At the feet of storytellers: Implications for practicing early relational health conversations

Abstract

A family-and culturally-centered approach to conversations about early relational health (ERH) can open up opportunities for universal family engagement. The appraisal of family-baby relational health is more trustworthy and useful when there is attunement to family voice and facilitator bias. Early Relational Health Conversations (ERH-C) is a model for ERH promotion and intervention. This model has eight components: preparing and entering the ERH-C space, accessing strength and knowledge in a healing-centered space, pausing and co-creating, storytelling, witnessing, mutual reflection, affirming, and claiming their relationship narrative, and mutual insight. It is a paradigm shift in working with African American families and possibly other historically marginalized families who are also impacted by structural racism. The eight components are explained, and examples are given from the perspective of an Africentric worldview. The importance of cultural humility, attuning to and honoring family culture is emphasized. Insights for implementation in primary care and other settings are provided. Healing-centered engagement practices embedded in ERH-C have the potential to move ERH work into the social justice arena. The ERH-C is a family reflection model. Ideas for future directions for ERH-C are discussed.

At the feet of storytellers: Equity in early relational health conversations

“…The Early Relational Health Conversations (ERH‐C) model has eight components. These are explained in detail in a companion article in this issue (Charlot‐Swilley et al., in this issue). It describes implications for practice within an Africentric worldview and offers vignettes readers can use as points of departure in testing the goodness of fit of ERH‐C in their communities.…”

“…ERH‐C was an outcome of the study, not the subject of the study. The model and implications for practice are described in a companion article (Charlot‐Swilley et al., this issue). Theories and the ERH‐C model need to be studied prospectively by families and practitioners who can bring diverse perspectives to bear on the work.…”

Early relational health – A promising approach for equitable systems change in pediatrics: A commentary

“…The accompanying article by Charlot‐Swilley et al. (this issue) describes their experiences of implementing ERH‐C and uses vignettes to demonstrate the parallel process between the parent(s)‐infant interaction and practitioner learning. With theoretical underpinnings in IMH, child development, neurodevelopment and related fields, the adaptations of ERH/ERHS highlighted within this special issue represent important advancements for pediatric primary care practice.…”

“…In essence, work in ERH presents an opportunity to the field “to change how things have been done” (e.g., Chicago Beyond, 2018) toward more equitable practice. ERH‐C in particular offers opportunities for authentic healing‐centered engagement (Ginwright, 2016), co‐creation and mutual reflection (Charlot‐Swilley et al., this issue; Condon et al., this issue). It requires the full engagement and intentionality of the practitioner.…”

“…To engage in intentional equitable practices, and especially within a system that is rooted in the oppression of ALANA communities and poor women, pediatric primary care must engage in deeply reflective change management and improvement processes across research, policy, and clinical practice. As noted, an anti‐racist, diversity‐informed approach would shift research from generic population‐based studies to intentionally engaging ALANA communities in community‐based participatory action research where their experiences are centered (Charlot‐Swilley et al., this issue; Fariñas, manuscript in development). Diversity‐informed, equitable and anti‐racist approaches would help ensure that potentially oppressive practices are not thoughtlessly reinforced by engaging in the status quo, but rather new practices are adopted that are deeply engaging and that encourage equitable practice changes.…”