www.videointeractionguidance.net

Colwyn Trevarthen (1970s)

Harrie Biemans ( 1980s)

Claske Houwing( 1990s

Hilary Kennedy and Raymond Simpson1993

And now ……………….

From Scotland to the Netherlands and back

Social Work

Health

Education

Charity

University postgraduate

AVIGuk Projects in UK March 2012

80 AVIGuk supervisors

750 trained practitioners

At least 500 in training

by using edited video clips of “better than usual” interaction of the client

in interaction with someone important to them

and supporting reflection and increase awareness within a collaborative mediated dialogue

which increases sensitivity and emotional attunement to the infant or child

reduces stress and increases self-confidence

inspires hopefulness and joy in disadvantaged contexts

activates clients to solve their own problems

VIG WORKS?

DVD

5. Child‘s Response (second turn)

6. Parent‘s Reception

4. Child‘s Reception

1. Child‘s Initiative 2. Parent‘s Reception

3. Parent‘s ResponseNew initiative

Eg child points at balland looks back at parent

Vigorous nodAnd returns look fromball to parent

Pulls parent towards ballAnd points again looking Back at parent

Returns look to child, smiles

and then looks towards ballsaying ‘ball’

Parent gets ball down for child

and gives it saying ‘there you are’ .

With friendly look and tone

.

Saying ‘Yes, you can see the ball up

high. I think you want it’.

In approving tone, looking from ball to

child

Interaction can continue

Context

The core principle for attuned interaction

% change in CARE-index sensitivity of parent to infant4-6 VIG sessions over 8 weeks

8-14 indicates ‘good enough’ 4-7 indicates ‘of concern’ 0-3 indicates ‘seriously compromised’

BEFORE VIG n=14Mean CARE-index sens 5.92

% good enough% of concern% seriously compromised

BEFORE CONTROL n= 25Mean CARE-index sens.7.16

% good enough% of concern% seriously compromised

AFTER CONTROL n=25 (5-47 wks)Mean CARE-index sens. 6.92

% good enough% of concern% seriously compromised

AFTER VIG n=14Mean CARE-index sens. 9.57

% good enough% of concern% seriously compromised

Kennedy, H. & Robertson,M. 2009

• Increases maternal reflective function and mind-mindedness key transmitter of secure attachment

• increases sensitivity and emotional attunement to the infant or child key transmitter of secure attachment

VIG is so useful precisely because it

Jane Barlow University of Warwick2011

Kim’s video

May 2012 Draft NICE Guidelines

Key recommended intervention For all those involved in the social and

emotional well being of In children 0-5

• Cochrane Review – Does VIG enhance Parental Sensitivity?

V ideo

I nteraction

G uidance

An intervention for changeUK and international standardsDeveloped in the Netherlands

V ideo

E nhanced

R eflective

P ractice

A method for reflective PracticeDeveloped in the University of Dundee

discordant cycleattuned cycle

VERP supports change from a battle of messages to a learning conversation

BATTLE OF MESSAGES

VIG supports changes from the NO- to the YES- Cycle

LEARNING CONVERSATION

BEING ATTENTIVE

ENCOURAGING INITIATIVES

RECEIVING INITIATIVES

ATTUNED INTERACTION

GUIDING

DEEPENING DISCUSSION

Par

ent

led

1. TOWARDS

INTERSUBJECTIVITY Pre-requisite for

building attuned interactions

2. INTERSUBJECTIVITY

The core of attuned

interactions

3. MEDIATED LEARNING

Developing the attuned relationship

Building blocks for parent as care-giver

Possible impact of each block for child as care-seeker

Feels love, recognized and important

Knows their parents are interested in what they are

doing and their wishes

Experiencing being received, parent commenting on what

they are doing and their wishes

Enjoys interacting with their parent

Enjoys being helped and learning from their parents

Is helped to manage difficult situations or learn new things

Check list for attunement inconversations

Foundations for attunementAre you being attentive by Looking interested Turning towards Giving time and space Smiling Friendly intonation and posture wondering what they are doing, thinking, feeling

Are you encouraging initiatives by Waiting Using friendly intonation Listening actively Looking for initiatives Naming postively what you see, hear, think, feel tabout them Name what you are doing, thinking , feeling

Initiative & Reception

Are you receiving their initiatives by

Showing you have heard, noticed their initiative Receiving with body-language Being friendly and/or playful as appropriate Returning eye-contact, smiling, nodding in response Receiving what they are saying or doing with words Repeating/using their words or phrases

