Parenting in Low-Income Context: Assessment of a Psychosocial Group Intervention in Brazil

Introduction

The Brazilian separated families often seek their own resources to cope with the changes caused by the divorce, and sometimes, seek assistance from the Justice system to make decisions in the face of family disagreements. Thence, we consider that the legal context often shows to be unprepared to deal with subjective family conflicts and, many times, unresolved problems remain or and families feel that the decisions were unfair. In Brazil it does not exist a public policy for divorced families that aims the promotion of a constructive marital separation for their members. Initiatives with this population occur mainly in the justice setting, like mediation and psychosocial advisory services to Family Courts [1, 2, 3]. Sharing experiences, beliefs, feelings and ideas in a group for separated and divorced parents can increase the distinction of family roles, as well as facilitate the family transition process from a married to a separated family and the decrease of parental conflicts [4]. In this sense, the authors of this paper developed a methodological proposal of a psychosocial group to low-income separated families with small children. This article aims to evaluate the methodology from the analysis of pre- and post-group questionnaires and the interviews conducted with the participants. This paper is part of the scientific dissertation of the first author, mentored by the second.

The focus of this work is on the reality of low-income separated families. The Brazilian and international scientific literature that studies group interventions with this population is scarce. Accordingly to Pérez and Bairon [5], about 78% of the Brazilian population belongs to low- income classes that represent families earning less than three minimum wages. This literature gap urges studies on separations and divorces with this specific population [6]. The research and the construction of the Brazilian scientific knowledge also need to look towards its majority population. Scientific evidences will provide more effective possibilities and solutions to their family struggles.

It is important to conceptualize the use of the term “separated families” instead of “divorced families” in the Brazilian context. Even though the legal terms separation and divorce are similar in different countries, the experience of low-income families facing a separation in Brazil has especial features. The term separation in this work refers to the ending of a consensual cohabitation between two partners and divorce means the formal and legal finalization of the marriage. This differentiation is crucial when working with low-income families, where informal separations are more common than formal marriages and divorces.

Family Systems Theory is the framework of this work. This theory understands families as dynamical systems and emphasizes the interactions between its members. The family system has two important subsystems: marital and parental. The first one relates to marital roles and expectations as a couple, while the second one refers to the role of raising and supporting the children [7]. After a separation, the marital relationship ends, but the presence of children requires the continuation of the parental relationship, especially if the children are young. Therefore, the differentiation between marital and parental roles is crucial to the emotional health of the separated family [7, 8, 9]. The parents not always overcome this challenge, especially when they don't have emotional, social and economic support. In this sense, the main goal of the psychosocial group intervention for separated low-income mothers and fathers was the differentiation of these roles in order to understand and promote the finalization of the marital relationship and the continuity and strengthening of the parental relationship.

The socioeconomic reality in Brazil imposes challenges to psychosocial services. The practice of psychologists and social workers in public policies must include the analysis of multiple levels, instead of looking only at the individual level [10]. The action proposed in this work was based on the psychosocial approach, which is a form of assistance to people in different and vulnerable contexts, such as health, social welfare and Justice Systems. The psychosocial approach goes beyond the traditional therapeutic setting, since it considers and engages in social, economic, political, cultural and legal proceedings that affects the psychological aspects. It also focus on empowering individuals who face many adversities to enhance their autonomy and citizenship by recognizing their own and available resources. It is recommended, therefore, to provide brief group interventions, to increase the feeling of belonging, acceptance, listening and transformation when exposed to people in similar situations mediated by a professional [11].

Method

The design of this study was based on the action- research approach, which is a method that integrates theory, research and action in order to address important issues of a group or community while also building scientific knowledge [12]. The psychosocial group intervention was a pilot study and its methodology included mixed-methods of qualitative and quantitative instruments to collect data while providing the interventions to the participants. Context: This research took place in the academic and psychosocial context, at a Psychology Clinic of a Brazilian federal university. This setting was in conformity with the methodological approach of this research, which differs from the adversarial reality of legal contexts. Furthermore, the practices carried out by a school-clinic are linked to the action-research approach, through the universities’ ethical and political commitment to provide services to low-income populations [2].

