Session 5: Mothers Personal Health

This session will be delivered two weeks after the birth of the child.

Objectives of this session:

 To briefly revise the content of previous session and inquire about the homework.
 To assess the mother’s mood.
 To apply the Thinking Healthy approach for improving mother’s personal health.

Objective 1: Revise the content of the previous session

Ask the mother and family if they have any questions about the programme since the last visit.

Using charts from the Health Calendar ask the mother if she has been able to follow some of the activities.

Objective 2: Assess the mother’s mood

Using the Mood Chart, assess the mother’s mood. Give her time to talk about her feeling

Remember the golden rules

 The Three Steps of Thinking Healthy approach
Step 1: Learning to identify unhelpful behaviour

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Objective 3: Helping the mother to improve her mood by paying attention to her personal health

Having discussed how the mother is feeling, tell her how mother’s health can affect her mood.

 Now show the mother the above pictures and ask her.
Q1: How is the woman’s mood? Q2: What is the woman doing?
Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her health?

 Tell the mother that women after their child’s birth can experience thoughts or engage in behaviour which can affect their personal health.
 It is important to identify them in order to address them.
 Encourage the mother to talk about her own unhelpful behaviour and accompanying thoughts in relation to her personal health. For example

Unhelpful behaviours Unhelpful thoughts

Not eating a balanced diet I cannot afford to eat balanced diet/my health is secondary

Not getting enough rest during day I have too much to do already, I can’t be bothered about my health.

Not having enough sleep I can’t sleep well at night

Not going for postnatal check-ups or vaccinations Getting unwell is in my fate, I don’t have time to go for checkups

Not expressing her concerns or problems to others My ill health is caused by an evil eye, nobody can do anything to help me

Make the mother understand the link between unhelpful behaviours, thoughts and mood

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 Step 2: Learning to recognise helpful behaviour

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Show the mother the pictures and ask her.

Q1: How is the woman’s mood? Q2: What is the woman doing?

Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her health?

 Tell mother that a woman’s good health after child’s birth is important for her child.
 Explain to the mother that engaging in the helpful behaviour, will help improve health.
 Ask the mother if there is any helpful behaviour which she can put into practice. For example

Helpful Behaviours Helpful Thoughts

Having a balanced diet Balanced diet doesn’t mean expensive diet. I can eat sensibly the food
available at home, to make my diet more balanced
Having a rest during the day I can organise myself in a way that some time can be spared for healthy
resting
Having a good night sleep Having sufficient sleep during the night will enable me to function
better during the day
Having regular postnatal check-ups and vaccination My good health is important for both me and my child

Expressing concerns and problems to someone trusted I have family and friends who care for me.

Make the mother understand the link between helpful behaviour, thoughts and mood.

Step 3: Learning to replace unhelpful behaviour with healthy behaviour through practicing.

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  Show, the mother the Diet Chart and the Rest Chart (from the Health Calendar) and go through it in detail.
 Discuss with the mother what problems she could experience whilst practicing activities and try to problem solve

Homework setting
 Set tasks with the mother
 Reinforce that practicing the healthy activities outlined in the chart will be beneficial for both her and her child.
 Arrange a time and venue for next session

Session 6: Relationship with people around mother

This session will be delivered, four weeks after the birth of the child.

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Objectives of this session:

 To briefly revise the content of the previous session and inquire about the homework.
 To assess the mother’s mood.
 To apply the Thinking Healthy approach for improving mother’s relationship with significant others.

Objective 1: Revise the content of the previous session

Ask the mother and family if they have any questions about the programme since the last visit.

Using charts from the Health Calendar ask the mother if she has been able to follow some of the activities.

Objective 2: Assess the mother’s mood

Using the Mood Chart, assess the mother’s mood. Give her time to talk about her feeling

Remember the golden rules

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 The Three Steps of Thinking Healthy approach
Step 1: Learning to identify unhelpful behaviour

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Objective 3: Helping the mother to improve her mood by paying attention to her relationship with others

Having discussed how the mother is feeling, tell her how ones relationships can effect mood.

