Learning and teaching care within the family: Experiential learning reflecting informal teaching

Teaching and learning to care within and for the family

Theories on teaching care have primarily targeted adults out of the family context, including those focused on formal educational contexts such as higher education (Hamington, 2020) and vocational or professional development of caregiver professionals (MecKelvey, 2018; Swanson, 1991). In both cases, scholars incorporate care ethics principles and different care steps into their teaching practices. Hamington (2020) emphasizes the world’s relational and agential character, proposing that care is entangled with the environment and bodies. Thus, teachers should consider that “how we teach is what we teach and how we learn is what we learn” (p. 45). Focusing on the education and training of professional nurses, Swanson (1991) proposed a middle-range theory of care to guide nursing professionals in their work with patients and families. Along the road, this theory has been re-purposed for educational contexts targeting nursing professional training, and the steps initially described by Swanson (1991) are used to guide teachers’ practices (MecKelvey, 2018).

Within the context of the family, although many external formal interventions have been developed to support parents in their function as caregivers as adults (e.g., Myntti et al., 2018; Sone et al., 2023; Wrede et al., 2008; Wyatt Kaminski et al., 2008), less is known about how parents learned to care before such interventions. Prior research suggests that caregivers may not have been taught how to care within the family effectively. In fact, the research suggests that caregiving within the family is often difficult and that many caregivers report feeling unprepared. For example, research has shown that when adults come to officially perform the role of caregivers within the family, such as in parenting situations, they often feel unprepared for the task. Raudasoja et al. (2022) found that Finnish mothers reported challenges with being prepared for parenthood, an issue that participants justified as being connected to not having “role models for being with children” (p. 760). The lack of knowledge and experience in caring for an infant was also true among teenage mothers across different cultures (Erfina et al., 2019) and negatively influenced Hong mothers’ sense of competency (Ngai et al., 2011). Thus, how people become caregivers, focusing on the developing process of this social role, is understudied. Consequently, there is a pressing need for empirical work addressing care as something that must be taught and learned.

Participants

Participants were 25 caregivers from the US (seven focus groups, M_age = 38.48, SD = 8.62, range 29–66, Median = 36) recruited primarily in College Station - Texas, and 20 from Finland (five focus groups, M_age = 40.61, SD = 5.66, range 28–45, Median = 33.5) recruited in Pirkanmaa region (Tampere, Nokia, Pirkala and Kangasala). The only inclusion criteria were that caregivers had children or cared for children who belonged to their family between the ages of 0–18. Caregivers noted caring for biological children, as well as taking in and caring for foster children, grandchildren, and great-nieces. Given our research goal to investigate caregivers’ experiences and practices, we recruited participants with the goal of homogeneous sampling. Thus, participant homogeneity was based on the shared status of unpaid family caregivers with a child within the household. Furthermore, to assess cultural differences, shared cultural context was an additional recruitment goal so that the number of focus groups for each country was sufficient for within-country homogeneity to also compare across countries. Most participants from the US were women (84%), married and Christian (88%), and identified as Non-Hispanic White (64%), while the remainder identified as Latinx (24%), Black or African American (8%), and Asian American (4%). US participants reported having an average of 2.28 children (range 1–5), with ages ranging from 4 months to above 18 years (as a second, third, or fourth child). Participants had a range of educational backgrounds, with 32% having a master’s degree, 28% having a bachelor’s degree, 24% having a doctorate, 4% having a vocational degree, 4% having some college education, and 8% having a high school diploma. Yearly income ranged from less than $10,000 to more than $150,000. In Finland, 95.8% of participants were women; 50% were Christians. While all participants had lived in Finland for at least 10 years and were Finnish citizens, 41% identified as Finnish, 33.3% as European, and 25.6% as non-European. Finnish participants reported having, on average, 2.1 children (range 1–3), with ages ranging from 7 months to 16 years. Most participants had master’s degrees (61%), 9% had doctoral degrees, 9% had high-school degrees, 10% had bachelor’s, and 10% had vocational degrees. Three of the participants in Finland were on maternal leave, while the remaining 17 were working full-time, with working hours varying between 37.5 to 40 hours a week. Most respondents (60%) reported a monthly income between €2000 and €4000, 20% earned less than €2000 and 20% above €4000.

