Abstract #360  -  TALC to PIP: the adaptation of TALC for Zimbabwe
Authors:   Presenting Author:   Dr. Sally Nyandiya Bundy - Univ. of Zimbabwe
Additional Authors:
Aim: To develop a psychosocial support programme for parents with HIV/AIDS and their children.
Method / Issue: Issue: the feasibility of adapting an American programme.
Results / Comments: Teens and Adults Learning to Communicate (TALC) was developed by Professor Mary Jane Rotheram and her team in the early 1990s. It targeted families in which parents were HIV positive. A coping skills-based intervention, TALC was designed to enhance parents’ and their adolescent children’s cognitive, affective and behavioural skills. These skills centre on emotional regulation, problem solving, social support building, verbal and non-verbal assertiveness, and goal setting. Evaluation in the USA found greater use of coping skills and significant positive outcomes in the short and long term, in intervention compared to control families. TALC has been piloted in Thailand, China, USA and now Zimbabwe. A study of the applicability and adaptability of TALC and TALK (the revised version) led to the ‘Needs Assessment’ in which we sought to establish feasibility and desirability of the intervention programme. Because the Needs Assessment was conducted with both HIV positives and negatives, in-depth interviews were later conducted only with HIV positive parents. Thus information from several sources contributed to adaptation of TALC and the development of the Parent’s Intervention Programme (PIP) and two Adolescent versions - APS (for adolescents aware of parental status) and NAPS (for those who were not aware). The style and format of TALC was maintained but some participants’ requests e.g. prayer at commencement, were incorporated. In 14 sessions PIP addresses the meaning of being HIV positive, disclosure, children’s needs and managing teens’ behaviour, skills for risk reduction, positive emotional coping and child custody issues. PIP pilot showed that parents were able to face their own strong feelings (fear, anger, sadness) in relation to being HIV positive; to shift from an earlier planned position of non-disclosure to disclosure to specific persons; and recognised that punishment while culturally acceptable is not the best way to change behaviour. The concept and practice of ‘active listening’ proved difficult for facilitators and parents (‘foreign’, ‘not natural’) in the pilot. In the main study verbal and non-verbal cues preceded ‘active listening’ and worked better. In both the pilot and the main study, distinguishing between assertiveness, aggressiveness and passiveness was easy. Practicing being assertive was not. Traditionally child custody issues are considered after a parent dies. This was initially upsetting, but by the end of custody sessions in both the pilot and main study, parents went from avoidance to a serious consideration of various options. Some relaxation sequences used successfully during the pilot were less successful in the main study.
Discussion: The above will be discussed in terms of the methodology and results of the pilot process with particular reference to dimensions of culture, gender and individual health. The paper concludes with the observation that the content and spirit of TALC can be successfully translated as evidenced by the pilots of the three intervention programmes: PIP, APS and NAPS.
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