 Now show the mother the above picture and ask her.
Q1: How is the woman’s mood? Q2: What is the woman doing?
Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her relationship with others?
 Tell the mother that women following the birth of their child can experience thoughts or engage in behaviour which can affect her relationship with
others.
 It is important to identify them in order to address them.
 Now encourage the mother to talk about her unhelpful behaviour and accompanying thoughts in reference to her existing relationships. For example

Unhelpful behaviours Unhelpful thoughts

Distancing oneself from the family members Nobody cares about me

Avoiding people to protect child from an evil eye People can cast an evil eye on him/her

Not wanting to go outdoors or socialising with others Discussing my health problem with people will help me to get good advice

Not asking help from the family members Nobody is willing to help me

Not sharing her problems with her husband My husband is too busy to understand my problems

Make the mother understand the link between unhelpful behaviours, thoughts and mood

Step 2: Learning to recognise helpful behaviour

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Show the mother the picture and ask her.

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Q1: How is the woman’s mood? Q2: What is the woman doing?

Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her relationship with others?
 Explain to the mother that engaging in the helpful behaviour, will help improve her relationship with others.
 The mother’s health is important for both the mother and her child’s wellbeing.
 Ask the mother if there is any helpful behaviour which she can put into practice while she is pregnant. For example

Helpful Behaviours Helpful Thoughts

Encouraging father to contribute in child care My husband likes spending time with us

Mother sharing her concerns with either the family member she feels I have people around me who cares for me and are concerned about
close to or the peer volunteer. my problems
Mother asking help from family members in doing the house work. Asking support in child care can reduce my burden

Mother getting some time out to visit family and friends or inviting them My family members cares for me and will help me out with the
at home. housework

Make the mother understand the link between helpful behaviour, thoughts and mood.

Step 3: Learning to replace unhelpful behaviour with healthy behaviour through practicing.

 Show the mother the Interaction with Others Chart (from Health Calendar) and go through each activity in detail.

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  Discuss with the mother what problems she could experience whilst practicing activities and try to problem solve

Homework setting
 Set tasks with the mother
 Reinforce that practicing the healthy activities outlined in the chart will be beneficial for both her and her child.
 Arrange a time and venue for next session

Session 7: Mother-Child relationship

This session will be delivered eight weeks after the birth of the child.

Objectives of this session:

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  To briefly revise the content of previous session and inquire about the homework.
 To assess the mother’s mood.
 To apply the Thinking Healthy approach for improving the mother-child relationship.

Objective 1: Revise the content of the previous session

Ask the mother and family if they have any questions about the programme since the last visit.

Using charts from the Health Calendar ask the mother if she has been able to follow some of the activities.

Objective 2: Assess the mother’s mood

Using the Mood Chart, assess the mother’s mood. Give her time to talk about her feelings.

Remember the golden rules

The Three Steps of Thinking Healthy approach

Step 1: Learning to identify unhelpful behaviour

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Objective 3: Helping the mother to improve her mood by improving the mother-child relationship

Having discussed how the mother is feeling, tell her how mother-child relationship can affect ones mood.

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  Now show the mother the above picture and ask her.
Q1: How is the woman’s mood? Q2: What is the woman doing?
Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her health?
 Tell mother that women, following the birth of their child, can experience thoughts or engage in behaviour which can impact mother-child
relationship.
 It is important to identify them in order to address them.
 Now encourage the mother to talk about her unhelpful behaviour and accompanying thoughts in reference to her relationship with her child. For
example

Unhelpful behaviours Unhelpful thoughts

Not engaging with the child while feeding I am finding it difficult to take care of my child

Not attending to the child’s need I haven’t got energy to look after my child

Not talking or interacting playfully with the child My child is too young to interact with him/her

Not going for checkups or vaccinations Being ill is in my fate- checkups will make no difference.

