Com mimo, carinho e gratidão, beijos aos molhos.
Met zorg, genegenheid en dankbaarheid, bergen van kussen.
With care, affection and gratitude, mountains of kisses.
Avec des soins, d'affection et de reconnaissance, montagnes de bisous.
Con cariño, afecto y gratitud, montañas de besos.

'

8. So, my practical intervention path began, in 1997, by directly contacting institutions which routinely use Kangaroo Method (KM) and specialists who use VIG in dyadic relationships in health services. This contact was achieved in AMC in Holland, where KM has been implemented since 1985. After an initial experimental phase, it became a current practice, in which parents have a crucial role at the end of the day, in an alternate way. I interviewed Doctor Richard de Leeuw , then I was introduced to the team, visited the unit, asked permission to two families and had the chance to film two fathers performing K (one already had some practice with this contact, the other was doing it for the first time and so was nervous, anxious and thrilled) with a view to disseminate and modulate it in Portugal. The contact and further study of VIG was carried out along with specialists that supervise VIG performance by professionals from a number of institutions (such as the Hospital of Hoorn and the Hospital of Groningen) – mostly were done by Susan Anneveldt. With this specialist, I analysed the recordings performed in AMC, followed her activities in the hospital and participates in the managements she carries out there. I also witnessed the management she receives from Harrie Biemans from time to time. With this practical “mini handbook” of VIG in my mind and the video recordings, I felt ready to initiate the intervention in Portugal. I arrived at Coimbra with my mind set on performing the practical intervention in Maternidade Bissaya Barreto (MBB), as I had had a personal contact at the end of 1994 and beginning of 1995, when our niece was born premature. By then, I already had a videotape VHS about KM in The Netherlands, which I had obtained from SPIN when I started researching VHT, for which I had the material, interiorisation and skills we acquired in The Netherlands. I agreed on a contract after interviews with the Director of MBB, the Director of NICU, the Managing Nurse, The Chief Nurse and the Director of the EIU (Early Intervention Unit). As my request was accepted, I had my first meeting with the NICU team, where I specified the practical aspects of my presence and way of acting inside the unit and access to parents. The video recordings of K procedure in AMC were used in this meeting. These caused a curious and rewarding receptivity: the professionals debated uniforms, technical material, similarities and differences in the monitors, the fact that parents don’t use hospital coats or any other protection, fathers doing K without shirts sitting on comfortable chairs (deck chairs), which I considered as a mental predisposition to the practical possibilities encompassed by my presence and intervention in that unit. When I first approached the parents with a letter of consent request, the tape with Dutch parents performing KM, and some scales, I was concerned with what I would find: pain, suffering, hope, sadness, receptivity, rejection… How would I deal with any of these emotions and let my interest, respect and true concern in helping to minimise pain show? I felt these questions quite strongly. First parents: excellent receptivity. We watched the videotape with Dutch recordings and questions were made and answered. I immediately felt their interest and anxiety in being able to share this contact with their daughters (these parents had two little premature twins, as a result of IVF). However, this result did not avoid the previous questions, as each couple of parents represented a new challenge, a new unknown reaction, a new pain, a new contact with people who could not wish I to support them (or to invade their personal experience and relationship privacy) – with all the respect and understanding due to this refusal, even if trusting that parents would be able to feel a skin-to-skin contact if they wished to do it, then deciding whether they wanted to repeat it and with what frequency. In this process of practical intervention, which approximately lasted three years, interrupted by some trips to The Netherlands for management and guidance on VIG performance, I initially had one definite refusal by a couple who had received the information that their daughter presented a brain ecography revealing problems in the motor and mental sections. By the same time, another mother refused to participate after speaking with the former, who considered K and VIG inappropriate. However, when the team proposed K to that second mother, she accepted it and agreed with the experiment. She sought me and asked to be filmed in care and skin-to-skin contact, but requested that I did not disseminate it. I assured her I would not. She felt quite satisfied with K and expressed enormous pleasure in showing the recorded images to their family. Besides these two cases, there was no other refusal. As a matter a fact, I had some requests, some included in the sample (according to the random distribution) and others outside its scope (which were not included, as they did not fit into our eligibility criteria), but foreseen in the application of VIG. Some requests arose because parents felt attracted by the image recording and other requests because they were wondering why other parents would be so special in that they were being filmed and followed by that psychologist and they did not. So I explained them why this research was important and the fact that I had to obey to certain criteria, which did not prevent me from filming and following them during that period. In what concerns the recorded infants and parents, I always brought the consent letter to be signed when they accepted participating. They also indicated if they authorized or not the viewing of the images by other professionals or parents, when subject to the intervention with VIG and/or VHT. Then I’d follow around 20 dyads at maternity, each contact parents-premature infant were filmed for 15 to 30 minutes, the sequence and visit to the incubator with recording and meeting to view the recordings happened between 1 and 3 times, depending on the need and parental availability. The reviews of films were made in an adequate room, which I oriented according to the criteria and items of the orientation tables of the VIG method. With 5 of those families (living in the neighbourhood) I scheduled home visit with the parents that would proceed with the VHT intervention. During the home visit, I filmed some moments of parents-child contact. Afterwards, we scheduled the visit for viewing the films. I had 2 “filming visit” and “viewing visit” sequences, which amounted to 4 home visits, each family. That’s endured till end of 2000.