Procedures

Data was collected through focus groups. Compared to interviews, focus groups allow for the researcher to take on a peripheral role, as a moderator, rather than leading every element of the conversation (Nyumba et al., 2018). Thus, caregivers could take a more active and engaged role in what and how they shared experiences, not only based on the researcher’s probing but in response to each other’s interests. One of the strengths of this method is that it allows participants to build on and draw on other’s experiences and thus generate responses that can be richer than those obtained from researcher-led one-on-one interviews (Thomas et al., 1995). Thus, in the present study, we employed the use of focus groups to meet our goal of exploring in-depth the collective experiences of caregivers, particularly with a focus on teaching and learning care. The data used in this study belongs to a larger project developed in collaboration between the authors and was collected from October 2021 to February 2022. The study received IRB approval from each author’s university for data collection in each country (U.S. protocol # IRB2021-0900 M, “Thinking about Care Within the Family”; Finnish protocol # Statement 59/2022, “From care receiving to caregiving: a developmental and cross-cultural investigation into the conceptualization of care within the family”). Given our goal to investigate caregivers’ experiences, participants were recruited through purposeful sampling. US participants were recruited through listservs and social media (e.g., Facebook) and received $30 for participation. Finnish participants were recruited via email listing accessible via daycare centers belonging to the first author’s network and received a movie ticket as compensation for their participation.

Given the cross-cultural goal of the study, the focus group protocol was designed by a team that included a member living in each country and familiar with the culture of each cultural context studied (as recommended by Cuoco et al., 2022). The protocol was translated from English to Finnish by a native Finnish speaker with a background in cross-cultural qualitative research and then back-translated. The protocol was also piloted to ensure the operationality of the interview script, respecting the semi-structured nature of the focus groups. Focus groups were conducted virtually through Zoom in the US and in person in Finland, with a minimum of 3 participants per group (M = 3.5), and lasted an average of 1.5 hours. Our number of focus groups per country (5 in Finland and 7 in the US) met the criteria for focus group data saturation found in the literature (e.g., Hennink & Kaiser, 2022). We also recruited with the goal that each group met at least the minimum number of participants recommended by the literature (e.g., Krueger, 1994), with the goal of more as scheduling between participants allowed, ultimately having group sizes that were not so unwieldy so that participants all had the opportunity to share their experiences and ideas in more depth (Mosadeh, 2012). U.S. focus groups were led by the first author, a Brazilian-American faculty member, ciswoman, married, heterosexual, and without children. Finnish focus groups were led by a research assistant, Turkish-Finnish, ciswoman, married, heterosexual, and with two children, who were trained to conduct focus group interviews by the second author. Participants were asked to discuss a series of questions (see Appendix A), which explored how caregivers conceptualized, practiced, and reflected upon learning and teaching care. Focus group questions included questions aimed at understanding their experiences of learning (e.g., How do you think you learned to provide care for others? Who taught you? In which ways? Why?) and teaching (e.g., In what ways do you think your child (and or other family members) are encouraged to take care of others?). This study focused on analyzing the experiences of learning and teaching care. The focus group interviews in the USA were conducted in English. In Finland, participants could choose to use Finnish or English according to their comfort levels; language was negotiated within all groups before the beginning of the interviews. All groups chose English. To ensure that the protocol was followed as planned, the focus group moderators in both countries were instructed to be attentive to any signs of participants’ distress, confusion, or doubt about the questions being asked and, if necessary, stop, clarify, or re-ask the question in another manner.