Make the mother understand the link between unhelpful behaviours, thoughts and mood

Step 2: Learning to recognise helpful behaviour

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Show the mother the picture and ask her the four questions.

Q1: How is the woman’s mood? Q2: What is the woman doing?

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Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her health?

 Explain to the mother that engaging in helpful behaviour, will help mother improve the mother-child relationship, even before the child is born.
 The mother-child bonding is good for both the mother and her child’s wellbeing.
 Ask the mother if there is any helpful behaviour which she can put into practice after the birth of the child. For example

Helpful Behaviours Helpful Thoughts

Taking care of child’s diet and hygiene Looking after my child’s diet and hygiene will help him/her to stay
healthy.
Showing warmth and affection to the child while breast feeding My feelings for my child with get stronger with time.
Interacting with the child through looking, talking, playing and singing to Interacting with the child will make my child healthy and clever.
him/her
Massaging the child Massaging will help my child to grow healthy
Involving the other family members in the upbringing of the child Involving other family members in my child’s upbringing will be good
for him/her

Make the mother understand the link between helpful behaviour, thoughts and mood.

Step 3: Learning to replace unhelpful behaviour with healthy behaviour through practicing.

 Show, the mother the Mother-Child Interaction Chart part 1 (from Health Calendar) and go through it in detail.
 Discuss with the mother what problems she could experience whilst practicing activities and try to problem solve

Homework setting
 Set tasks with the mother

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  Reinforce that practicing the healthy activities, outlined in the chart, will be beneficial for both her and her child.
 Arrange a time and venue for next session

Session 8: Mothers Personal Health

This session will be delivered twelve weeks after the birth of the child.

Objectives of this session:

 To briefly revise the content of previous session and inquire about the homework.
 To assess the mother’s mood.
 To apply the Thinking Healthy approach for improving mother’s personal health.

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Objective 1: Revise the content of the previous session

Ask the mother and family if they have any questions about the programme since the last visit.

Using charts from the Health Calendar ask the mother if she has been able to follow some of the activities.

Objective 2: Assess the mother’s mood

Using the Mood Chart, assess the mother’s mood. Give her time to talk about her feelings.

Remember the golden rules

The Three Steps of Thinking Healthy approach

Step 1: Learning to identify unhelpful behaviour

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Objective 3: Helping the mother to improve her mood by paying attention to her personal health

Having discussed how the mother is feeling, tell her how mother’s health can affect her mood.

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  Now show the mother the above picture and ask her.
Q1: How is the woman’s mood? Q2: What is the woman doing?
Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her health?
 Tell the mother that after their child’s birth women can experience thoughts or engage in behaviour which can affect their personal health.
 It is important to identify them in order to address them.
 Encourage the mother to talk about her own unhelpful behaviour and accompanying thoughts in relation to her personal health. For example

Unhelpful behaviours Unhelpful thoughts

Not eating a balanced diet With so many mouths to feed, I can’t afford to eat balanced diet.

Keeping oneself busy all day without resting It is impossible to get some time out to rest during the day.

Not having enough sleep I don’t have time to care about my health

Not going for postnatal check-ups or vaccinations My ill health will not harm anyone other then myself

Not expressing concerns or problems to others If I will express my concerns I might be wrongly judged

Spending most of the time sitting alone in the room No one is bothered about me or my child

Not doing any exercises to strengthen the body My body has grown so weak that it will be difficult to get the strength back.

Make the mother understand the link between unhelpful behaviours, thoughts and mood

Step 2: Learning to recognise helpful behaviour

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Show the mother the picture and ask her the four questions.

Q1: How is the woman’s mood? Q2: What is the woman doing?

Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her health?

