.

Programs are run in conjunction with community organisations. Families with children aged up to 3 years are eligible to participate, with an emphasis on families experiencing pressures that impact upon the resources and confidence of parents. Families can be referred to Sing & Grow through an organisation that is supporting them in their community.

Prior to participating in the Department of Families, Housing, Community Services and Indigenous Affairs father-inclusive practice program, 94 per cent of carers who attended Sing & Grow sessions with their children were women. Sing & Grow managers were keen to increase the participation of fathers. It was felt that the structure of the program had good potential to appeal to fathers as it involves active and ‘hands-on’ activities that enable men to engage with their children and has the capacity for some flexibility in terms of when sessions are run so working fathers can attend.

Working with their mentor assigned through the father-inclusive practice pilot, Sing & Grow managers developed several goals for increasing the involvement of fathers. It was decided to work toward these goals in NSW, with a view to expanding fatherinclusive practice nationally in the future. The goals were:

Initially

Then

The success of the program would be measured by: an increase in the number of fathers attending; fathers’ satisfaction; observable engagement of fathers in sessions; and positive responses by community organisations. Project level changes would be measured by: updated protocols for management team; session leaders all participate in training; and Sing and Grow literature updated to be more father-inclusive.

Strategies to achieve these goals included:

There was an 85 per cent increase in men’s participation in Sing & Grow in NSW for the sessions during which the program was trialled. There was also a 400 per cent increase in the number of men attending who identified as their child’s primary carer. The fathers’ feedback survey indicated that they were satisfied with both the program and the session leader and valued the benefits of the program to their child. Some fathers reported that the program assisted them with various aspects of their child’s development such as teaching their child to count and encouraging language development.

Training in father-inclusive practice for Sing & Grow session leaders was held in Brisbane, Sydney, Melbourne and Adelaide. Training focussed on the rationale for father-inclusive practice, reviewing father feedback and discussing the experiences and expectations of staff in involving more fathers in the program. Father-inclusive practice is now a regular topic for discussion at in-serves and program set-up. The materials developed, such as the checklist, invitations, flyers and father surveys, will be re-used and refined through subsequent programs.

The response to the father-inclusive practice pilot from community organisations working with Sing & Grow was overwhelmingly positive. Organisations recognised the value of involving fathers and actively participated in recruitment.

Some strategies did not work, or did not go ahead. Initially administrative forms were adapted to collect personal information about fathers required for the invitations. This was found to be ineffective and difficult to complete. Personal approaches to mothers were found to be the best way to engage with fathers. The father-only groups were also not run as fathers clearly indicated they preferred mixed-gender groups.

Centacare Broken Bay, Sydney, NSW

Centacare Broken Bay provides services to children from newborns to primary school-aged, including:

As with all early childhood centres, the staff at Centacare Broken Bay, in the Northern suburbs of Sydney, are extremely busy. So a major challenge for the father-inclusive practice pilot involved identifying strategies to increase the participation of fathers that could be easily integrated into the existing workload of staff. A program which required extra time or work for staff would probably not get off the ground.

Working within these parameters, staff at Centacare Broken Bay developed a model of father-inclusive practice that was simple and easily manageable. Strategies included:

Achievements

City of Greater Dandenong, VIC

The City of Greater Dandenong provides a range of services to support the needs of families and children within the municipality. Services range from Maternal and Child Health (MCH) services to playgroups, child care, education and crisis support.

Dandenong is an outer-metropolitan area of Melbourne. It is a relatively low socio-economic area with a large number of refugees and newly arrived migrants residing in the region, high rental compared to owner-occupied housing rates and large numbers of public housing. The area can be quite isolating for many people, with a number of areas poorly serviced by public transport.

Being a local government service provided unique opportunities for the City of Greater Dandenong to develop a multi-service approach to father-inclusive practice.

A working group was established involving: community health dads’ workers; playgroup development officer; the library; immunisation (environmental health) workers; youth services; and MCH workers. The group met eight times during the father-inclusive practice pilot and was facilitated by the fatherinclusive practice mentor. The group will continue to operate as a network and meet regularly after the pilot program has finished. The group also met with the Children’s Protection Society, another agency involved in the father-inclusive practice pilot.

