Lessons from the nursery: The role of childcare in a cognitive behavioral treatment intervention for Latinas

Abstract

Providing childcare along with interventions for disadvantaged mothers increases the benefit. However, program designers rarely focus on the implementation of that care and how it affects program participants. Using the common factors model as a lens, this paper explores the challenges that arose in the third year of an intervention that provided childcare to Spanish-speaking immigrant mothers enrolled in a Cognitive Behavioral Treatment (CBT) group when the socioeconomic status of beneficiaries and the population of children needing care changed. We used data collected by the childcare coordinator—participant observation, field notes, and administrative documentation—to examine the meanings participants assigned to problems in the childcare program, their resolution, and how it affected the therapeutic alliance. Data analysis focuses on the extent emerging themes were consistent with the concepts from the common factors approach. Four lessons for providers of interventions with similar supports emerge: attend to the physical environment, anticipate that learning from and rectifying mistakes can improve the therapeutic relationship, select and train childcare providers to understand they are clinical helpers, and recognize that participants view the childcare service as an extension of the intervention. Findings underscore the importance of support services in fostering the success of social work interventions in community settings.