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  Tell mother that a woman’s good health after her child’s birth is important for her child.
 Explain to the mother that engaging in the helpful behaviour, will help improve her health.
 Ask the mother if there is any helpful behaviour which she can put into practice. For example

Helpful Behaviours Helpful Thoughts

Having a balanced diet If I spend a small amount of time for my health every day, I will remain
healthy
Having a rest during the day If I prioritise my work and do essentials first I might get some time to
rest.
Having a good night sleep If I follow the rules for a good night’s sleep I might be able to sleep well

Having regular postnatal check-ups and vaccination I have to take initiatives which are important for me and my child’s
good health
Expressing my concerns and problems to someone I trust There are some family members who will understand me and will not
misjudge me.

Make the mother understand the link between helpful behaviour, thoughts and mood.

Step 3: Learning to replace unhelpful behaviour with healthy behaviour through practicing.

 Show the mother the mother the Diet Chart and the Rest Chart (from the Health Calendar) and go through it in detail.
 Discuss with the mother what problems she could experience whilst practicing activities and try to problem solve

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Homework setting
 Set tasks with the mother
 Reinforce that practicing the healthy activities outlined in the chart will be beneficial for both her and her child.
 Arrange a time and venue for next session

Session 9: Relationship with people around mother

This session will be delivered, sixteen weeks after the birth of the child.

Objectives of this session:

 To briefly revise the content of previous session and inquire about the homework.

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  To assess the mother’s mood.
 To apply the Thinking Healthy approach for improving mother’s relationship with significant others.

Objective 1: Revise the content of the previous session

Ask the mother and family if they have any questions about the programme since the last visit.

Using charts from the Health Calendar ask the mother if she has been able to follow some of the activities.

Objective 2: Assess the mother’s mood

Using the Mood Chart, assess the mother’s mood. Give her time to talk about her feeling

Remember the golden rules

The Three Steps of Thinking Healthy approach

Step 1: Learning to identify unhelpful behaviour

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Objective 3: Helping the mother to improve her mood by paying attention to her relationship with others

Having discussed how the mother is feeling, tell her how ones relationships can effect mood.

 Now show the mother the above picture and ask her.
Q1: How is the woman’s mood? Q2: What is the woman doing?

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 Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her relationship with others?
 Tell the mother that women, following the birth of their child, can experience thoughts or engage in behaviour which can affect their relationship with
others.
 It is important to identify them in order to address them.
 Now encourage the mother to talk about her unhelpful behaviour and accompanying thoughts in reference to her relationship with significant others.
For example

Unhelpful behaviours Unhelpful thoughts

Being distance from the family members I am better off not discussing the problems with anyone

Avoiding people to protect child from the evil eye There are some people who are jealous of my child and can cast an evil eye on
him/her
Not wanting to go outdoors or socialising Nobody really likes or wants to interact with me

Not asking help from the family members Nobody is willing to help me

Not discussing problems with anyone I don’t have the confidence to talk about my health problems with others

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 Make the mother understand the link between unhelpful behaviours, thoughts and mood

Step 2: Learning to recognise helpful behaviour

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Show the mother the picture and ask her the four questions.

Q1: How is the woman’s mood? Q2: What is the woman doing?

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 Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her relationship with significant
others?
 Explain to the mother that engaging in the helpful behaviour, will help mother improve the mother’s relationship with significant others.
 The mother’s health is good for both the mother and her child’s wellbeing.
 Ask the mother if there is any helpful behaviour which she can put into practice after the birth of the child. For example

Helpful Behaviours Helpful Thoughts

Encouraging father to contribute in child care My husband likes spending time with us

Sharing concerns with either the family member I trust or with my Peer Other people have gone through similar experience, they will
Volunteer. understand my problems
Asking help from the family members in doing the house work. Some of my family members are very caring, if I ask them they will help
me out
Getting some time out to visit family and friends or inviting them at If I will meet and talk to other people, it will take my mind away from
home. my worries

Make the mother understand the link between helpful behaviour, thoughts and mood.