 

Attuned Interactions

Are youdeveloping an attuned interaction pattern by

Receiving and then responding Checking they are understanding you Waiting attentively for your turn. Having fun (if appropriate) Giving a second (and further) turn on same topic Giving and taking short turns Interrupting long turns in the yes-cycle Contributing to interaction / activity equally Co-operating - helping each other

Developing the relationship

Are you giving guidance by Extending, building on their response Judging the amount of support required and adjusting Giving information when needed Providing help when needed Offering choices that they can understand Making suggestions that they can follow

Are you deepening the discussion by Supporting goal-setting Sharing viewpoints Collaborative discussion and problem-solving Naming difference of opinion. Investigating the intentions behind words Naming contradictions/conflicts (real or potential) Reaching new shared understandings Managing conflict (back to Being attentive and receive initiatives aiming to restore attuned interactions)

Analysis of 8 minutes consultation

A B C

No of turns in 8 mins (480 secs.) 28 26 30

Total length of turns in seconds (480 secs) 354 375 385

Average length of turn 12 14.5 12.5

Longest turn 90 61 55

Number of very short turns 5 0 7

Number of turns by category of Consultant C and Patient C

0 5 10 15 20 25 30 35

minimal response

acknowledges

name action

name feelings

giving information

propose strategy

seeking closed question

seeking open question

gives opinion

checking for reception

checking understanding

No of contributions in 8 mins

Patient C

Consultant C

Number of turns by category of Consultant B and Patient B

0 1 2 3 4 5 6 7 8 9 10

minimal response

acknowledges

name action

name feelings

giving information

propose strategy

seeking closed question

seeking open question

gives opinion

checking for reception

checking understanding

No of contributions by category

Patient B

Consultant B

GETncm/justsaycust-recrate-itemcommunittg/stores/dtg/stores/d-favorite-listruejust-say-no

Number of turns by category of Consultant A and Patient A

0 5 10 15 20 25

minimal response

acknowledges

name action

name feelings

giving information

propose strategy

seeking closed question

seeking open question

gives opinion

checking for reception

checking understanding

No. of Contributions in 8 mins.

Patient A

Consultant A

Number of turns by category of consultant and patient in 8 mins

0

5

10

15

20

25

30

35

ConsultantA

Patient A Consultant B Patient B Consultant C Patient C

minimal response

acknowledges

name action

name feelings

giving information

propose strategy

seeking closed question

seeking open question

gives opinion

checking for reception

checking understanding

Perspectives

Angela Roger Lynn Kelly

University of Dundee

VERP in a Child Protection Environment: empowerment or surveillance?

VIG 24 May 201216:54

What did we find?We hypothesised that VIG might be considered a form of surveillance or control in a CP context

What we found was:• Participants found the experience of the teaching to be ‘luxurious’ and

‘nurturing’

• Participants did not use the video, but used the ‘principles’ on ‘a daily basis’

• Participants found that the teaching most helped them in their working relationships and communication, many used it as a tool for supervision

• Participants found it helped them to ‘get more information’ from clients

• Participants found it helped them reflect on their own behaviour and practice

• Participants did not immediately consider issues of surveillance or power but came to consider it as part of the interview ……to be followed up

BLUEBIRD HOUSE

Introducing VERP in a Secure Adolescent Psychiatric Hospital

Group 1 – March 2012

WendyOT Team Leader

OllieConsultant Psychiatrist

EmilyHCSW

JackieConsultant Psychologist

Helen WAssistant Psychologist

GailDeputy HeadTeacher

LeanneHCSW

KarenWard Manager

TimSenior Nurse

HelenVIG Supervisor

MartinVIGSupervisor

Participant’s Hopes for Training

Opportunity to improve and reflect on my own interaction skills

To be in a position to promote VIG across the unit through clinical supervision and other avenues

Learning from other members of the multi disciplinary team

How I can help young people and their families build better relationships through communicating effectively

To have another and very different skill to support my team

To contribute to developing a culture of identifying and reinforcing positive skills and achievements of staff and young people

www.videointeractionguidance.net

2 Chapters on VERP

Calum and Sandra StrathieIntroduction to VERP coursesandVERP in DundeeChildren’s homes

CARE Accolade award

Cave, Roger and YoungUniversities of Newcastle and DundeeVERP in Higher Education

http://www.youtube.com/watch?v=6XNxYLthKB4