This is a reflective piece in which I describe some of my experiences as a VIG guider travelling through the first 3 stages of VIG training and practice. Hopefully it communicates a sense of how I was ‘hooked in’ and why I have become so passionate about this way of working.
Video Interaction Guidance encompasses a set of ideas that enable practitioners to support clients to communicate in a more meaningful and rewarding way with important others and, as a result, develop stronger connections that allow them to feel more positive and hopeful about their lives. In essence this is done by videoing real life interactions which are edited by the guider into short clips that show ‘better than usual’ interaction. These clips are then reviewed by the guider and client who together develop a shared understanding of what they are seeing, why it was successful and how this might feed into positive changes and developments in the future.
I have been working with children, young people and their families in the Highlands of Scotland for about 35 years. I trained as a social worker and have had a variety of different roles with children and families and in fostering and adoption. Latterly I have worked in the Child and Adolescent Mental Health Service as a Primary Mental Health Worker (PMHW). During that time I have become increasingly interested in the central role that relationships play in our lives. Over the years I have tried to support families to make sense of the complexities of their relationships and the impact they have, exploring different ways of “being” in these relationships to make them more rewarding and fulfilling. I have also tried to be aware of how I use my relationship with clients to facilitate these processes. Starting to use VIG and exploring the theories that drive it has brought new depth and colour to these key themes in my work.
I had been aware of VIG for a number of years, having heard it mentioned by various colleagues. Although it sounded interesting I never seriously considered it, being put off by the paraphernalia I thought the process must involve and, I suspect, an acknowledged fear of my practice being examined by others and my flaws being exposed! However, when a fellow worker explained VIG in more detail and described what a powerful tool it was I became more interested and when our team manager offered to arrange VIG training for other team members I put my name forward.
I approached the initial two-day training in an interested but fairly neutral frame of mind. My interest was piqued as I realised the theoretical basis fitted snugly with ideas I was particularly interested in and other, attachment based, training I had been fortunate to take part in. I approached the role-plays on day 2 with a typical anxious reluctance. As usual it felt stumbling and slightly false and awkward; however, as we viewed the video of the interaction and the trainer skilfully identified and explored the positives something clicked! I felt empowered, more confident and more aware of myself and how I could seem to others. I had a stronger sense of being able to do what I could do and could also sense ways in which I might be able to do this more effectively. I could see and, most importantly, feel that this was a very powerful process; and I was keen to start using it with the families I support.
Although my first few sessions were slightly stressful as I tried to remember all the things I needed to do, I soon began to feel more comfortable with the process as, in many ways, it was similar to the way I had tried to work with parents and families for many years. However, I sensed that this approach could be a far more effective way of working together. Previously discussions with parents had relied on them describing what had been happening between them and their children. Often this involved parents grappling with frustration and other difficult feelings related to their situation and fears about their inadequacies as parents. Now the relationship was present with us in the room. Indeed, not only was it present but it was present in ways that suggested it could be different, more fulfilling for both parent and child.
Being able to view and explore the relationship alongside the parent changed the dynamic between us. Rather than reacting to a story being told to me (often being drawn into an ‘expert’ role) we were now able to look at the relationship together and explore it more equally, developing a shared understanding. This was brought home to me in an early shared review. The parent was able to explain to me that what I had interpreted as her patiently creating space for the child’s initiatives was actually her feeling very anxious about what the child was going to do next and wondering whether or not she would have a tantrum. I was no longer the expert! This helped me develop my understanding of the relationship and led to a helpful discussion about the child’s perception of what was happening between her and her mother.
As I grew more comfortable with the videoing process I became aware of the transforming power of editing and creating positive clips. Early on I remember viewing a particularly distant and empty piece of interaction between a mother and her 8 year old daughter. It felt bleak and I needed my supervisor to help me to identify the few glimpses of more positive interaction. Once these had been edited out and were viewed alone the distance between the parent and child seemed to have grown smaller and I started to feel more hopeful about the relationship. Since then there have been a number of occasions when concern and sadness I felt after making an initial video has been transformed by carefully selected clips into something far more hopeful and positive. I am sure this is then reflected in the way I approached the shared review with the parent. For me one of the joys of VIG has been bringing these hopeful glimpses of a better future into people’s lives. It has been a wonderful thing to have been able to offer.
The regular supervision sessions that are part of VIG have been a gift. In my experience opportunities to have our practice directly observed and appreciated by colleagues are relatively few and far between. I think the ephemeral and transitory nature of our interactions with one another coupled with underlying doubts / anxieties arising from our own attachment experiences (which may be what drive us into this work in the first place) are such that many of us harbour doubts about how good we are at what we do. Coming to supervision with real evidence of interactions has helped me to challenge such self-doubts, enabling me to see the things I do well and the areas I can develop this further. Theories about the power of using video, such as ‘self-confrontation, self-awareness and self-modelling’ (Wels from Kennedy Landor & Todd (2011)) suggest that seeing these interactions taking place allows them to be held in mind in a different way. I have a sense that for me this has created a new, semiconscious awareness of how I am with people when I am interacting with them and that this has made these interactions more considered and meaningful. For example, viewing shared reviews with my supervisor has helped me recognise that I have a manner that generally helps clients to feel comfortable and relaxed in sessions and more able to participate as a result. In terms of the attunement principles in which VIG is rooted I do this by being attentive and encouraging and (crucially) receiving their initiatives. This helps them to feel heard and valued and, as a result, empowered to engage collaboratively and work with me in an attuned interaction. Recognising this helped me to feel more confident and relaxed in sessions, which, in turn, enabled me to leave more space for clients to explore their experiences. This space helped me to be more aware of opportunities where I could use activating questions to support clients to construct new meanings, and to use my theoretical knowledge more sparingly – as a tool for guiding and deepening discussion when helpful, rather than using it to directly advise.
