An interview with our Guest Contributor, Karen Bateson

Thank you for taking the time to chat with us, Karen. As a Joint CEO of OXPIP, your work involves providing intensive therapeutic support to parents and babies, focusing on strengthening parent-infant relationships. Can you share some key principles or approaches that guide your organisation’s interventions in supporting families from conception to two years of age? 

Thanks so much for your invitation Daisy. The Oxford Parent-Infant Project is an Oxfordshire charity which delivers specialist parent-infant psychotherapy where we work with the baby and parents in the room together.  All our work is based on psychodynamic approaches, so attachment, parental reflective functioning and conscious and unconscious communication are all thought about carefully within the therapeutic process.  We use knowledge about attunement, polyvagal arousal, trauma and child development to guide our work. In terms of key principles, viewing the baby as an active agent in the relationships is important, because babies communicate such a lot when you observe and listen carefully. Also, holding on to the importance of both parents, and of the family’s history and narrative including their “ghosts” and “angels” in the nursery, concepts proposed by Selma Fraiberg and Alicia Lieberman, is key. In other words: thinking with parents about how unresolved issues from past relationships might negatively impact on their relationship with their baby in the here and now; or, conversely, how helping parents access their memories of feeling loved and protected might support them in the parent-infant relationship in a positive way.

The work of OXPIP is invaluable to infants and parents. Can you share a success story or moment that exemplifies the impact of your work on the families you serve? 

One of the most special things about OXPIP is that we recruit clinicians who already have great experience in this field and who have then completed our Parent-Infant Therapist training. So, the outcomes of the work are phenomenal: 91% of families show an improvement in the quality of their parent-infant relationship (the main focus of the work) and 77% report an improvement in their own mental health (an important corollary benefit).  That’s data from almost 500 families, so we’re confident about our outcomes.  But alongside these two outcomes, we know from our work that parents experience other benefits such as increased confidence, our groups help parents forge new social support networks and build better relationships with key professionals such as midwives, and of course the babies are benefitting directly too.

We see families from across the social spectrum and with really varied stories.  One example is a young, sex-trafficked woman from the African continent who we saw for a year of weekly OXPIP therapy with her young baby. Initially, she had rejected the baby after being conceived by rape. Through the sensitive work of her parent-infant therapist, she was able to see that her baby was also a victim, so finding compassion for him and was able to bond with him. Her child, when seen 4 years later, was thriving, lively and engaging and their relationship was close and secure. Mum had also gone on to study and get a degree.

OXPIP plays a crucial role in promoting the well-being of families in and around Oxfordshire. How do you ensure that your services are accessible and inclusive, particularly for families facing barriers such as socioeconomic challenges or geographic isolation? 

We’re very grateful to our funders because we’re able to provide our specialist psychotherapy for free to any family in Oxfordshire that needs it.  It’s a large, mainly rural county so we work from community venues such as community centres and church halls so that as many families as possible can access our service locally to them.  When it’s clinically indicated, we support with families’ transport to our centres, and we also provide interpreters for non-English speaking parents when funds allow.  We’re also one of only a few parent-infant relationship services around the UK to accept self-referrals and right up to the day before the child’s second birthday. Our online referral form uses Recite-Me so that parents or practitioners with sensory or literacy needs can access it more easily. 

Collaboration is often key in addressing complex issues affecting families. How do you foster partnerships with other organisations – like The For Baby’s Sake Trust – and professionals to ensure that families receive comprehensive support beyond what OXPIP can offer alone? 

OXPIP is celebrating its 25th anniversary this year [technically, we celebrated this last year and even that was a year late – up to you!] so we’ve been working in these communities a long time and that’s meant we can build up a good reputation and good relationships.  We have developed really good relationships with midwives, and in fact almost half our referrals now come in during pregnancy.  Working from community venues means we have been able to develop good relationships with other community colleagues too, such as health visitors, family support teams and  voluntary sector organisations.  The benefit to families is that we can work in close partnership with other people who can provide the wider family support that underpins our specialist work.

Your background as a clinical child psychologist informs your approach to supporting parent infant relationships. Can you discuss how your expertise contributes to the development and delivery of effective interventions at OXPIP? 

I work as Joint CEO (Executive Director), alongside Helen Callaghan as Joint CEO (Clinical Director) who is a Consultant Parent-Infant Psychotherapist, and we both use our clinical background in every aspect of how we run OXPIP.  For me, the most important way my clinical background influences me in this role is through understanding what clinicians need in order to do their best work.  That’s about good supervision, reflective team process where we can think together, the right therapy rooms, the right IT systems, the right outcome measures. It’s my responsibility to secure funding, so being able to talk with genuine understanding and experience of the clinical work and of its importance to babies is really important to me. I hope it helps our clinicians feel more secure knowing that the person writing funding applications about their work understands what they need to achieve superb outcomes for families.  