Instruments: The data of this research came from the application of pre- and post-group questionnaires, individual interviews with each participant and seven group meetings. All instruments were created by the research team and followed semi-structured guides.

Participants: Seven separated parents (four mothers and three fathers) participated in the individual interviews. The inclusion criteria set out in the research project for selection of participants were: men and women separated between four months and one year; have children with up to 12 years old; have personal income lower than three minimum wages; and agreed with the informed consent.

Participant Occupation Individual income

Antonia Servant 1.9 MW Elementary school Catholic Multiracial Bruno Seller 2 MW Higher education Christian Multiracial Claudio Analyst 1.3 MW Incomplete higher Dalva Domestic maid 2.2 MW Incomplete elementary school Protestant White Elza Nursery assistant 1.6 MW Incomplete higher Fatima Cleaning servant 1.5 MW Incomplete high Gerson Electrician Not declared Elementary school Not declared Multiracial * Values in minimum wages (MW). According to Law number 8,166 of 12/23/2013, one national minimum wage (1MW) in 2014 was established in 724.00 Brazilian _Reais_per month, which at that time valued approximately US$ 322.00 per month or US$3,864.00 per year. Table 1: Demographic Information about the Participants. Procedures: The school-clinic and justice agencies referred the participants. After evaluation of the inclusion criteria, 24participants were selected and invited through a telephone interview that followed a semi-structured guide. They all agreed to participate voluntarily, but only seven attended the individual interview. Before this interview, each participant completed the pre-group questionnaire. At the end of the interview, they confirmed their participation in the group meetings, but only three of them showed up for the first group meeting, and only two participated in all seven meetings planned accordingly to a semi-structured guide. At the end of the last group session, the participants completed the same version of the questionnaire answered previously.

Unfortunately, the low participation in research projects is a reality in Brazil, where the scientific culture is not enough spread or encouraged. In that country, offering any amount of money to the participants goes against ethical regulations in research with human beings, making the research process even more difficult, especially with vulnerable populations. They were offered child care support; public transportation costs reimbursement, and snacks to facilitate their * Schooling Religion Race/Ethnicity education Protestant White education Catholic Multiracial school Protestant Multiracial participation. Even though, only a few participated. However, the heterogeneity of the participants and the data revealed to be significant to bring representativeness and relevance for the construction of scientific knowledge with this population underserved and understudied.

The structure of group meetings followed the psychosocial intervention methodology proposed by Costa, Penso and Conceição [13], which is organized into three phases: introduction, development of the main activity and closure. Each group meeting had specific topics that were planned according to the main aspects related to the differentiation of marital and parental roles of separated parents [8, 9, 14, 15]. The meeting themes and activities were: 1) Participants’ integration and bonding: sharing their stories after drawing their families. 2) Marital roles: reading and discussion of a poem about ties, cremation ritual activity of the marriage. 3) Parenting: discussion on the metaphoric roles of “clue, bullet and luggage” that children may play after the separation (i.e. children acting to reunite the parents, to take insults or messages from one parent to the other [14].

4) Communication: discussion about communication patternsbefore and after the separation. 5) Transgenerational influences: listening to a Brazilian song about parents (“Como Nossos Pais” by Belchior, 1976) and genogram drawing, which provided the background to discuss about how the participants learned to parent [16]. 6) Social networks support: each participant received a network map developed by Sluzki, where they identified people among their families, work, neighborhood, and other systems they considered important for themselves [17]. 7) Assessment and evaluation: listening to a Brazilian song about moving forward (“Seguindo em Frente” by Sater & Teixeira, 1991) and discussion about individual and group transformations that occurred along the action-research process [18].

