P.A.I.R.S. group programs are for parents experiencing difficulties following the birth of their baby. Sometimes these difficulties arise from medical or surgical problems during the pregnancy or birth (for mother or for baby), or from traumatic birth experiences or prematurity of baby, from prolonged sleeplessness or anxiety or depression in the parents, or from a colicky or reflux baby who is difficult to settle.

Adverse life events can impact on the parenting experience, as can family of origin issues. All these factors can interfere with the parent-infant relationship, which means the experience of parenting is less enjoyable than it might otherwise be.

Parent-child relationship difficulties may have arisen due to premature births, maternal post-natal depression, illness, family of origin issues or other adverse life events. Each program consists of ten weekly two-hour groups. Groups include up to eight mothers and infants under two years of age.

Group programs facilitators are multi-agency and multi-disciplinary. They have included Maternal Child and Health Nurses, a Medical Officer, Child Psyciatry Regristrars, Psychologists and a Physiotherapist from Specialist Children’s Services and Psychologists from Southern Health and other health care networks.

Referrals are accepted from welfare agencies, maternal child health nurses, doctors, paediatricians, mental health programs and other related agencies.

The program was piloted as a joint venture between Frankston Maternal and Child Health, Specialist Children’s Services, and Monash Medical Centre Child Psychiatry in 1996.

P.A.I.R.S. group programs run for 10 weeks, with 2 hourly sessions each week. Infants and parents spend 45 minutes in a conjoint group. Then the infants and parents spend 45 minutes in separate groups that run in parallel. The mothers and infants then rejoin for a combined discussion and farewell (30 minutes).

The aim of the conjoint session is to improve parenting skills and confidence by understanding the children’s behaviour as well as the parents’ own needs and reactions. Parenting skills are developed through observation of other mothers and babies, and through working with staff to match the individual needs of each mother and baby. Mothers are assisted to develop relationships with their infants using activities such as play, singing, dancing, and baby massage. After returning from the separate sessions, the infant therapists provide feedback to the mothers about the infants’ activity while the mothers were absent. The therapists provide feedback about the themes of the mother’s group, allowing the mothers to reflect on their own situations.

Mothers are able to have a tea or coffee break apart from their infants. This session provides a safe forum to explore more intensely their ambivalent feelings about motherhood. Issues related to the experience of pregnancy, childbirth, and management of their infant, as well as partnership and life changes which come with the transition to parenthood are discussed.
As well as receiving professional support, the mothers are supported by each other and encouraged to develop new self-help skills.

In the separate group, supported by professional therapists, infants have the opportunity to develop an awareness of other infants and to become more actively engaged with a therapist and to play with each other.

A written report is provided to the family and the referrer after the group. Future management decisions are negotiated with the initial referring worker and the family.
Some families form their own play groups or join other long term community groups at the end of the P.A.I.R.S. program.

The effectiveness of the P.A.I.R.S. program has been assessed as part of a research project funded through an innovative grant by the Department of Human Services in 1997. Assessment of the infant’s development, the mother-child interaction, and maternal depression is undertaken pre-group and post-group. Feedback regarding this assessment is provided to referrers and families as part of the written report. The program will continue as part of core business for CAMHS. The findings of the research have been very positive and an article describing outcomes illustrated by three case studies is in press for January 2010.

Enquiries

Program Coordinator: Dr. Jan C. Smith
Telephone: Telephone/Fax: +61 3 9681 6990
Mobile:+61 416 297354
Email: enquiries@pairs.net.au

Training Programs

Training programs may be conducted onsite by arrangement. Workshops can be held periodically on request at regional and interstate sites. Supervision and consultation is available via email or phone by arrangement.

Newsletter

• An article entitled "A Decade of Parent an Infant Relationship Support Group Therapy Programs" will be published in the International Journal of Group Psychotherapy, Volume 60 Number 1, 2010.
• PAIRS programs around Australia report that: Twenty programs have now been conducted by Sophia Constantiides and colleagues at Wundeela, Ringwood East Hospital in Melbourne. Sophie is planning the 21st PAIRS Group for early 2010, proposed for the Knox/Ferntree Gully Region of Eastern Health.
• In NSW, John McMillan and Bec Young who trained in Canberra in 2008 wrote that they completed their first PAIRS group by December, 2008. “A student on placement with us was valuable in assisting with the process and overall we are encouraged by the results from client and facilitator assessment, including our own responses. In 2009 Bec added “I ran a second PAIRS group in term 2 this year. Had planned for a third during the latter part of the year but unfortunately didn’t get enough referrals. However, the group is very well supported by the mental health manager, and various other agencies including DoCS, Centrecare, Division of General Practitioners and Community Health, so I’ll be offering it again early 2010. She continues I was much happier with the running of the second group, ‘pactice makes perfect’ as the saying goes! The wonderful singing voices were even more in tune! I was only able to do post- group assessments for two of the five families, due to relocation and health issues. Those two had quite significant improvements though, which was lovely to see. Well done with the publication and thanks for keeping in touch with us.
• At mid year 2009 Yvonne Poels wrote from Canberra “we have an ongoing commitment to PAIRS - in partnership with a few other agencies. These include ourselves (CAMHS), the Child and Family Centres, ACT Health, the Domestic Violence Crisis Service. We spent a lot of time before the first group sorting out a whole range of referral processes. Hilary Ferguson and the other facilitators have also firmed up the program so they're clearer about content and rationale for some aspects such as the parent sessions. We ran our first group last year and are one week into our second group. I believe that a group will be able to start on the Northside of Canberra some time this year as well. Even though we have tried to target not the really pointy end, this is the group we seem to come up with. Parents presenting with a range of issues. I have copied Hilary into this email as she is our main organiser and one of our facilitators of PAIRS. She might like to give you a brief picture of the mix of women. We are working in partnership with the University of Canberra with a Psychology Masters student, Jannah Keighran. She is conducting a piece of research, basically to see if we can replicate the results you have achieved. So each group is quite involved in terms of pre and post assessments. However, worth it at this stage. All in all, we see great value in PAIRS for those who have attended. And it's been a great PD exercise in itself for those running it.

P.A.I.R.S. Resources

PAIRS Resource Order Form Dec 09