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Let's Talk about Children in Neuvola

The LT has been implemented extensively in some areas in Finland, including, in kindergartens, neuvola and school health, settings in addition to as well as in health and social services.

This time, I had an opportunity to learn about LT in neuvola from Mikko Lohilahti, who is a psychologist and who has been doing LT in neuvola this setting.

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Mikko is a psychologist, a family therapist and an LT trainer. He has worked for 23 years with adults in psychiatric care. Currently, he works at the Ilomantsi Perheneuvola (Family Guidance Office). His clients primarily are children with different symptoms. He does a great deal of family therapy. Furthermore, he uses LT in his family guidance work. They collaborate extensively with neuvola and have had many LT discussions with the customers at neuvola. His history with adult psychiatric care has a great impact on why he started to do LT with these clients.

I would like to know why you made the decision to do LT with every family facing pregnancy in neuvola.

When I went to Ilomantsi, they had the idea to do some preventive work, but they did not know what it might be. I had in my previous work with adult psychiatric patients many conversations about their childhood and the environments in which they had grown up. The meaning of everyday life is important, and, many times, behind the mental illness, there are parents with mental illness, alcohol problems or financial problems. Those problems have a great impact in everyday caregiving and interactions. I also did LT in my previous job.

I thought that LT was a good preventive tool. It is easy to learn. It emphasizes everyday interactions, and my experience with LT has been that, even though it is a structured method, it makes interaction easier. So, in short, LT offers a good way to talk about everyday life with everybody. It is an honorable way to engage in discussion when there are some problems within the family. When there are problems in the family, especially severe mental problems, it is big risk that we took off the parenthood from parents. That is a big problem in psychiatry and in social work.

I am very interested in what you told me following: “Parents with 1 ½- and 4-year-old children have come approximately 75% of the time to LT.” You think this is a good result in that area. You also told me that nowadays, parents have come together. When you started, fathers were frequently absent. Now, I would like to know about the benefits or experiences in greater detail, especially for you and your colleagues as well as for the parents.

As I told you, we have not done a study. However, we have asked every time for feedback after LT. Our question is simple: What do you like about this kind of conversation? The feedback has been good. Additionally, in those situations in which customers had experiences with being a psychiatric patient or social work and child welfare customer, they said that LT was totally different. There were no guilty feelings, and we listened to what they thought about as parents.

My colleague, a social worker who has also done child welfare work, spoke about the same from her point of view. She was very tense before our first LT discussions because of her history as a child welfare worker. She did not have had any negative comments about doing LT, and it has been the same person with whom she has worked before.

According to your email, you are doing LT at three time points with the parents: during pregnancy (at 30 weeks), when the child is 1 ½ years old, and when the child is 4 years old. I would like to ask you how you decided upon these three time points (i.e., 30 weeks of pregnancy, 1 ½ years after birth, and 4 years after birth)?

We picked those three time points because those are the times when they do a wide-reaching examination at the neuvola. Pregnancy is important to support fathers. I heard somewhere that fathers are sensitive to becoming a father in the last third of pregnancy.

You are doing LT at three time points with the parents at neuvola: during pregnancy (at 30 weeks), when the child is 1 ½ years old, and when the child is 4 years old. I would like to know what kind of experiences you and the parents had.

Parents are very enthusiastic to talk about their baby a second time. That is also a good situation in which to talk if there are some problems with the child or with the siblings or in the relationship. It is also easier to talk about difficulties when you know the workers already.

I think that the staff members in neuvola also have discussions with parents. Are there differences in the features between “LT” and “interviews” in the neuvola?

I think that LT makes it easier to discuss mental health problems. In the first place, it is not a screening/scanning method where we pick up some problems. Many times, they fill out paper/pencil questionnaires at home and bring them to neuvola where they look at them with a public health nurse and discuss problematic points. The key point is to identify problems. LT takes more time, I believe. However, it is a real discussion where the parents are the main part.

Finally, I would like to express my appreciation of Dr. Tytti Solantaus because she introduced me to Mikko Lohilahti and gave me this opportunity.

I would like to thank Mikko Lohilahti so much again. In 2004, We met each other at Högsand Tammisaari in Finland. I hope that we will meet again!