Results and Discussion

The data were analyzed according to the methodology of thematic analysis that defines theme as linked participants’ statements about a particular topic. It can be represented by a word, a phrase or a summary [19]. The thematic analysis process happens in three stages: pre- analysis, exploration of the data and processing of results and interpretation. The first step consists in reading throughout all data without judgment. After, the material is explored for a second time when significant keywords and statements are selected. The third step refers to the interpretation of the themes and construction of thematic units.

Throughout the thematic analysis process in this action-research, the data selection came from the participants’ spontaneous or motivated expectations and evaluation about the group process. The pre- and post- questionnaires responses were also compared, which resulted in the Table 2. From the extensive reading of the results, four thematic units were built, which are: 1) Psychosocial group setting as a space to talk and listen. 2) Paradoxical feelings of fear and safeness in the psychosocial group setting. 3) What changed and what stayed the same along the psychosocial group. 4) Dissemination of this psychosocial group intervention to other people.

Table 2: Comparing pre-and post-group questionnaires. Thematic Unit1. Psychosocial group setting as a place to talk and listen: “Here we can say everything.” Along the group sessions, participants valued the psychosocial place, where they could talk to and vent about their problems, as synthesized by Antonia in the session 4: “Here we say everything, it seems we vent, put it out and we own start to organize our thinking, that's what I found so far. The importance of a group like this in our life." It is known that expressing about themselves to others can promote their autonomy, by becoming the protagonists of their own history [3]. Although venting by itself does not bring deep transformations, it can contribute to the decrease of the marital animosity after a separation.

The group needs to be a safe place, so the participants feel comfortable in sharing their family issues. The data demonstrated that this psychosocial group created a respectful context of listening, like Antonia said: “the advantage of the group that I found, from the time that I'm here, is that here we can talk about everything and no one gives an opinion. (...) And at home when we talk, all the time, we don't find anyone; we’re still lost when we will talk about it there.”_Antonia confirmed the need for a context free of judgment, opinions and advices of what must be done. This position was adopted by the research team, who believes in the potential of the families to find their own resources and to seek the most appropriate solutions for their problems. This intervention encouraged the expansion of the participants’ understanding about their potentialities and did not provide advices about what to do. This attitude of respect for the families’ values and beliefs was adopted by both the team and the participants, which can be confirmed in Bruno’s statement: “_Each one here talking and respecting the views of others”. Rapizo (2012) emphasizes the importance of creating a respectful group setting with separated families [2].

The scientific literature indicates the importance of creating interventions where divorced people can talk and listen to other people in similar situation, in order to discuss the challenges faced after the ending of the marriage. It is common that this topic overwhelms the immediate social networks, who might not have the availability to assist properly separated people, which often leads to family and social isolation [2, 9, 17]. The participant’s concerns with their kids and social isolation were mentioned in the pre-group questionnaires. In this direction, the psychosocial group demonstrated to be a meaningful support to the participants. Sharing similar experiences leads to feeling belonging and decreases social isolation that the separation promotes, as Antonia said in the fourth session: “Everyone suffers, it’s not only me! Why would it be only me? If others overcome, we can also do it!” The psychosocial group became a part of the participants’ social network, where they could feel safe and supported. According to Sluzki (1997), a sensitive, active and reliable social network generates resiliency and health [2, 17].

This intervention promoted the development of interpersonal interactions, in which the participants could compare and find similar and different aspects between themselves. This was demonstrated in what Bruno said in the last session: “I think the feelings are very similar, but each one has a different reality”. The group context provides identification and amplifies the understanding about their own separation [9, 14]. Furthermore, the homogeneity of low-income participants advanced these interactions and identification, by sharing similar values about family and culture. In addition, the differences were also present in the group, such as the gender, that also enriched the interactions by exposing the participants to different perspectives. This contributed to a broader understanding and flexibility with their ex-partners. When separated people are open to listen to others point of view, even from outside their families, it increases the possibilities of listening, dialogue and consensus [2, 20]. The participants brought this aspect since the first interview, as Claudio mentioned: “I believe that sometimes when we listen to someone else, it gives a click in our mind, and you notice or see the mistakes made by another person and also their successful histories. I think it's very productive, I think it’s good”. In a similar way, Bruno shared in the third group session: “You see other people, you see, let’s say, the same situation from a different angle. That's what I find most interesting, huh? So you, sometimes, stop, think, look and say: ‘Hey, I had never thought in that way’. Sometimes this also helps you.” The multiple perspectives from different people help to view and face the situations differently [2]. The sharing of feelings, thoughts and experiences in the psychosocial group context contributed to a better adaptation and adjustment of the family situation of marital separation, such as found in other researches [21, 22, 23]. The work developed here with low-income families demonstrated to be highly relevant, since this population have little access to services in which they can share their dilemmas, challenges and possibilities.