The working group put a lot of effort into reflecting on practice and planning strategies to become more fatherinclusive. This involved in-depth discussion about what it means to be father-inclusive and ways that cultural change can be implemented in organisations to make them more father-inclusive. The group also became an avenue for planning collaborative practice in a number of areas. Group members will continue to build on this work into the future.

Other strategies implemented include:

Communities@Work, Canberra, ACT

Communities@Work is a community organisation with a broad range of services and programs that support families and individuals with a diverse and complex range of issues. These services include a number of early childhood services, school-aged care, family support, community education, community development programs, parenting courses and a Behaviour Guidance Program.

Communities@Work have a number of strategies in place to support father-inclusive practice. This includes:

While this is just the beginning for father-inclusive practice at Communities@Work, the program has already achieved an increased awareness within the agency of whether programs are father-inclusive. Previously, there was little consciousness of this and no critical assessment of whether programs or services implicitly excluded men.

Good Beginnings, Darwin, NT

Good Beginnings is a national organisation providing early childhood services. Across the country Good Beginnings has a strong history working with fathers, but in Darwin they had to start at the beginning. A number of strategies were trialled to begin with including:

The program has been a big learning curve for staff and has revealed a lot about the way in which service staff can think it is being father-inclusive when it is actually not. However, the service has achieved a lot in terms of increasing staff awareness about how to engage with fathers and starting to build connections with men in the local community. Over time consciousness of father-inclusive practice has filtered across the service as a whole and has become an integral part of practice, ensuring that a focus on father-inclusive practice will be sustained long-term.

Centacare Wilcannia-Forbes, Forbes NSW

Centacare Wilcannia-Forbes provides a range of child and family services and has funding to run programs for men under the Men and Family Relationships Program. Services offered under this program include:

The father-inclusive practice pilot supported all these activities by focussing on enhancing the profile of the men’s work within the organisation. This ensured all staff were more supportive of activities being run with men and fathers and more likely to refer men to services and encourage female clients to talk to their male partners. Strategies to achieve this included:

Produce a flyer advertising the range of men’s activities that all staff can hand to clients.

Producing the flyer was a positive activity for the men’s workers as it presented an opportunity to articulate and reflect on the scope and quality of activities they have established. It also reinforced the important role of the men’s program to other staff within the organisation.

Good Beginnings, Moe, VIC

Good Beginnings La Trobe is located in Moe in regional Victoria. It runs early childhood programs for vulnerable and at risk families and is accessed by people from a range of small towns across the area. Good Beginnings La Trobe implemented a number of strategies as part of the father-inclusive practice pilot including:

One of the challenges involved with introducing father-inclusive practice in this service has come from the need to prioritise services. The playgroups are only small and fathers who are coping well should be moved on to mainstream services to allow space for other parents (fathers or mothers) with higher needs. The need to maintain and encourage the involvement of fathers has to be considered in the context of the broader objectives of the service.

The service has also had to develop strategies for working with men from other cultures, in particular the Sudanese community of which there is a large population in the local area. This has been challenging as attitudes toward parenting differ quite substantially between Sudanese and Australian cultures. Newly arrived migrants are also dealing with a range of other issues related to adjusting to a new culture.

In a rural area it is difficult to get fathers together from a number of towns as the travelling time is so great. There are three separate playgroups in different towns, but to achieve sufficient numbers the fathers’ groups would need to combine towns.

Family Relationships Centre, Traralgon, VIC

The Traralgon Family Relationships Centre provides a number of services including individual and relationship counselling, family dispute resolution and community advice, support and education. Traralgon is a regional centre in the Gippsland region of Victoria, with a population of around 21,000 people.

Working with fathers is an inherent part of the work of the Family Relationship Centre as fathers become engaged with the service through family dispute resolution work and other counselling services. However, the nature of the service also means men are most likely to access it when they are in crisis or at a difficult point in their lives. Father-inclusive practice in this context, therefore, is about ensuring the service environment is welcoming for men and that staff are comfortable and skilled in working with fathers, while also developing specific programs to support fathers.

