A study in failure

Failure can be both chastening and instructive, but not while it is rendered undiscussable by its taboo status which itself is unwittingly supported by dilemmas of careers and jobs, by vagaries of funding, and not least, by ideological investments. The impetus for this study derives from a recently completed demonstration project which had been designed to evaluate the impact on child development of group counseling of young, first-pregnancy mothers. The project was directed toward improving the social-emotional-cognitive interaction between mother and child. Its larger aim was to demonstrate the effectiveness of a preventive mental health component of a comprehensive health program for children. A complementary objective was the training of public health clinic nurses to become group counselors with a view toward enlarging their roles, skills, and services at public health pre-natal and well-baby clinics.Demographically matched experimental (N = 94) and control (N = 89) groups were drawn from first-pregnancy patients at public prenatal clinics. Both groups were visited and interviewed every two weeks at home by trained interviewers who administered a complex, time-staggered set of test-retest instruments. Extensive demographic and psychosocial information was collected, including data about child-rearing practices. Mothers in the experimental group were to attend (prenatally and postnatally) 20 weekly counseling meetings conducted by public well-baby clinic nurses who had been assigned by their clinic staff to participate in the project and who received intensive training by three mental health clinicians (two child psychiatrists and a clinical psychologist).It was expected that after 20 group-counseling sessions the experimental and control groups of paired mothers/infants could be compared on a number of mental health and developmental measures based on a battery of informal, openended interviews as well as established test instruments.The clientele was prototypically black, teen-age, unmarried, and of lower socioeconomic status; the very “problem” group presumably in need of, and to whom, such programs are addressed.