Family centred Early Intervention programmes in Jordan: A grounded theory study into family and occupational therapists’ collaboration

This study looks into the perspectives of occupational therapists and families of children with disabilities in Jordan engaged in Early Intervention (EI) programmes. The aim of this study is to explore how EI programmes apply the family-centred approach, and specifically to investigate: • The perspectives of families regarding their role within the intervention, and what steps were taken by OT to establish and encourage this role. • The perspectives of OT on how they facilitate family-therapist collaboration within EI programmes. • Generate a theory to describe parent-therapist collaboration within early intervention in Jordan. Data were collected from multiple-sources including field notes, session observations, and interviews with experienced early intervention Jordanian occupational therapists and their clients’ families, to determine the extent to which family centred model is being promoted by accessing records, observing parent- therapist meetings, and studying intervention records. Grounded theory is used to explore the different factors influencing the process of constructing family-therapist collaboration. Findings: Several themes emerged from the data describing the parent-therapist collaboration within the early intervention programme in Jordan, including: power imbalance in the parent-therapist collaboration, early intervention within the Jordanian culture, categorising parents, and language use in sessions. These themes generated the Power Scale framework, which describes the therapeutic collaboration between therapists and parents within EI programmes. The Power Scale framework has three main elements: Knowledge, Expectations, and Engagement. Each element is described from the perspective of parents and then the therapist at the start of the collaboration, with an explanation of the relationship between these elements which changes as the collaboration progresses. The Parent-therapist collaboration in early intervention is also impacted by a variety of external factors including the cultural view and political context within which this collaboration operates. Only through understanding the elements of the parents-therapist collaboration and the external factors impacting it can we achieve a positive therapeutic relationship within the early intervention programme. Conclusion: The parent-therapist collaboration within the early intervention is a complex process that starts at the beginning of the intervention and develops over time. This process is influenced by internal factors including parents’ and therapists’ knowledge, expectations, and is reflected in their engagement. It is also impacted by external factors such as the cultural understanding of the role of health professionals, the awareness of the OT role, and the policies governing early intervention programmes in Jordan. Although family centred model within early intervention ideally promotes a partner role for the parents with the therapist assuming a support role, the reality of early intervention programmes in Jordan reveal a compromise achieved by therapists and parents which allow for different versions of this role ranging from recipient to trainees, and depending on the internal and external factors that influence parent-therapist collaboration.