There are some particular challenges to introducing father-inclusive practice initiatives in regional areas such as Traralgon. Staff of the Family Relationship Centre have observed a fairly traditional view of the role of fathers among the community. Fathers are more inclined to see themselves as the ‘bread-winner’ and are reluctant to become involved in support groups or children’s activities. Distance and geographic isolation are barriers when it comes to organising groups or sessions for men. Men who work full time are often reluctant to spend a long time driving to attend a group session. A lot of men in the Traralgon region also work shift-work, so it is difficult to organise times when a number of men can regularly attend a service or group session. Additionally, in small towns where people are more likely to know other people attending the service, confidentiality can be a concern for some people, discouraging them from participating in support groups.

A major challenge for the father-inclusive practice pilot at the Traralgon Family Relationships Centre was finding ways to recruit fathers to programs, particularly those fathers who are most vulnerable or marginalised. Attempts were made to recruit fathers to a support group through a local children’s contact centre, a strategy that was intended to reach fathers who would not be likely to access services or support in other ways. It was hoped a group could be established that involved fathers at different points in their life – some more stable, some in a more difficult time–so that the group could support each other. A group comprised only of men in crisis would not offer this level of support and the range of perspectives within the group would be limited.

However, recruitment to this group proved difficult. On reflection, it was decided that the creation of men’s support groups would need to be a longer-term objective which introduced the idea to the community gradually. The reputation of the groups would need to be built over time, with a conscious focus on promoting the groups to the community. Once a few men are involved, they can then become mentors and local representatives to help build the profile of the group and encourage more involvement.

Other father-inclusive practice pilot strategies introduced by the Traralgon Family Relationships Centre were to work with Relationship Australia to run a ‘Fathers Using Networks’ (FUN) for kids program, which is a course for fathers run in local schools.

Traralgon Family Relationships Centre also made an effort to ensure the reception area of the service was inclusive of men and included posters of fathers on the walls.

All these strategies, whether or not they were successful in terms of involving men, have increased awareness of father-inclusive practice among staff across the services as well as in partner agencies.

Relationships Australia, Darwin, NT

Relationships Australia Northern Territory (RANT) is a counselling and family relationships agency that offers counselling for individuals, couples and families, family dispute resolution, relationships education courses, professional supervision and a range of other services.

RANT concentrated on three key activities to make the service more father-inclusive:

The success of the above strategies was related to:

Centacare, North West Tasmania, Burnie, TAS

Centacare North West Tasmania delivers a broad range of support and counselling services for adults, children and families, including Family Dispute Resolution. Centacare North West Tasmania also have funding to run men’s programs under the FaHCSIA Men and Family Relationships program.

The service has developed a range of initiatives to become more father-inclusive, some of which link directly into their existing men’s programs while others are simple strategies aimed at making the service more father-inclusive as a whole.

Some strategies at the organisation are:

At the program level, some strategies included:

Centacare North West Tasmania has also achieved a profile in the local community around the work they have done with men. This has resulted in a number of speaking engagements in the local community and media articles highlighting the men’s programs or where Centacare staff have been consulted about men’s issues. This has the dual impact of both promoting the service and the groups and helping to ‘normalise’ men’s involvement in support services and father’s activities.

Other achievements include:

Mundubbera Community Development Association, Mundubbera, QLD

Mundubbera Community Development Association (the Association) provides a broad range of services relating to health and social issues including childcare services, welfare and disability support.

The Association is keen to increase the attendance of fathers at the playgroup for children aged 0-5 years (Pips playgroup). However, the service is limited to running the playgroup in business hours which excludes most working fathers and is a major limitation for father-inclusive practice in this area. Out-of-hours events may be a possibility, but distance is a barrier when it comes to evening or weekend events.Mundubbera is 2.5 hours drive from a major town. This often means that Saturdays are taken up by families travelling to town for shopping leaving only Sundays free.

The local area has been severely affected by drought which has the potential to impact on men’s mental health and wellbeing. A drought focussed group–‘Local Blokes, Local Answers’–has been established. The program will be taken to six local towns and has already been attended by in excess of 150 men. The Association has also launched a ‘mature males’ group. Interestingly, the programs appear to have attracted fathers with older children rather than younger.