Analysis

Focus groups were recorded and transcribed verbatim. The material in Finnish was translated into English by a native speaker with professional proficiency in English and then back-translated, ensuring that semantic meanings were preserved. Transcripts were analyzed thematically (Boytazis, 1998; Braun & Clarke, 2006, 2021), supported by Dedoose (Version 9.0.62), a qualitative coding software. Due to the exploratory nature of our study, our approach was inductive. The initial step was to employ a codebook thematic approach (Boyatzis, 1998), where initial codes were created for each data set (Finnish and US separately) through familiarization with the text, inductively developed by each culturally informed respective coder (the second author as the US-based researcher coded US data, and the first author as the Finnish based researcher coded Finnish data) based on semiotic meanings (Braun & Clarke, 2006, 2021). Our choice of semiotic meanings as our level of analysis was due to our focus on participants’ explicit interpretations of teaching and learning. In developing our codebook, each code was given a name, definition, and example(s) of an excerpt that contained the code from the text. This approach served as an important foundation for comparing across codebooks in a culturally informed way, as definitions, rather than code names, allowed for discussion of nuances in how ideas were discussed within each data set (as well as whether ideas were present in both datasets). Considering that we were aiming to compare culturally shared and distinct experiences of teaching and learning care, the codebook approach, which included making the definitions of ideas we identified in the data explicit, allowing for a strong and clear basis for cross-cultural understanding across the two researchers drawing from data sets from distinct cultures.

The following step consisted of code developers reviewing codebook decisions to achieve the first finalized codebook (for the final codebook, please contact the first author). Following code application, themes were developed by each coder for each country as they had in-depth familiarity with the data. Rigor was ensured through peer debriefings, where the researchers met frequently and engaged in discussion throughout data familiarization, code development (including a 2-week intensive with daily sessions), code application, theme development, and narrative writing (Janesick, 2015). The authors, who were also the main coders, continuously checked each other’s code definitions and discussed the application, interpretation, and coherence of themes. Themes were created based on code prevalence (across focus groups and overall frequency of application), code co-occurrence, and shared underlying meanings and assumptions. These were reviewed through re-reading excerpts associated with the code(s) concerning our research question. As a final step, reflexivity was ensured through multiple sessions of thematic discussion where the researchers from both countries would explore different aspects of specific topics in the material from micro (local) to macro (cross-cultural) perspectives. In such sessions, socio-cultural particularities were also considered, contextualizing the narratives under analysis. This process ensured a coherent theme development process.

Learning: Imperfect mirroring of past parenting with present parenting practice

This theme brings out the shared patterns of meanings explaining how childhood experiences are noted as the foundation of learning for present caregivers caring behaviors and, in many situations, guide decision-making processes in parenting. However, although the theme is shared between the countries, what is incorporated from the past and how it affects current care practices differs significantly (see supplementary files).

Challenges in relying on informal sources of knowledge

Our study finds that shared processes of learning to care for Finnish and US caregivers: all caregivers reported learning by observing and also by doing while caregivers as adults. Thus, overall, learning was informal and based on experiences. This is in keeping with previous studies on how children come to collaborate and learn to engage in social activities, such as doing chores, by observing adults and participating in joint activities (Correa-Chávez et al., 2015; Rogoff et al., 2001; Silva-Oliveira et al., 2022) and with a series of studies indicating that parenting skills are built gradually during the process of parenting as adults (Hodkinson & Brooks, 2022; Raudasoja et al., 2022). However, there are several challenges, discussed in detail below, in caregivers’ reports of their learning experiences for thinking about the education of caregivers.

First, caregivers relied primarily on experiential, self-teaching, and informal processes of learning, which may hinder their ability to develop a comprehensive understanding of care. In both countries, groups reported self-teaching through books, research, and other professional-produced materials to guide their parenting practices. This is in keeping with prior research finding that caregivers often spend time gathering information and continuously learning about how to provide care, although with this came the challenge of potentially not receiving accurate information (Cuoco et al., 2023). Indeed, in our study it was unclear how the content in such materials was transformed into practice or how the scientific/professional guidance was taken as a reference for care practices. For example, caregivers in Finland did not elaborate on the opportunities for formal teaching during their schooling and through Neuvola services, nor did participants in the US groups about what they learned through private counseling and research. This suggests that, on the surface, caregivers are more likely to rely on their own experiential learning (i.e., through past and present experience; Kolb, 1984) than on the systematic and formal teaching they receive, regardless of the new trends and knowledge (Miller, 2017). Alternatively, what is learned and then operationalized may be a matter of a hierarchical knowledge domain, where experiential learning operates at a deeper level than learning through systematized knowledge. Finally, we find that observation of what happened in the past was something that US adults had to often teach themselves to unlearn, given the power of observation and experiential learning during childhood. However, in both cases, reliance on experiential learning alone in an informal context may make it challenging for learners to identify the elements of their experience that make the situation one of care– i.e., learners may not focus on or be aware of all the elements involved in the process that they experience as care.

