Communicating with Intention: Family-Centered Care in Early Intervention Through the Interpersonal Lens

Effective therapist-parent communication is critical for implementing family-centered practices from a relationship- and capacity-building perspectives. This dissertation aimed to examine the interpersonal aspects of family-centered care using the Intentional Relationship Model (IRM). Two studies were conducted to achieve this aim. The purpose of Study I was to explore therapists’ and parents’ perspectives on 1) parents’ participation, 2) therapists’ use of family-centered practices, and 3) therapists’ communication. Data were collected using online surveys. A total of 101 therapists and 19 parents completed the study. Parents were somewhat involved in the EI sessions. Family-centered behaviors most frequently included relationship-building and least frequently included information sharing. Therapists demonstrated a high frequency of therapeutic communication and low frequency of sub-optimal interaction. Therapists most frequently used empathizing and encouraging modes of communication, followed by instructing, collaborating, problem-solving, and advocating. Parent participation was associated with therapists’ training in family-centered care, training in therapeutic communication, and frequency of family-centered practices. Family-centered practices were significantly associated with therapeutic communication and sub-optimal interaction. The purpose of Study II was to pilot the feasibility, acceptability, and preliminary effectiveness of an IRM-based curriculum for therapists and parents in EI. A total of 27 therapists and six parents completed Study II. Data was collected and analyzed using quantitative and qualitative approaches. Participants appreciated opportunities for social, experiential, and reflective learning and found the IRM applicable to their everyday experiences. Upon course completion, therapists and parents demonstrated increased knowledge, awareness, and reflexivity specific to the interpersonal components of the therapist-parent-child relationship. When describing challenging interpersonal events, participants often felt “stuck” in instructing or empathizing. Upon follow-up, therapists and parents reported increased capacity to cope with stressful interpersonal events through purposeful pausing, as well as increased intentionality and flexibility in their communication. Additionally, therapists demonstrated increased EI self-efficacy, frequency of family-centered practices, and therapeutic mode use. These findings offer evidence supporting 1) a growing need to integrate additional opportunities for translating family-centered theory into clinical practice, and 2) the effectiveness of an IRM-based curriculum for promoting therapists’ and parents’ interpersonal competence in EI.