ACQ Vol 12 No 2 2010

Working with families

Students’ experiences of family-centred strength- based practice in a non- traditional clinical setting Emma Grace, Bernice Mathisen, Graeme Stuart, and Heather Hawes

Family-centred practice Family-centred practice involves a number of values, attitudes and approaches to working with children with special needs and their families (Moore & Larkin, 2005). In family-centred practice, the family, rather than just the child, is the focus of intervention. The family is recognised as “the expert” in relation to the child and the constant in the child’s life. A family-centred approach not only treats families with dignity and respect, but works in partnership with families by ensuring they have the information they need to make decisions about service provision (Dunst, Trivette, & Hamby, 2007). Family-centred practice can be widely applied in speech pathology. In regards to alternative and augmentative communication, it is seen as vital in working with both adults and children, and may reduce issues such as speech generating device abandonment (Goldbart & Marshall, 2004; Johnson, Bloomberg, Perry, & Reilly, 2003). It applies in the area of paediatric swallowing, in which a family commonly experiences grief and loss associated with feeding difficulties in the child (Mathisen, 2009). It is consistent with the principle that, in dealing with complex communication needs, “training and support should be available for all regular and/ or significant communication partners” (Johnson et al., 2003, p. 2). In particular, family-centred practice is seen as critical in the area of special needs (Goldbart & Marshall, 2004). Over the last twenty years, the rights of a person with special needs have been recognised and legalised internationally (Caudrey & Dissinger, 2007), reminding healthcare providers of the centrality of the rights of their clients, and of the importance of developing mutual respect in client–clinician relationships. When working with children, this legislation reminds practitioners of the importance of respecting the needs, rights and expertise of the family as a whole. Treating the whole family as the client is seen as central to family-centred practice. The family is a child’s primary environment and plays a vital role in child development (Watts Pappas, McLeod, & McAllister, 2009). Improving the way individuals function in their natural environment is not only a target of speech pathology, but also a measure of quality of life (Cruice, 2008). The relationship between parents and clinicians is also a central theme in family-centred practice; incorporating mutual respect and participation. Within this partnership, the right of the parent to make decisions is valued and respected (Watts Pappas et al., 2009). Parental decision-

The Special Needs Unlimited Group (SNUG) program of the University of Newcastle’s Family Action Centre conducts camps for children with special needs and their families in rural NSW. At the camps, families access much-needed respite, support and healthcare. SNUG also provides undergraduate speech pathology students with the opportunity to augment their clinical education by becoming SNUG volunteers. Through the camps students experience strength-based, family- centred practice and gain insights into the lives of families living with special needs. This paper addresses the theoretical framework and skills required by SNUG volunteers, and the potential benefits for students in an intensive non-traditional learning environment. T he importance of family-centred practice in healthcare is now widely acknowledged (Watts Pappas & McLeod, 2009). An increase in community-based care, the complexity of client needs, and a deeper understanding of the needs of families have contributed to the relevance of family-centred practice in health service provision in Australia (Caudrey & Dissinger, 2007; Goldbart & Marshall, 2004; McAllister, 2005). A strength-based approach enhances family-centred practice by recognising that parents have many strengths and resources that support their child’s development (Johnson, Cournoyer, et al., 2003). Incorporating both these approaches to healthcare delivery is associated with fewer hospital visits and fosters independence in families, facilitating self-sustaining healthcare benefitting both families and service providers (Caudrey & Dissinger, 2007; Goldbart & Marshall, 2004; Warmington, 2003). The Special Needs Unlimited Group (SNUG) combines these approaches in residential camps for families of children with special needs run by The Family Action Centre at the University of Newcastle and supported by student volunteers. Student learning and professional development is supported by practical experience to facilitate an integrated understanding of practice known as deep learning (Fieldhouse & Fedden 2009). This paper addresses the theoretical framework and skills required as a SNUG student volunteer in a family-centred, strength-based and non- traditional setting.

This article has been peer- reviewed Keywords clinical education family-centred practice rural and remote practice SNUG strength- based practice

Emma Grace top), Bernice Mathisen (centre) and Graeme Stuart

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ACQ Volume 12, Number 2 2010

ACQ uiring knowledge in speech, language and hearing