Step 3: Learning to replace unhelpful behaviour with healthy behaviour through practicing.

 Show the mother the Interaction with Others Chart (from Health Calendar) and go through each activity in detail.

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  Discuss with the mother what problems she could experience whilst practicing activities and try to problem solve

Homework setting
 Set tasks with the mother
 Reinforce that practicing the healthy activities outlined in the chart will be beneficial for both her and her child.
 Arrange a time and venue for next session

Session 10: Mother-Child relationship

This session will be delivered twenty weeks after the birth of the child.

Objectives of this session:

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  To briefly revise the content of previous session and inquire about the homework.
 To assess the mother’s mood.
 To apply the Thinking Healthy approach for improving mother-child relationship.

Objective 1: Revise the content of the previous session

Ask the mother and family if they have any questions about the programme since the last visit.

Using charts from the Health Calendar ask the mother if she has been able to follow some of the activities.

Objective 2: Assess the mother’s mood

Using the Mood Chart, assess the mother’s mood. Give her time to talk about her feeling

Remember the golden rules

The Three Steps of Thinking Healthy approach

Step 1: Learning to identify unhelpful behaviour

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Objective 3: Helping the mother to improve her mood by improving mother-child relationship

Having discussed how the mother is feeling, tell her how mother-child relationship can affect ones mood.

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  Now show the mother the above picture and ask her.
Q1: How is the woman’s mood? Q2: What is the woman doing?
Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her health?
 Tell the mother that following the birth of their child women can experience thoughts or engage in behaviour which can affect her bonding with her
child. It is important to identify them in order to address them.
 Now encourage the mother to talk about her unhelpful behaviour and accompanying thoughts in reference to her relationship with her child. For
example

Unhelpful behaviours Unhelpful thoughts

Not looking after the child’s diet or hygiene. I do not have the energy to look after my child.

Not interacting playfully with the child. My child is too young to interact with.

Not massaging the child. I am too busy with the housework.

Not holding or looking at the child with warmth and love It is difficult to look after all the children

Not going for checkups or vaccinations. Checkups make no difference, fate determines health.

Failing to take adequate measures if a child becomes unwell. I cannot do anything if my child will become unwell.

Make the mother understand the link between unhelpful behaviours, thoughts and mood

Step 2: Learning to recognise helpful behaviour

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Show the mother the picture and ask her.

Q1: How is the woman’s mood? Q2: What is the woman doing?

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Q3: What is the woman thinking? Q4: How is the woman’s behaviour impacting on her health?

 Explain to the mother that engaging in helpful behaviour, will help mother improve the mother child relationship
 The mother-child bonding is good for both the mother and her child’s wellbeing.
 Ask the mother if there is any helpful behaviour which she can put into practice after the birth of the child. For example

Helpful Behaviours Helpful Thoughts

Taking care of child’s diet and hygiene Looking after my child’s diet and hygiene will help him/her to stay
healthy.
Showing warmth and affection to the child while breast feeding My child responds s to my feeling when I interact with him/her.
Interacting with the child through looking, talking, playing and singing to Interacting with the child will make my child happy and healthy.
him/her
Massaging the child Massaging will help my child to grow healthy
Involving the other family members in the upbringing of the child Involving other family members in my child’s upbringing will be good
for him/her
Taking adequate measures if a child become unwell such as giving ORS I can learn from my Lady Health Worker what measures I can take if my
when the child has diarrhoea child become unwell

Make the mother understand the link between helpful behaviour, thoughts and mood.

Step 3: Learning to replace unhelpful behaviour with healthy behaviour through practicing.

 Show the mother the Mother-Child Interaction Chart (from Health Calendar) and go through it in detail.
 Discuss with the mother what problems she could experience whilst practicing activities and try to problem solve

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Homework setting
 Set tasks with the mother
 Reinforce that practicing the healthy activities outlined in the chart will be beneficial for both her and her child.
 Arrange a time and venue for next session

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