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Think-family approaches to child health
A ‘think-family’ approach aims to assess need and provide services to individuals while appreciating that the health, wellbeing and behaviour of children and their parents (carers) are interrelated. This perspective remains a firm priority in health policy in England and Wales and internationally (also known as ‘family paediatrics’ or ‘whole-family’, ‘family-centred’ approaches or ‘child-centred’ approaches within adult services). We aimed to inform further development and evaluation of think-family interventions within healthcare by reviewing, conceptually defining and giving examples of relevant interventions which have already been implemented. We found that helping the child through the parent (usually the mother) has been a common way of implementing a think-family approach to child health in high-income countries for specific types of parental health need (parental psychosocial problems which potentially affect capacity to parent and can affect child development and health). These interventions took the mother as ‘patient’ and aimed to see ‘the child behind the adult’. Our results suggest that therapeutic relationships may underpin all efforts to help the child through the parent (identify parents and engage and motivate parents to change their behaviour), a hypothesis supported by other relevant reviews. Our results suggest that building these therapeutic relationships appear most feasible within intensive programmatic interventions but that such relationships might also be possible to integrate into existing pathways. We are grateful to the Department of Health and Social Care for funding this study through the previous Children and Families Policy Research Unit. These findings have been published (see publications tab).
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