PAIRS workforce development
PAIRS is a specialist parent-infant relationship service and is part of LEAP and South London and Maudsley NHS Foundation Trust (SLaM).
PAIRS is based within Lambeth CAMHS and offers direct clinical interventions including Parent-infant psychotherapy, video based interventions and parent/baby groups to families. PAIRS also offers training, supervision and consultation to the wider Lambeth early years workforce which includes:
- Reflective supervision for parenting workers and children's centre practitioners in the borough who facilitate Circle of Security-Parenting (COSP) groups.
- Reflective supervision for midwives and health visitors delivering the Baby Steps antenatal group programme.
- Training to early years professionals across the borough
- Consultation to early years practitioners including a joint consultation space with the Lambeth Perinatal Mental Health Team.
Implementing and scaling up Circle of Security Parenting
COSP was designed by Circle of Security International with broad implementation in mind. The model is intended for use by registered facilitators who may not have therapeutic training, without the need for extensive post training, so is suitable for early years or community workers. The PAIRS team, along with a number of Better Start Workers, trained in the model in 2018 and began to deliver groups to parents/carers in the LEAP area, which covers approximately 20% of Lambeth. This model worked well in the local children’s centres as a Better Start co-facilitator could support the parent/carer outside the sessions and assist with the recruitment of families, and the venue could provide a creche space for participants’ children. Experience highlighted the helpfulness of providing an opportunity for facilitators to share their thoughts, feelings and experiences in connection to their work with the group.
In 2020, after the successful delivery of COSP groups and positive feedback from professionals, partners agreed that COSP would be included in Lambeth Council’s borough-wide parenting offer. Two new parenting posts were created in the council to lead on co-facilitating the groups with Better Start Workers and more practitioners undertook COSP training.
Supporting practitioners in their work with families
The PAIRS team agreed to provide a reflective supervision space online to co-facilitators delivering COSP groups after each session.
PAIRS also identified a need for some broader, locally-tailored preparation for newly-trained COSP facilitators, since COSP training primarily focuses on the evidence base and COSP model. The team led six online workshops addressing issues relating to group delivery, such as managing group dynamics and collecting outcomes measures. The workshops and reflective supervision enabled the workforce to share their experiences and expertise in parenting work and provided practical solutions to setting up and delivering groups, covering all sessions and pre-post sessions.
PAIRS also supported the set-up of a COSP café, which is now led by the two Parenting Workers leading on COSP. The COSP café is an online space for co-facilitators to meet during and post groups to share reflections. As the expansion of COSP in Lambeth coincided with the Covid-19 pandemic, training and support for facilitators was initially offered online and continues to be the preferred mode of delivery.
Feedback from COSP facilitators
“I look forward to supervision every week as a way to help me process what has happened in the session and why things went the way they did (good or challenging). It gives me space to offload and gain perspective so that I don't need to carry the group with me for the rest of the week. It also helps to remind me that just because there is rupture, doesn't mean there can't be repair, and that helps to boost my confidence as a facilitator”.
“Without supervision "being hands" for us as facilitators, we would have been less able to "be hands" for the group. I think there would have been more drop-off from parents and the group would have been less successful without the support offered to us”.
The impact of PAIRS on Lambeth's workforce
Responsibility for COSP delivery has now fully transitioned from PAIRS to the local authority. Band 8a clinicians in the PAIRS team provide reflective supervision for up to four groups per term.
PAIRS has successfully implemented COSP in Lambeth, enabled its scale-up to reach many more families, and continues to support the local workforce to deliver the intervention and embed Circle of Security principles in their wider practice.
LEAP is currently designing an evaluation to better understand PAIRS' wider impact within Lambeth, building on routine monitoring data collected since the service launched.