The efforts of a multidisciplinary approach in the rehabilitation institute for deaf children: a psychosocial intervention aimed at breaking the pattern of stalled productivity

Abstract

The multidisciplinary approach for the treatment of hearing impaired children presented the work group with several tasks: the group had to integrate different competences and techniques, to share common treatment goals, to manage relational dynamics with the children and their parents, and to explore the families’ expectancies. These efforts may create stressful conditions for the work group and, consequently, might negatively affect the quality of the intervention to be carried out. Our aim was to illustrate a psychosocial analysis performed in a religious Institute for hearing impaired children, intended to break the pattern of the Institute’s stalled productivity, to avoid inefficient and fragmented treatments, to prevent unelaborated relational dynamics among the staff members and between the staff and the children’s families. By means of the Content Analysis of semi-structured interviews administered to staff-members and families we have analyzed the quality of the teamwork, the relational arrangements towards the families and local services (25 interviews with 5 staff members); the family-Institute relationship and the family’s representation and satisfaction of the Institute (7 interviews with 13 hearing impaired parents and non-hearing impaired parents). The institute activity seemed to be more characterized by the maintenance of the relationship with the families per se, rather than oriented to productive goals. The non hearing impaired parents seemed to be more satisfied than the hearing-impaired parents, possibly because the former are more prepared to receive the Institute’s help. The stalled productivity can only be overcome by the elaboration of those relational/emotional dynamics which prevent staff members and children’s parents from focusing on productive goals. The staffmembers’ training should be improved in order to develop specific competences, to perform an integrated, multidisciplinary approach in treatments, to negotiate with the families, and share the work program and treatment objectives with them.

Multidisciplinarni pristup tretmanu dece oštećenog sluha postavlja pred stručni tim mnoge izazove: članovi tima treba da integrišu različite kompetencije i pristupe u radu, da dele zajedničke ciljeve tretmana, da upravljaju dinamikom odnosa između dece i njihovih roditelja i da ispituju očekivanja porodične zajednice. Za članove tima navedeni zadaci mogu biti veoma stresogeni što, posledično, može imati negativan uticaj na kvalitet planiranog tretmana. U ovom radu je dat primer psihosocijalne analize koja je sprovedena u verskom Institutu za decu oštećenog sluha. Cilj ovog postupka je da razreši pat-poziciju u radu Instituta, da izbegne neefikasne i parcijalizovane oblike tretmana, da predupredi pojavu neraščišćene relacione dinamike između zaposlenih, kao i između osoblja i članova porodice. Sadržinskom analizom semistrukturisanih intervjua sa zaposlenima i članovima porodice obuhvaćeni su: kvalitet timskog rada; relacioni dogovori sa članovima porodica i servisima lokalne zajednice (25 intervjua sa 5 članova osoblja); odnosi između porodice i Instituta, način na koji porodica sagledava rad Instituta i stepen zadovoljstva tim radom (7 intervjua sa 13 roditelja oštećenog sluha i čujućih roditelja). Po svemu sudeći, aktivnost Instituta je više usmerena ka održavanju odnosa sa porodicom, nego ka produktivnim ciljevima. Čujući roditelji su zadovoljniji radom Instituta od roditelja oštećenog sluha, verovatno zbog toga što su spremniji da prihvate pomoć koju im Institut nudi. Izlazak iz pat-pozicije može se prevazići samo detaljnom razradom svih onih relaciono-emocionalnih dinamičkih odnosa koji i osoblju i roditeljima onemogućavaju fokusiranje na produktivne ciljeve. Potrebno je poboljšati obuku zaposlenih u pravcu razvoja specifičnih kompetencija; realizacije integrisanog, multidisciplinarnog pristupa u tretmanu; ostvarivanja dogovora sa porodicama i saradnje u definisanju programa rada i ciljeva tretmana.