Thematic Unit 2. Paradoxical feelings of fear and safeness in the psychosocial group setting: "People confuse Psychology with craziness." The group setting can initially bring uncertainty and mistrust to the participants. Although people are often surrounded by others and inserted in group contexts, actively participate in an unknown group of people can generate anxiety and fear of exposure. This might have been one of the reasons of the small number of participants in the group sessions, as Claudio shared during his individual interview: “Look, I believe, when you talk about a group, it scares me a little, because human beings are very complex, huh?” Other participants disclosed their prejudices regarding the Psychology field, when the research team members introduced themselves as part of this profession. These aspects can be observed in the following dialogue in the fourth session: Antonia: Because a lot of people confuses Psychology with craziness. Bruno: People have prejudice. Always had. The stigmatized view of psychological practices pushes people away from seeking psychosocial attention spontaneously. This was one of the great challenges of this action-research: to engage people without a spontaneous need for changing. It seemed clear that the ones who participated in the group meetings were more motivated to attend psychosocial service offered. The psychosocial work in Brazilian public services faces the same situation, especially when families are mandatory referred by professionals [14]. The construction and implementation of these psychosocial group practices in the Brazilian context confront many difficulties, especially when it comes to active engagement and effective participation of the population in the process. Professionals and clients still relate asymmetrically, considering the scientific knowledge in a hierarchical position. This complimentary relationship of power and passivity generates dependency and prevents the development of autonomy and citizenship [20].

To deal with these challenges, it is essential to build a respectful environment that favors the development of participants’ confidence in the group setting. Initially, a trustful relationship between the participants and the research team must be built, in order to guarantee and facilitate a constructive process. Some participants statements since the individual interviews and first group session demonstrated that the research team was providing a safe place to share: Elza: I like to talk, and some things that I said here I had never shared to anybody else before. (Individual interview) Claudio: And here we feel safe, not because you don't know our families, but we feel safe to talk, right? Feel free and comfortable to talk, and know I'll not be in risk of being exposed or humiliated, right? Anyway, on the contrary. (1stSession) Mirroring the research team’s attitude, the participants also contributed to build a safe group space, as Antonia said in the third session: “T_here are things I say_ here that I'm not going to talk to my son, to my daughter, because it can even bring us to fight there. What I'm sharing here are things that they don't even know at home. You can't tell everything to them.” Throughout the sessions, it became clear that the participants felt comfortable to share issues that are difficult to discuss with others. In addition, they were able to understand the psychosocial work differently from the common sense. In conclusion, offering individual and group moments to the participants proved to be crucial in building confidence in the team and others. Thematic Unit 3. What changed and what stayed the same along the psychosocial group: “From very bad to bad!” The group context facilitated the beginning of some changes in the situation of separation with small children. The psychosocial group helped to activate the participants’ own resources to move forward a better separation process. The marital relationship and the negative effects and feelings still present after the separation seemed to decrease during the group process. The communication between the ex-partners, such as in Bruno’s situation, also advanced in the child’s best interest. At the beginning of this action-research, his son was living with Bruno’s ex-mother-in-law. After a few group sessions, Bruno improved his communication with his ex-partner and they came to a consensus to transfer to him the custody of their son without the interference of the Justice. These advances also reflect the goals defined in this action-research, of differentiating marital and parental roles after the separation.

