Power to the caregivers

JOHNSON CITY (June 30, 2020) – While much of the world, activities and businesses, have paused for COVID-19, services and daily care for infants and children cannot take a break, and as a result, licensed clinical psychologist and assistant professor of psychology Dr. Diana Morelen hasn’t either.

Morelen, a researcher in infant and early childhood mental health and the professor overseeing the ARCH (Affect, Regulation, Coping and Health) Lab at East Tennessee State University, has found that caring for the caregivers is an effective avenue to help support children.

“Ultimately, I want to help improve the lives of our babies and young children, and I want to help break the generational transmission of trauma and abuse and mental health struggles that we tend to see get passed down,” Morelen says. “I want to give families hope in the face of adversity so that they can provide a different experience for their children.

“To do that, I feel really motivated to be at the ground level working with children, families and care providers. I love that work. I learn something new with every group I serve.”

While some of her work must pause because of the kind of physical data required, Morelen continues to press forward with two research projects, one providing resources for mothers and their children and a second project that sprang from Morelen’s concern regarding pandemic stresses on care providers for infants and children and their families.

When Morelen came to ETSU from post-doctoral work at University of Michigan, she brought the Mom Power project, a relationship-based parenting group for mothers of children up to the age of 6. Mothers who have been impacted by trauma, mental health difficulties or socio-economic challenges are referred to the project by local organizations and programs.

“I had the privilege of doing a two-year post-doctoral fellowship with the developers of Mom Power,” Morelen says. “Mom Power was the most life-changing and profession-changing intervention that I had seen across my eight years of clinical experience. When it came time to move on, I asked for and received the Mom Power creators’ blessing to plant the seed of Mom Power in Tennessee.”

This project, supported by funds from Ballad Health and ETSU’s Research Development Committee, focuses on giving mothers the experience of being seen, heard and cared for so that they feel empowered to better see, hear and care for their babies. For 10 weeks, Mom Power provides to groups of 10 mothers at a time: transportation to the meeting site; a shared family meal; child care by trained child development staff; parenting psychoeducation; instruction in self-care and relaxation skills; attendance incentives, such as diapers; and referrals to additional community-based services.

“We're also really trying to meet the psychological needs of the mamas so that they can better meet the psychological and developmental needs of the kiddos,” says Morelen, who is also an Infant Mental Health Leadership Cohort member of Project Launch and the Association for Infant Mental Health in Tennessee.

Mothers who engage with Mom Power do so for a variety of reasons, Morelen says.

“Not all mamas are sure Mom Power is right for them in the beginning, and we welcome their concerns and apprehensions,” she says. “Some mamas are anxious about being in a group with other mothers. Some mamas don’t think they need parenting support but have to complete a parenting class for one reason or another. In Mom Power, we want to meet mamas where they’re at and listen to their concerns.

“The beautiful thing is that by the end of Mom Power, almost all mamas express a desire that the class would be longer and are able to speak to the ways that Mom Power changed how they view motherhood and how they’re able to better care for their child or children.”

So far, six Mom Power groups have been completed in the state, hosted by the community agency Families Free. Although the spring Mom Power group had to pivot to virtual delivery because of COVID-19, Morelen says she is working on a way to move the project forward while keeping mothers and children safe and healthy, with Carter County as the next location, in collaboration with the Carter County Drug Prevention Coalition.

Rather than rerouting or delaying research progress, the pandemic and its additional stresses inspired Morelen’s newest study: “Taking care of the caregivers: Resilience in the Infant and Early Childhood Mental Health (IECMH) Workforce in the Time of COVID.”

Family interventionists, child services workers, home visitors, family services administrators and pediatricians could not curtail their essential services for young families because of the 2020 pandemic.

“I do a lot of training and what's called reflective supervision, where we try to take care of the providers so that they can take care of the family, so that the families can take care of the kiddos,” Morelen says.

As the special requirements and added anxieties and fears of COVID-19 extended into late spring and tornadoes added to the stresses of workers in infant mental health, Morelen realized that caregivers, like front-line health care providers, were feeling burned-out and overwhelmed.

“I was getting asked to do a lot of training on self-care, and I realized that I wasn't really sure what the specific workforce needed – how they felt supported or not by their systems, how they were doing mentally, how COVID and these disasters were impacting them and their work, and what they needed in terms of self-care,” she says. “Rather than just imposing what Diana thought that they needed for self-care, I wanted to develop a project that asked them what they needed and wanted to take care of themselves as they support young children and families throughout this pandemic.”

So, Morelen devised what she calls a “rapid-response research project,” developing an initial stress and well-being survey and self-care videos. She sent these out to connections across the state through support from the state infant mental health group, Association of Infant Mental Health in Tennessee.

“I wanted to ask, ‘How do we take care of the caregivers in this time of COVID? How are you? What's being done for you and what do you need to be done for you?’” she says.

For the initial survey, Tennessee IECMH caregivers receive a short survey, get to pick one less-than-10-minute video that guides them through a self-care activity, then give feedback on whether the video was helpful or how it could be more helpful, given their unique needs. 

“Then, I will follow up every month for the next year to briefly check in on how they’re doing,” Morelen says.

The yearlong study on caregivers already has 100 participants statewide. Meanwhile, Morelen also continues to work for what she calls “top down” legislative and policy change to better support young families and services for them.

“It's been an interesting professional growth experience for me as a clinical researcher to try to balance the clinical intervention needs with the research needs and thinking about how to use science to benefit the families now, and also use science to help create sustainable growth in the future,” Morelen says.

By Lise Cutshaw, Contributing Writer
Media and Marketing Coordinator, Mary B. Martin School of the Arts