Secondly, the informality of the learning process resulted in scattered and multiple sources of learning care. Our results indicate cultural differences in the sources that served as caregivers’ references to learning care. While US groups reported learning by observing their parent’s behaviors primarily, building the nuclear family as the main reference for learning care, Finnish participants included observations of other parents, both in their past experiences (e.g., parents of their friends) and in present time (e.g., other parents within their social network, Raudasoja et al., 2023). In both cases, there are consequences of primarily relying on observations and personal perception to create references of care. On the one hand, the ample source of models reported in the Finnish groups, i.e., family, friend’s parents, and other parents, provides a wider scope of caring examples, which could explain why Finnish groups reported noticing the experience of parenting as a rich learning process, while US participants depicted a sense of unpreparedness and struggle. Likewise, a broader reference frame could be implicated in the more global approach to care adopted by Finnish caregivers, which included independence and a sense of citizenship in their teaching lessons. Nevertheless, informally incorporating a variety of references of care can also be detrimental for parents, particularly young ones. For example, in investigating the causes of parenting burnout among Finnish parents, Sorkkila and Aunola (2020) have called attention to the behavior of comparing parental skills and dangerously undertaking a socially prescribed idea of a perfect parent. Perfectionism related to parenting is one of the main variables correlated to Finnish parent burnout (Raudasoja et al., 2022; Sorkkila & Aunola, 2020). On the other hand, the narrower reports the U.S. shortcoming of primarily relying on their parents as a model for parenting is that they can limit one’s perspectives on how situations can develop (Holden, 2019). It impoverishes learning processes and, in this case, traps parents in either copying a pre-experienced model, often reproducing a behavior without reflection, or creating a caring relationship based predominantly on specific behaviors to be avoided.

Disconnections between learning and teaching care

Whereas caregivers in both countries also report relying on informal processes (e.g., serving as a role model) to teach care, results indicate that what they learned about care (content) is not precisely what they aim to teach care to be to their children. While caregivers in both groups described their learning experiences as connected to how they felt cared for, they don’t explicitly mention the construction of good memories– of making their child feel well cared for–, as a guiding principle in their own teaching care practices. Teaching is primarily pragmatic, involving household chores (US) or actions relevant to independent adult life in society (Finland). In both cases, there is a lack of coherence and systematization between learning and teaching care. While previous studies have consistently shown the relevance of observations and participation in learning care processes (Correa-Chávez et al., 2015; Rogoff et al., 2001), our results open the debate on the need for other approaches, one that supports the integration of experience and systematized knowledge and that is more capable of enlightening the socio-material affordances for caring in relations within the family.

Particularly, we call attention to how care starts before caring acts are in place (Midgette & Ferreira, In press). It entails many psychological processes involving anticipating needs and understanding the context and the role of people in responding to others’ needs, all of which are fundamentally related to how one learns to know the other in a caring relationship. The feelings experienced growing up were central in our participants’ reports, evidencing the fundamental relational component in learning care (Noddings, 2003). Aligned, previous work suggests that care within the family depends highly on intimacy, affection, and bonds of trust within social interaction (Glenn, 2010; Noddings, 2003). However, there is no empirical indication of how we learn to establish these elements and ensure that care happens in a well-functioning relational environment. Our study suggests, from the absence of reference to many of the “higher” cognitive requirements involving the process of care (Midgette & Ferreira, In press), that teaching practices of care, despite the formal educational processes available in Finland, are yet far from including intersubjective skills that can support one to identify possibilities for care actions (affordances for care), which are an essential part of the care process.

