Colwyn Trevarthen (1970s) Harrie Biemans ( 1980s) Claske Houwing( 1990s Hilary Kennedy and Raymond Simpson 1993 And now ………………. From Scotland to the Netherlands and back

Social Work Health Education Charity University postgraduate AVIGuk Projects in UK March AVIGuk supervisors 750 trained practitioners At least 500 in training

by  using edited video clips of “better than usual” interaction of the client in interaction with someone important to them  and supporting reflection and increase awareness within a collaborative mediated dialogue which  increases sensitivity and emotional attunement to the infant or child  reduces stress and increases self-confidence  inspires hopefulness and joy in disadvantaged contexts  activates clients to solve their own problems VIG WORKS?

DVD

5. Child‘s Response (second turn) 6. Parent‘s Reception 4. Child‘s Reception 1. Child‘s Initiative 2. Parent‘s Reception 3. Parent‘s Response New initiative Eg child points at ball and looks back at parent Vigorous nod And returns look from ball to parent Pulls parent towards ball And points again looking Back at parent Returns look to child, smiles and then looks towards ball saying ‘ball’ Parent gets ball down for child and gives it saying ‘there you are’. With friendly look and tone. Saying ‘Yes, you can see the ball up high. I think you want it’. In approving tone, looking from ball to child Interaction can continue Context The core principle for attuned interaction

% change in CARE-index sensitivity of parent to infant 4-6 VIG sessions over 8 weeks 8-14 indicates ‘good enough’ 4-7 indicates ‘of concern’ 0-3 indicates ‘seriously compromised’ Kennedy, H. & Robertson,M. 2009

Increases maternal reflective function and mind-mindedness key transmitter of secure attachment increases sensitivity and emotional attunement to the infant or child key transmitter of secure attachment VIG is so useful precisely because it Jane Barlow University of Warwick 2011

Kim’s video

May 2012 Draft NICE Guidelines Key recommended intervention For all those involved in the social and emotional well being of In children 0-5 Cochrane Review – Does VIG enhance Parental Sensitivity?

V ideo I nteraction G uidance An intervention for change UK and international standards Developed in the Netherlands V ideo E nhanced R eflective P ractice A method for reflective Practice Developed in the University of Dundee

discordant cycleattuned cycle VERP supports change from a battle of messages to a learning conversation BATTLE OF MESSAGES VIG supports changes from the NO- to the YES- Cycle LEARNING CONVERSATION

BEING ATTENTIVE ENCOURAGING INITIATIVES RECEIVING INITIATIVES ATTUNED INTERACTION GUIDING DEEPENING DISCUSSION Parent led 1. TOWARDS INTERSUBJECTIVITY Pre-requisite for building attuned interactions 2. INTERSUBJECTIVITY The core of attuned interactions 3. MEDIATED LEARNING Developing the attuned relationship Building blocks for parent as care-giver Possible impact of each block for child as care-seeker Feels love, recognized and important Knows their parents are interested in what they are doing and their wishes Experiencing being received, parent commenting on what they are doing and their wishes Enjoys interacting with their parent Enjoys being helped and learning from their parents Is helped to manage difficult situations or learn new things

Check list for attunement in conversations Foundations for attunement Are you being attentive by  Looking interested  Turning towards  Giving time and space  Smiling  Friendly intonation and posture  wondering what they are doing, thinking, feeling Are you encouraging initiatives by  Waiting  Using friendly intonation  Listening actively  Looking for initiatives  Naming postively what you see, hear, think, feel tabout them  Name what you are doing, thinking, feeling

Initiative & Reception Are you receiving their initiatives by  Showing you have heard, noticed their initiative  Receiving with body-language  Being friendly and/or playful as appropriate  Returning eye-contact, smiling, nodding in response  Receiving what they are saying or doing with words  Repeating/using their words or phrases  

Attuned Interactions Are you developing an attuned interaction pattern by  Receiving and then responding  Checking they are understanding you  Waiting attentively for your turn.  Having fun (if appropriate)  Giving a second (and further) turn on same topic  Giving and taking short turns  Interrupting long turns in the yes- cycle  Contributing to interaction / activity equally  Co-operating - helping each other 

Developing the relationship Are you giving guidance by  Extending, building on their response  Judging the amount of support required and adjusting  Giving information when needed  Providing help when needed  Offering choices that they can understand  Making suggestions that they can follow Are you deepening the discussion by Supporting goal-setting  Sharing viewpoints  Collaborative discussion and problem-solving  Naming difference of opinion.  Investigating the intentions behind words  Naming contradictions/conflicts (real or potential)  Reaching new shared understandings  Managing conflict (back to Being attentive and receive initiatives aiming to restore attuned interactions)

Analysis of 8 minutes consultation ABC No of turns in 8 mins (480 secs.) Total length of turns in seconds (480 secs) Average length of turn Longest turn Number of very short turns 507

Number of turns by category of Consultant C and Patient C

Number of turns by category of Consultant B and Patient B

Number of turns by category of Consultant A and Patient A

Number of turns by category of consultant and patient in 8 mins

Angela Roger Lynn Kelly University of Dundee VERP in a Child Protection Environment: empowerment or surveillance?

VIG 24 May :54

What did we find? We hypothesised that VIG might be considered a form of surveillance or control in a CP context What we found was: Participants found the experience of the teaching to be ‘luxurious’ and ‘nurturing’ Participants did not use the video, but used the ‘principles’ on ‘a daily basis’ Participants found that the teaching most helped them in their working relationships and communication, many used it as a tool for supervision Participants found it helped them to ‘get more information’ from clients Participants found it helped them reflect on their own behaviour and practice Participants did not immediately consider issues of surveillance or power but came to consider it as part of the interview ……to be followed up

BLUEBIRD HOUSE Introducing VERP in a Secure Adolescent Psychiatric Hospital

Group 1 – March 2012 Wendy OT Team Leader Ollie Consultant Psychiatrist Emily HCSW Jackie Consultant Psychologist Helen W Assistant Psychologist Gail Deputy Head Teacher Leanne HCSW Karen Ward Manager Tim Senior Nurse Helen VIG Supervisor Martin VIG Supervisor

Participant’s Hopes for Training Opportunity to improve and reflect on my own interaction skills To be in a position to promote VIG across the unit through clinical supervision and other avenues Learning from other members of the multi disciplinary team How I can help young people and their families build better relationships through communicating effectively To have another and very different skill to support my team To contribute to developing a culture of identifying and reinforcing positive skills and achievements of staff and young people

2 Chapters on VERP Calum and Sandra Strathie Introduction to VERP courses and VERP in Dundee Children’s homes CARE Accolade award Cave, Roger and Young Universities of Newcastle and Dundee VERP in Higher Education B4