The Association is keen to establish more programs for fathers that engage them in practical activities and involve partnering with local agencies. For example, the local Bluelight Association runs an annual billycart race each year, which has the potential to be a great event for fathers and kids to be involved in together. There may also be options for involving fathers in groups or courses that have a practical focus such as mechanics.

Children’s Protection Society, Heidelberg, VIC

The Children’s Protection Society (CPS) provides child and family services and has a specialist therapeutic counselling program for children who have been sexually abused, children with sexualised behaviours and children with sexually abusive behaviours. The service also has funding to run programs for men under the Men and Family Relationships Program. Services offered under this program include:

The following specialist services are also offered by the Men and Fathers Support Program

Father-inclusive practice work linked in with the above programs, but was also focussed on making the service as a whole more father-inclusive. Strategies included:

Agencies for South West Accommodation, Bunbury, WA

Agencies for South West Accommodation (ASWA) provides a range of services including housing support, crisis and supported accommodation, family and parenting programs, youth services and an employment program. ASWA also run programs funded under the Family Relationship Services Program Men and Family Relationships services initiative. ASWA sees a relatively high proportion of male clients. Just over 26 per cent of all clients seen in the parenting program over the past year were men, including a proportion of single or separated fathers.

ASWA’s father-inclusive practice work has included:

Anglican Community Care, Mount Gambier, SA

Anglican Community Care (ACC) provides a broad range of family relationship services including: Men and Family Relationship Services; Family Relationship Education and Skills Training; parenting groups; Specialised Family Violence Services; the Children’s Contact Centre, and most recently was awarded a Family Relationship Centre and Post Separation Cooperative Parenting Program. ACC has its head office in Mount Gambier in South Australia’s South East. Whilst having other regional offices in Berri and Murray Bridge. ACC also operates smaller offices in Naracoorte, Millicent, Bordertown and Waikerie. ACC describes itself as having a father-inclusive focus in place, which has been strengthened by the father-inclusive practice pilot.

Specific activities have included:

Upcoming plans will focus on marketing the service to men, including through a business card product for men, replacing the traditional pamphlet with carpentry pencils with telephone numbers to distribute through the timber mill industry. Other marketing ideas to be explored include a ‘sample bag’ of resources for fathers and a newsletter targeting fathers.

In the long term it would be fabulous to obtain funding for a men’s shed program, providing an activity-focussed space to attract isolated men, including fathers, where access to supports can be promoted and a sense of community can be maintained. Partners in such a venture are likely to include service clubs and sporting associations, particularly where they have stated support for men’s health and well being.

Ngala Parenting with Confidence, Kensington, WA

Ngala is a large service offering multiple programs across several sites in inner, outer and regional areas of Perth. The appointment of a men’s worker some years ago had been a key resource in strengthening father-inclusive practice, for example, the ‘Hey Dad’ program run by Ngala. The father-inclusive practice pilot presented an opportunity to build on this work. Initially the intention had been to focus the project on a specific program area, but the cultural audit tool provided the chance to broaden the effort to a whole of service strategy.

The cultural audit tool was divided into the questions addressing the leadership group and those relevant to program staff, and circulated as a survey across the organisation. 129 staff responded from across nine sites, including managers, full-time and many part-time program staff. As predicted, managers displayed a stronger level of awareness and greater knowledge about father-inclusive practice, and where a program had a father-inclusive ‘champion’, the results for that program area were also stronger.

The survey results also revealed the risk that father-inclusive practice becomes ‘yet another thing’ for staff to ‘do’, rather than being seen as a way of strengthening practice. This fatigue was identified by Ngala as a key barrier to achieving a high standard of father-inclusive practice. Other barriers include the absence of identified workers to generate change at local program levels, and the lack of internal training resources or a training unit to drive the agenda. Without dedicated resources it is easy for father-inclusive practice to be overrun by other more immediate pressures on workers and management.

Ngala is responding to these challenges at two key levels: firstly a tailored training strategy is being developed in response to the gaps revealed through the survey, and secondly, at a whole of service level, father-inclusive practice is being built into the Service Delivery Framework, which is the platform for all the work of the organisation, giving it a status beyond the ‘one more thing to do’ position, and making it central to the way all services are delivered.

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References

15. Information and accreditation