The experience of viewing video of me interacting with someone else within the context of a warm receptive relationship has been particularly helpful. This has enabled me to feel what we are discussing and to learn experientially. The fact that this is repeated throughout the process – parent and child, parent and guider, guider and supervisor – creates a consistency, honesty and shared sense of purpose that resonates powerfully. I feel this is something that is often lacking within the organisations in which we work where the way we are expected to engage with the people who use the service is not mirrored within the organisational structure. This, I believe, leads to confusion and distress throughout the system.
Viewing videos in preparation for supervision has also been beneficial, helping me to notice things I had missed during the initial interaction. As my training has progressed I have become more efficient at recognising particularly helpful parts of the shared review; however, I am still aware that close examination of the whole shared review often reveals valuable information I would have missed otherwise.
Supervision has been greatly enhanced by having a supervisor who has embodied the principles of attunement and has felt like a kindred spirit in terms of the way we approach our work. She has helped me to have the courage of my convictions at times when I have felt the message about the importance of our relationships and interactions is not being received by others!
More generally I have enjoyed the way discussions about VIG lead to fascinating conversations with others about the nature and importance of our interactions, and I have valued the sense of connection these conversations create.
As I have become more comfortable and competent in my use of VIG I have been aware of how the process creates a safe and containing space in which people begin to explore areas of significant difficulty and vulnerability in their lives. I think for the parents I have been working with these underlying issues have often been associated with feelings of shame, which then create further disruption in the vulnerable relationship that is causing the distress. I think expressing these fears and feelings and having them recognised and accepted has led to significant moments of change. It has been interesting to see how focusing on positive interaction and actively avoiding examples of the type of interaction that causes the pain has allowed such expressions of difficulty and self-doubt to be expressed spontaneously. This has enabled me, as guider, to grasp a fuller understanding of their narrative and move on in an attuned way to explore how the narrative can develop and evolve. Having the evidence of a new narrative in front of you to return to after exploring the pain and distress is so valuable …. It is a wonderful process to be involved in!
Of course it hasn’t all been plain sailing. I have had one situation in particular where I have really struggled to use VIG to make a difference. However, I’m sure I would have struggled to have been effective in this case regardless of my approach and that by using VIG I was able to provide the family with some positive experiences, even if they were only short lived. There have been a number of situations where families and I have only done 1 cycle of VIG and then moved in a different direction. In all of these I feel the use of VIG, albeit limited, has been helpful in terms of providing clients with helpful insight and building confidence which has helped things to move forward.
Incorporating VIG into my day to day practice
As VIG has helped my practice to develop I have been interested to read more about its theoretical roots, in particular intersubjectivity and how this links with attachment theory. This was helped by recently having the opportunity to attend part 1 of Dan Hughes’ Dyadic Developmental Psychotherapy Training (DDP). This approach is also underpinned by ideas based on attachment, intersubjectivity and narrative, and resonated powerfully with the VIG work I have been doing.
As part of my role I provide post adoption support to families across Highland. This has previously involved consultation and training. I have recently begun to integrate VIG into this work. This has felt exciting and worthwhile and I have had some very positive feedback. I am looking forward to developing this work and thinking about how I might use video to enhance the training sessions I provide.
Delivering training is a key element of the PMHW role. I am now incorporating the new understanding VIG has brought me into these sessions. I am interested in how video might be used to make training sessions more experiential. Discussions with colleagues suggest that developing an understanding of, and beginning to use, VERP will be an exciting and effective way to take these ideas forward. This feels like an important next step.
A number of the situations in which I have used VIG as an intervention have been quite complex. I am also aware that working with older children in situations where patterns of interaction have been in place for a long period of time often makes it more challenging to achieve lasting change. I have begun to think about how VIG can be interwoven with other approaches. I think it is likely to work particularly well with attachment based interventions such as DDP.
In this piece I hope I have given a sense of how important providing VIG is proving to be for me. Previously, in my career in social work, I had become ‘lost’ in middle management, isolated from clients and no longer even providing supervision. I left to become a PMHW in order to get back to direct work. It had felt like a positive change; however, at the point I started VIG training I was beginning to feel stuck and was considering making a change, perhaps back into management. As described above VIG quickly opened doors and allowed me to begin to develop areas of work I had been grappling with for years. I felt re-energised and quickly recognised that developing my skills and understanding in this area would be far more rewarding and satisfying for me than returning to management … and so my VIG journey continues!
Primary Mental Health Worker Skye & Lochalsh and South West Ross
Portree Hospital Portree, Isle of Skye IV51 9BZ Tel: 01478 613168 Mob: 07909 894761 email: David.Morton2@highland.gcsx.gov.uk
Kennedy, H., Landor, M. and Todd, L. 2011 Video Interaction Guidance: a relationship-based intervention to promote attunement, empathy and well-being. London: Jessica Kingsley Publishers.