Oftentimes, people think that the work with separated families is to seek a marital reconciliation. Otherwise, since the beginning, the research team had made it clear that they would not interfere in the participants’ decisions in terms of their marital status. The goal was set to minimize their suffering by differentiating marital and parental roles. Claudio’s statement in the first session represented the understanding of this goal: “I came to this meeting not thinking about rescuing my marriage, but to have a better relationship with my ex-partner. It also includes finalizing it.” That demonstrates the understanding of the need for finalization of marital relationship, but keeping a respectful environment as parents.

Regarding the relationship with the former spouse, the pre-and post-group questionnaires showed changes in Antonia’s situation. Although she maintained some distance with him, she improved a little the evaluation of their relationship, moving from “very bad” to “bad” after participating in the group. Her survey also confirmed a decreasing of aggressiveness in the parental communication. The feelings of anger toward the ex- partner were reduced over the sessions, which contributed to this slight change in Antonia’s perception of the co-parenting relationship, even with conflicts still present. According to Costa et al. (2015), this is expected to happen in group settings. Although the group setting affects the intensity of negative feelings, it might not be enough to transform family dysfunctions [20].

The questionnaires also assessed the participant’s opinion about the relationship between the ex-partner and the children. Antonia changed her perspective from a close relationship to eventual. During the group sessions, she also mentioned that her daughter was becoming more distant to the father. This result might be a case of the child’s triangulation between the parent’s conflict. When the co-parenting relationship is hostile, the children may be caught in the middle and emotionally forced to choose one side over the other. This loyalty process seemed to be present in Antonia’s case, where her daughter chose the mother and became more distant toward the father. This process is harmful to the children’s development and goes against their best interest and right to maintain the involvement with the whole family [10, 24].

On the other hand, Bruno recognized the importance of the mother’s family side in his son’s life. This may also have affected the improvement in his perception of the relationship between his son and the mother of his former partner, from “eventual” to “close”. While the distance and animosity between the parents can influence on the detachment of the child from one of the parents as in Antonia’s case, the appreciation of the other parent in the child’s life and the desire to establish a parental relationship brings more benefits to the children as in Bruno’s case. When the children feel free to transit between one parent to the other, they are allowed to maintain contact with both parents and their families, without being required to be exclusive loyal to one of the parents [10, 24].

Another change observed in the questionnaires was related to the presence of conflict and violent situations among the ex-couple and other family members. Bruno’s post-group survey pointed to a rise in the conflict perception, changing from “seldom” to “often”. This difference might be affected by his feeling of more confidence to share this information that could be kept in secret. Another hypothesis is related to the group process that might have brought a broader awareness, since this was a topic discussed during the sessions. In Antonia’s case, her perception of her relationship with her ex- mother-in-law improved, which was also affirmed during the group sessions. In general, the responses of the pre- and post-group questionnaires have not changed significantly. The conflicts with the ex-partner were still present and the co-parenting relationship had insignificant changes. Although there is enough evidence that supports a reduction of marital conflicts after the group meetings, this intervention was not enough to improve the co-parenting relationship. The marital and parental roles, although related, seem to hold different aspects. While the marital relationship fades over time, and the group intervention can facilitate this process, the co-parenting relationship has greater challenges. Sharing the responsibilities of raising the children sometimes is not even present during the married family. In this sense, other interventions that focus on the strengthening of the co-parenting relationship are recommended. Thematic unit 4. Dissemination of this group intervention to other people: “This intervention should be a law.” During the group sessions, the participants mentioned their expectation of disseminating this intervention to other people in similar situation. In the second session, Claudio expressed this suggestion: “This [intervention] should be a law! Every guy who separated, every woman who separated should have to go through a process like this.” This type of manifestation was also present in a similar intervention proposed by Brito et al. (2010) [9]. There are no Brazilian public policies that focus on separated and divorced population. In other countries, such as the United States, several States have standards that ensure access to psycho educational programs about separation and divorce for families that have children in the context of dispute in Family Courts. In 2014, the Brazilian National Council of Justice recommended that the Family Courts around the country provided workshops to parents, mothers and children in order to prevent and resolve family conflicts [25]. Even in a slow pace, these initiatives demonstrate advances to extend the resources to families that are facing the challenges of a separation or divorce.

