Introduction: This short essay offers an account of one successful example of person-to-person support and invites accounts of comparable past or present support in any country that operates outside western psychology. The account is of a small UK voluntary organisation named 'One Hundred Hours' (OHH)[1] that supported new parents of babies with serious, and sometimes life-threatening, impairments – typically of a neurological origin.

My purpose is to make an initial exploration of the phenomenon of one person taking on the task of supporting another at a time of need and to collect sources of information for a deeper study. I am assuming that person-to-person support is not a modern invention.

One Hundred Hours: This was a small group of professionals (e.g. teachers, nurses, social workers) in the 1990s who took on the role of keyworker to support disabled infants and their families. This was a free service and parents were free to use our service or not.  While the role was multifaceted focusing on both the child and the family, this essay will deal only with the person-to-person support offered to the parent or primary carer.

The OHH helping process: Each family is unique, as were our keyworkers, and we did not follow any detailed template in the helping process. At the first meeting, usually in the family home or the child's hospital, we would listen to the parents describing their situation and explain what we could offer. Saying if they wanted to meet the keyworker again was the only agreement they had to make. There was no formal contract and parents did not have to articulate what they needed from us. One or two families did at the first meeting, others could do so later and some families never voiced clear needs to us – and perhaps not to themselves. Our continued support was one or two meetings a week/fortnight over six months, a year, two years or more and drawing to a gradual close as parents felt they no longer needed us.

Parents' needs when we first met them: We were deeply impressed with the level of parental and family need we encountered – need that was not commonly acknowledged or catered for in the UK at that time. On discovering that their baby had, or might have, significant disability parents were typically plunged into a dark place very different from the joy and celebrations that come with a 'perfect' baby. We saw anger, sadness, confusion, shame, blame, guilt, anxiety – and strong urges to fight, to hide or to run away.  Some parents, after we had go to know them, told us that suicide had been on their mind before getting support from us – very strong negative emotions indeed!

The characteristics of the keyworker: Keyworkers were appointed from various professions – teaching, social work and nursing – on the basis that they liked the OHH approach and already had some understanding of the common issues for families of disabled infants. They were not selected for having a qualification in counselling, psychotherapy, or similar. OHH keyworkers: 

• were comfortable with the OHH way of working with families in their own homes, could develop helping relationships[2] with family members and were good listeners
• could work within agreed rules of confidentiality and knew not to make assumptions
• were compassionate, respected parents and valued the disabled infant, any siblings and other close family members
• could acknowledge the family's predicament and the feelings of family members about it
• were prepared to face any anger, tears or discord that might arise
• never offered advice of the 'If I were you...' sort
• had no agenda other than to support the child and family.

Signs of success: Success depended on establishing the necessary level of relationship, empathy, communication and rapport. The signs that a constructive relationship was developing or had developed included the following: 

1. Keyworker and parent were warm and relaxed with each other and meetings became less formal.
2. Keyworker and parent valued each other and enjoyed meeting.
3. At each meeting the conversation would home in at some point on something significant of value to the parent in their continuing adjustment to the situation.
4. The keyworker became what one parents described as a 'professional friend' – more friendly than a distanced professional and more professional than a friend.

What the parent gained from this person-to-person support: This can only be an attempt to put into words something which had elements beyond verbal definition or description. Thomas Moore[3] writes about dark nights of the soul from which a sufferer can emerge stronger and more whole. We were privileged to be witness to this and have to assume the person-to-person support played some part in it offering warmth, companionship and understanding to parents at the time of suffering and helping them develop some insights into their predicament. Of course, not all parents changed in this way – at least while we knew them.

We saw many parents move into a lighter place where smiles and laughter became more frequent than tears and hand wringing. Alongside this parents were increasingly able to face each day's challenges and less fearful of the future. It was as though they were no longer spinning in confusion, had found their feet and had developed a sense of direction. They now knew what had to be done and felt they had the resources for it. An important part of this was a parent becoming less a passive recipient of health and education services for the child and more in control.

The help I am looking for: This person-to-person support can be defined as an agreement between two people, one who is in a time of crisis or unhappiness and one who is in a position to offer support and who is acknowledged as such, to meet together for conversations intended to be supportive and constructive.

In an effort to promote this model of person-to-person support and to support people who, though not qualified psychologists, psychiatrists or counsellors, are or would be helpers, I would like to gather information about similar past and present practice in any country. I am looking for practice that pre-dates modern western psychology or is current but operates outside western scientific influence.  In moving away from western science I do not want to enter the realms of religion and so I am not looking for models that would require the person being helped to adopt any particular devotional practice.

I would value: 

• accounts of past or present practice in support of persons in crisis or distress for any reason
• names of particular people who hold information about practices
• pointers to other sources
• published work

I shall publish in some form information that comes to me and make all sources of information available to anyone who wants to make a deeper study of this subject.

Thank you for your help

Peter Limbrick. October 2013.

Contact:

• Peter Limbrick, Interconnections, Parks Farm, Clifford, HR3 5HH, UK
• E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
• Tel/fax: (UK) 01497 831550

[1] A good account of this work is The Keyworker: A practical guide by Gudrun Limbrick-Spencer, published in 2001 in Britain by WordWorks in association with the Handsel Trust

[2] Hilton Davis gives an account of the helping relationship in Working in Partnership: The Family Partnership Model published in 2010 in Britain by Pearson

[3] Dark Nights of the Soul: A guide to finding your way through life's ordeals. Published in Britain by Piatkus in 2004

If so, the Australian Centre for Child Protection would like to hear from you to help researchers gain an understanding of how children are matched to out-of-home care placements. Participation in the survey is entirely voluntary. You may choose not to participate in the survey, or to withdraw from the research at any stage.

Your individual survey results will be confidential and will not be identifiable. The data obtained from this study will be kept in a locked cabinet at the Australian Centre for Child Protection for 7 years following completion of the study. This data will only be accessible to the researcher of this project. All information here.

In this short video, parents share stories about dealing with development pressures on babies. Parents talk about having appropriate expectations about development milestones and time frames. Although it's tempting to compare your child with others, no two children develop in the same way. Don't let your expectations become a burden on you or your child. Look here.