The For Baby’s Sake Trust emphasises the importance of a whole-family approach, early intervention, and trauma-informed support for families. How does your work align with these principles? 

We couldn’t agree more!  All our work is aligned to these principles and the fact that almost half of our referrals are antenatal attests to our commitment to early intervention.  We work with both/all parents but like many, there’s still more to do to engage more fathers and LGBTQ partners.  Some of the parents we work with have had traumatic experiences in the past and creating a safe space to explore the impact of that on their relationship with their baby is a central part of our approach.

Policy initiatives can have a significant impact on the work of organisations like OXPIP and The For Baby’s Sake Trust. How do you engage with policymakers and advocate for policies that prioritise early intervention and support for families during the crucial early years of parenting? 

We do this in three ways.  Firstly, we’re keen supporters of the work the Parent-Infant Foundation and the First 1001 Days movement do, and that includes supporting their policy campaigns and attending the APPG meetings.  Secondly, we facilitate visits to OXPIP by MPs to promote the importance of this work. And finally, we promote our work to a wide audience through our newsletter, including talking about important policy initiatives that will improve outcomes for babies.

Looking back at your career, what inspired you to focus on supporting parent-infant relationships, and how has this focus evolved over time? 

Clinical Psychology training involves placements across the age range, and I was lucky that my first training placement was with older adults, then adults and then children.  Each placement, I came away thinking “we’re not getting in there early enough”.  It gave me a clear perspective that the roots of psychological distress are growing quickly during our earliest years.  That’s not to say every mental health problem arises from early childhood, but even in the oldest adults I could see the impact of attachment disruptions and childhood adversity.  So, by the time I qualified, I knew working with children under 5 was my purpose. Like many helping professionals in this field, my early years weren’t ideal, but I feel blessed to have had many positive experiences during my life, so my work is very much based on hope, optimism, and the power of relationships to heal early harm.  I’m also a biologist at heart – it was my favourite subject at school – so the neurological research about brain development and trauma has fascinated me and confirmed my belief that the first 3 years of life really are the most important.

Reflecting on your own professional journey, what are some of the most valuable lessons you’ve learned about leadership, resilience, and maintaining passion and purpose in the face of adversity? 

What a good question! In terms of leadership, role models – good and bad – shape your thinking. I read leadership books on Audible during my commute.  I think resilience is a misunderstood concept because our ability to be resilient is so closely connected to attachment styles. So for me, resilience is about finding your people, your place and your balance.  Building a network of people you like, trust and respect is crucial.  I have a network of talented, kind peers who help each other out, no questions asked, and I use that network for all kinds of support.  I’ve also worked with some fantastic people from whom I’ve learned such a lot.  And in parallel to our work with families, understanding the importance of rupture and repair/ falling out and making up after conflict. When you’re stuck, seek help from people outside your network.  I’ve frequently had a mentor to learn from and to challenge me.  I’ve leapt into self-employment twice and come out feeling better on the other side on both occasions. So, be brave! Finding your balance is about keeping a sharp focus on your own health and wellbeing.  That might be through therapy, a strong commitment to continuous learning, going to the gym, getting enough sleep, or eating well.  In the last two years, now that my children are older,  I’ve learnt to pace myself better and to take periods of rest during the working week, and that has been a revelation.  

As a leader in the field, what advice would you give to other professionals who are passionate about making a positive difference in the lives of families? 

I’m not sure I can give others advice, but I can tell you what I’ve observed about the people and behaviours that I’ve seen make a positive difference. The people who make the biggest positive impact in the lives of families always, without fail, keep their focus on the children and families they are serving.  They are also always learning, they are honest even when saying difficult things, and they know that change is messy and time-consuming.  My hobby is walking the Wainwrights in the Lake District and that has taught me that you will get there if you pace yourself, look after yourself, have a map and just keep going. Specifically in our sector, I would also say educate yourself about the importance of baby communication.  Understanding what and how a baby is communicating opens up a much deeper awareness of that child’s needs and experiences.  This is especially important for safeguarding, so for me it would be essential learning for all pre-qualification courses in health and social care.

And finally, looking ahead, what are your aspirations for the future of the charity sector? 

Certainly I’d like the charity sector to be given due credit for the enormous contribution it makes to communities.  It frustrates me when charity colleagues aren’t treated with equal status and respect as other sectors, although that’s thankfully not the case in Oxfordshire.  I’d also like to see more collaborations between charitable funders and research funders.  It’s almost impossible to get those two sources of funding to line up, but we could develop some really exciting innovation in practice if we could academically evaluate new projects and ideas.  More broadly than that, I’d like to see every family that needs it have access to high-quality parent-infant relationships therapy, and the charity sector is the longest serving provider of that in the UK so we’ve got lots of learning to share.

If you’d like to be involved in our Guest Contributor series, please email daisyobrien@forbabyssake.org.uk