I realize that there isn't enough money floating around to actually
compensate for this, but my feeling is that when I take on a client, I am
going to do enough follow up that she also feels emotionally supported
through the crisis.  This seems to make the diff. in duration outcomes.
While I don't do general counseling over the net or by email (feeling that
it lacks enough real-time feedback to catch subtle indicators that are
useful in clinical situations) I do a lot of email follow-up for my clients.
I like it because I can answer questions and provide reasurrance (without
phone tag.) Moms appreciate the brief written reinforcements of what we've
discussed on visits.  I do this by phone if mom doesn't use email -- even a
voice mail message makes the mom feel attended to.

 I feel that the intensity of the follow-up reassures the mom that she has
someone who will see her through.  It also gives me such great feedback.  I
can adjust the care plan and move the mom through the various stages of the
interventions -- esp. the all important backing away phase.  Moms otherwise
often lose their nerve when it gets time to pull the props.  My ideal
outcome is  returning everyone to normal (totally or as near as can be.)
Moms seldom overuse this help.  I agree that social support is key, but as
some others have commented, I refer to groups and the moms often don't feel
comfortable going.  If the woman  already has therapeutic relationship with
me, and a kind of emotional bond, I can provide a degree of the "care
community" support while finishing my work managing her case.  I see this is
much the same way homebirth midwives bond with clients, see them through,
and then sort of gently disappear.  Moms in both situations seam to wean
themselves easily once their time of need is over.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com
PLEASE NOTE NEW EMAIL ADDRESS:  [log in to unmask]

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html