The relevance of this intervention can be observed in the statement of Antonia in the seventh session: “But this is what I say, the importance of the group. People had to become aware, because if there’s something hurting you, you vent it, throw it away. If people had someone to talk, someone to say...”. Along the group meetings, the participants realized the importance to discuss these topics, which are not present in social programs. Usually, separated parents do not have access to dialogic spaces where they can expand their understanding of this difficult time. Low-income families are even more apart from this type of service, not only due to the lack of similar initiatives, but also because they are struggling to survive in vulnerable contexts. The public services provided to this population usually have few and precarious resources and are overloaded. In addition, the majority of these services’ professionals still focus on the individual work and remain in hierarchical and moralistic positions with this population [8]. It is necessary to expand the systemic understanding and psychosocial group approach to these spaces dealing with complex issues and vulnerable contexts.

In the group intervention of Brito et al. (2010), the participants also claimed to discuss the parental roles after separation in different settings, such as schools, universities and justice [9]. Those participants manifested their outrage and disappointment at the professionals who handle their cases without sufficient knowledge about the multiple family challenges and circumstances during the separation process. The participants of the action-research presented in this paper also demonstrated to be dissatisfied with professionals of the Justice, health and education. However, they did not make political and social claims with a broader impact on people’s lives. Even though this work does not allow generalizations, it is known that the low-income population is still aside from the political and democratic participation, which influences in their lack of knowledge about their constitutional rights. The historical constitution of the Brazilian society based on colonialism and imperialism maintain the majority of its population in a powerless position. Besides, the Brazilian political and legal norms sustained by elitism and capitalism obstructs low-income citizens in their emancipator process [26].

Conclusion

The psychosocial group intervention demonstrated to promote the differentiation of marital and parental roles by sharing experiences and feelings from the separation. In the beginning of the group process, it is expected that the participants fear of being exposed and judged by others. The facilitators of the group must respect those feelings and provide a safe environment by adopting an ethical, coherent and professional attitude. Therefore, the group setting represents a valuable work to promote significant dialogues and reflections along its process.

Despite the fact that the group contributed to the differentiation of parental and marital roles, parenting conflicts were still present. Distinguishing these roles does not necessarily leads to improving the parents’ capacity to share the children’s fostering. Interventions need to target the co-parenting relationship in order to guarantee the children’s best interest after a separation.

The particularities of the Brazilian cultural, social and economic reality need to be considered in the development and implementation of programs and interventions. The Brazilian people face difficult situations related to poverty, lack of resources and inequities. Despite these vulnerabilities, they overcome overwhelming and hurtful situations with a unique resilience and joy that need to be considered in the planning of each group meeting. The proposal of this psychosocial group intervention with separate low- income people with small children addressed the gap of studies and intervention with this population. Besides, it also demonstrated to be in conformity with the Brazilian context. It is suggested the dissemination of these interventions for other contexts and people who experience the separation with children, especially for low-income families, who are most disadvantaged in ensuring their rights. The group format proved to be significant with these families, who shared problems and solutions along the reflective dialogues and interactions. However, this was an introductory work that still raises questions about its effectiveness in the long- term. The formulation of public policies for separated families must be present on the agendas of health, education, social welfare and justice, since the issues involved in these situations are increasing in Brazil and affect significantly low-income families.

Compliance with Ethical Standards

This research was approved by the Ethical Research Review Board of the Human Sciences Institute of the University of Brasilia. For participation in research, the participants agreed and signed an informed consent, as required by National Health Council Resolution number 196/1996. The real names and identification data of the participants, as well as the integrity of audiovisual recordings remained confidential.

Conflicts of Interest

The present research shows no conflicts of interest.