7. In Christmas 1995, I was writing my masters dissertation, when my niece was born extremely premature. It activates the need to intervene and the certainty of being able to contribute to make that experience less painful as possible. As personal and emotional guide along this path I always had the wish to promote the development of tenderness between parents and child, staff and children, staff and parents, and between me and each of these people. Moreover, I also wanted to act and establish an empathic relationship of effective help and deep respect for the other.

6. After a first research (rearward referred) where I got more involved in the Dutch project VHT, getting in touch, understanding and thinking of implementing it, I also had the chance of obtaining information about VIG and its application to premature infants.

5. In my master’s dissertation there is a chapter about the V.H.T. method, which begins with a review of the authors who provide a theoretical background for the method. Firstly I examine the framework proposed by Schepers (1994), which relates aspects of human ethology with different aspects of communication science, and science of education with different areas of psychology; references are also made to other authors considered relevant. Then I proceed to a theoretical contextualization, which begins with aspects of communication pragmatics (Watzlawick, 1967), and covers examples of family communication (Lange, 1983; Kelley, 1983 and Hawkins, 1988), characteristics of parent-child relationships (Threvarthen, 1989; Schaffer, 1984 and Schaefer, 1980), and parent-child relational disorders (Schaffer 1977, and Paixão, 1988). Finally I look at attempts to approach these aspects by means of video (Dowrick 1991 and Threvarthen 1989), and the importance of working with parents is broached. There follows an analysis of the socio-political context that gave rise to the V.H.T. method in Holland, which is integrated into the regional, mobile intervention programme HOMETRAINING. The methodology itself is described: its origin, organization and institutions involved; adoption within the country and abroad, both quantitatively (number of regions and professionals involved) and qualitatively (target population and flexibility of aims); staff training; application criteria; therapeutic, pedagogical, social and economic objectives; and its practice: basic assumptions, directives, charts (for the analysis of basic communication), and procedure (which takes place in four stages, namely evaluating the reason for referral, taking the decision, the intervention itself and follow-up). Finally I weigh up the advantages and disadvantages of the application from a cultural perspective. At the end I draw some general conclusions about the method, in the form of topics surveyed in the literature on VHT, and in some theoretical references referred to in the conceptual framework. I also comment on the advantages of using video in this area of work.

4. In 1994, starting at middle of March, I applied V.H.T. to 4 families selected according to criteria mentioned above. It proceeded at a rate of approximately one session a week, for the first five weeks. Then there was a week's pause for the supervision session in Holland (made by Guy Schepers from ORION) and a seminar in Israel. In the next two months, V.H.T. was applied at two-or-three-week intervals with three of the families, (since one of the families had arrived at a terminus at the end of May). When the intervention was completed, the 4 families were retested, and I returned to Holland for further supervision and a final evaluation of the work done. This was done in September / October 1994, and continues as follow-up. In this second semester of 1994, results were analyzed and all the theoretical and practical research was recorded in my dissertation. Besides I did VHT with 2 families from clinical work and 4 children during consultation with me.

