Mindfulness among Home Visitors in Head Start and the Quality of Their Working Alliance with Parents

The effectiveness of home-visiting programs in improving children’s health, developmental, and educational outcomes may depend, in part, on the quality of the relationships between home visitors and parents, one aspect of which is their working alliance (shared bonds, goals, and tasks). However, little is understood about what modifiable factors are associated with a stronger working alliance. The purpose of this study was to determine if home visitors with higher levels of dispositional mindfulness reported a stronger working alliance with parents and whether this association was mediated by greater psychological well-being in the home visitor. In the spring of 2012, an anonymous, web-based survey was administered in 50 Head Start and Early Head Start programs in Pennsylvania. Responses were received from 307 of 418 (73.4 %) home visitors. Home visitors reported on dispositional mindfulness (Cognitive and Affective Mindfulness Scale-Revised), psychological well-being, and their working alliance with parents (modified Working Alliance Inventory, Short Form). After controlling for confounders, a 1 SD higher mindfulness score among home visitors was associated with a 0.27 higher score on their working alliance with parents (p < 0.001). This association was mediated by visitors’ positive psychological well-being [indirect effect = 0.12, 95 % confidence interval (0.08, 0.21)]. Among home visitors in Head Start and Early Head Start, those who had higher levels of mindfulness reported a stronger working alliance with parents. Interventions to promote mindfulness among home visitors may be one approach to strengthening their working alliance with parents and the effectiveness of home-visiting services.