In addition, besides the lack of elements related to identifying affordances for care, teaching care, even from a more global perspective as portrayed in the Finnish caregivers’ description, was still mainly guided by attributes caregivers find to be important for a future independent adult (e.g., dealing with their own frustrations, using money - to invest, and take care of themselves) instead of building the bases for interdependence. It shows the immense gap yet to be bridged in educational endeavors aimed at supporting a caring orientation. We call attention to the need for enlarging theoretical perspectives in approaches to learning and teaching care and argue the way to focus on understanding and creating systems to promote skilled human actions, including those dependent on social interactions and engagement (Rietveld et al., 2018).

The need for more intentional and comprehensive approaches to care education

Investigating how parents educate their children and aim to teach them how to practice care has implications for considering how health and psycho-educational programs can support parents in this aim. Based on our results, we argue in favor of psycho-educational programs and health intervention processes that can systematically address two pressing issues in learning-teaching care - the complexity involved in care processes and understanding the intersubjective nature of the construction of caring relationships. Using (Midgette & Ferreira, In press)’s framework to guide the psychological processes in care associated with experiential (phenomenological) perspectives to support the analysis of the interpersonal mechanisms involved in learning could bring a comprehensive psycho-educational approach to care.

On the one hand, (Midgette & Ferreira, In press)’s framework facilitates breaking down the complex steps and psychological processes involved in care, affording more tangible planning for learning-teaching experiences. For example, our results from US participants indicated that many caregivers have concentrated mainly on teaching how to perform specific care-related acts. However, teaching children to undertake household chores (i.e., competence in care as a skill), although important, will not ensure that caring will happen in the future (Fairchild, 2021). Teaching care must include noticing the needs and reflecting on how and whose responsibility is to address them, competencies that are not developed spontaneously through observing caregivers perform acts of care. Thus, teaching to care requires intentionality and an explicit mediation of sense-making of what, how, and why things happen.

To conclude, the current study suggests a lack of educational engagement in teaching all the elements involved in care, particularly those involving establishing and sustaining a caring relationship. We suggest considering employing the (Midgette & Ferreira, In press)’s framework in dialogue with enactive cognition theory and particularly the work around the concept of participatory sense-making (De Jaegher et al., 2017; Di Paolo et al., 2018) and the framework for developing skilled intentionality (Rietveld et al., 2018), since these could provide a comprehensive understanding of the intersubjective processes embedded in caring relationships relevant to learning-teaching care. When both are applied in learning-teaching care, this perspective focuses on how the caring relationship is established, developed, and maintained between caregivers and care receivers. An enactive perspective calls for a process that seeks to understand what is relevant to both individuals within interactions so that all their actions confluence and learning happens. Ultimately, it would mean clarifying the reflective and analytical processes connected to how the interactions between caregivers and care receivers are established, allowing for changes in the “bad parenting behaviors” from one generation to the other. Such a psycho-educational program would contribute immensely to enhancing parents’ repertoire in care, decreasing stress created by uncertainties revolving around care, and preventing generational trauma. Ultimately resulting in better parenting.

Limitations

Although the current study made an important contribution to the field by lending empirical support to the call for making care an educational objective, it had several limitations. First, our study was limited to caregivers who were taking care of children up to the age of 18. Caregivers may teach their children to care by accompanying them through their caregiving process. Thus, future research should investigate the role of those who teach care within their family of older children across, ideally, the lifespan. Moreover, we did not investigate the caregiver’s sexual orientation or disability status. Future research is needed to investigate how various positionalities within a society influence caregivers' experiences of learning and teaching others how to practice care. In addition, the study was limited to caregivers’ recollections and self-report of their experiences teaching and learning. Future research is needed to observe how caregivers engage in teaching care (e.g., similar to Rogoff et al.’s (2001) methodology) with the intent to teach care (thus paired with field interviews), as well as developmental interviews to ask children and caregivers across the lifespan how they are learning to care. It may be possible that memories of how caregivers learned in their childhood may not match what children themselves feel and believe that they are learning. Finally, the current study was limited to two cultures within the West.