3. In 1993, I compiled all the information available on the subject, and attempted to relate it to a Portuguese cultural and scientific context in a study presented at the Faculty of Psychology and Sciences of Education, University of Coimbra. This study was entitled 'VIDEO-HOMETRAINING: Exploration of a New Method of Family Intervention for Pedagogical and Relational Problems', and was done as part of the subject 'The Family and the Education Process' of the Masters course, supervised by Drs. Ana Paula Relvas at University of Coimbra and at Coimbra and Dr L.T. Van Der Linden at the University of Amsterdam. In the first semester of that year, I collected all possible materials, studying the literature available and requesting copies of the most recent studies done in Holland. This included information about family intervention in general, the use of video in psychological intervention, and VIDEO-HOMETRAINING in particular. I also contacted the institutions that would be involved in the practical application, and obtained a sample of accompanied children from allergy clinics at the Paediatric Hospital, aged between 7 and 12, who were living with their parents in the district of Coimbra. The second semester was spent in Holland, witnessing the V.H.T. method in action. I participated in all the stages of intervention, in the training of the people who administered the intervention, and in the administration.

2. Over the next two years, I maintained contact with Holland through Drs. Van Der Linden, and learned of significant changes that had taken place. Some literature had appeared (still scarce, and theoretically superficial) but a beginning; moreover, the organizations which had initiated the method embarked upon research aimed at readjusting some of its characteristics and principles in order to respond to different real-life situations with the necessary flexibility.

So I’ll describe how my interest in this method arose and increased:

1. The first step was my decision, at the end of 1989, to participate in the exchange programme ERASMUS with the Faculty of Educational Sciences at the University of Amsterdam (under supervision of Drs. Bert Van Der Linden), as part of a Masters course in Science of Education (begun in the academic year 1989/90 at the University of Coimbra). During the first semester of 1990, VIDEO-HOMETRAINING, which had been in operation in Holland since the 80's, came to my attention, and I made contact with some of the people involved in the scheme. As V.H.T. was still in an 'intuitive/subjective' phase, information about it was scanty, and it had a certain aura of mysticism. Thus, there was very little literature or research available on the subject, and it was difficult to draw any parallels or theorize about it. Anyway I felt quickly attracted and interested to that way of working with the family, instead of working for them, by principles of VHT method.

Involvement with VHT/VIG - I

Since I remember that I want to do something to help out others, I was looking and searching for different ways how to do it.
During this process I discreetly moved from the somewhat harmless fight (trying to build the world according to my inner “eyes”) to paying attention to the others’ “eyes”, trying to see as each of us sees and wishes it. It is only with this change of perspective that I feel that my fight has new achievements - although they are less exuberant - finding so many other worlds, respecting them and helping to build them. Meanwhile, my world was being renewed, opening paths to new projects and elaborating strategies to fulfil others that already existed.
Thereby it is within this ongoing and progressing personal and professional construction that my involvement in VHT/VIG and its fulfilment arise. So I’ll describe how my interest in this method arose and increased:

quem sou eu? Who am I?

Inicio oficial no mundo virtual daquele que é um projecto aliciante sobre o Método Video Hometraining (VHT) e Video Interaction Guidance (VIG), de origem Holandesa, que tenho vindo a investigar e a implementar em Portugal.
Aqui pretendo ir dando informações sobre este método de intervenção diádica e grupal, ao nível dos seus conteúdos, metodologias, implementação em Portugal e acontecimentos práticos e teórico-científicos que vão pautando a sua existência nacional e internacional.


This is the official beginning in the virtual world of an enticing project, the Method Video Hometraining (VHT) and Video Interaction Guidance (VIG).
VHT/VIG has its origins in the seventies in the Netherlands. In nineties I’d start to study it, then I’d continue by getting expertise in that intervention method, researching in Portuguese reality and implement in Portugal.
Here I intent to give information about this dyadic and group’s intervention method, at the level of his subjects, methodology, implementation in Portugal, and practical and scientific-theoretical events that are happening in its national and international existence.