Idea #5 Relationship with the mother

What’s the idea?

Partner support and relationship satisfaction are strong protective factors against perinatal mental health disorders [ref. 30].

Why implement it?

Talking to parents about their relationship with each other and about their co-parenting acknowledges the importance of these factors in their lives. This can help parents think about the different factors that impact on them, and their baby, and where they can make changes. Providing or signposting to relationship interventions can help parents improve communication and co- parenting, which has a positive impact on all family members.

Actions to consider

  • Ask questions about the mother’s relationships to identify if there are difficulties which are impacting on her mental health or recovery.
  • If the mother is co-parenting, ask questions about the quality of this relationship to identify problems or concerns.
  • Support the couple relationship or other adult family relationships by providing or signposting to therapies which focus on relationships.
  • Be aware of services that are available in the local area which provide relationship support for couples, families or new parents.
  • As services develop, consider which members of the team could be trained to deliver couple and family interventions and how this will be supervised.

Practice example: Couple relationships

Kensington, Chelsea and Westminster Community Perinatal Mental Health Service, Central and North West London (CNWL) NHS Foundation Trust

The community perinatal team have noticed an increase in the clinical need for couple work with the families accessing their care, primarily due to the stresses and demands that couples face when transitioning to parenthood, within the added context of the presence of a maternal mental health difficulty and the impact this can have on the couple relationship.

The service is able to offer couple therapy, using a systemic approach, due to the therapeutic training backgrounds of team members. Sometimes two practitioners work together to provide this therapy and provide the expertise and skills needed. The team value being able to use this systemic approach, but also incorporating psychotherapeutic theories and techniques where possible.

Practice tips: box 7

Identifying relationship needs

  • At early contacts ask parents about the  quality of their relationships and any recent changes in their relationships:
      • How would you describe your relationship with X?
      • Have you noticed any changes in your relationship?
      • How do you make sense of these?
  • Normalise relationship changes and highlight that the relationship may need some extra effort across the transition to parenthood.
  • What aspects of your relationship do you miss? How could you re-introduce these moving forward? What ways have you found of supporting each other? What else could you do?
  • Remember to consider domestic violence and abuse [see Idea #1 Mapping the family and support network].