A Home Visitor's Guide to Supporting Families at Risk
Tackling the Tough Stuff
Early Childhood

The problem-solving framework in this practical guide will help home visitors manage even the most difficulty on-the-job challenges—and support and empower vulnerable families of children birth to 3.

Contains Companion Materials
79277 978-1-59857-927-7
2016 240
Available Stock

Home visits with at-risk families present unique, complex challenges that professionals must be ready to address with skill and sensitivity. The problem-solving framework in this practical guide will help home visitors manage even the most difficult on-the-job challenges—and support and empower vulnerable families of children birth to 3.

The authors' PAUSE framework (Perceive, Ask, Understand, Strategize, and Evaluate) walks home visitors through the entire process of addressing problems, from recognizing a difficult situation to evaluating the chosen action steps. Readers will learn how to apply the framework in real-world situations, partner with parents to understand their perspectives, take direct and effective action to help the parents and children they work with, and give at-risk families the tools they need to resolve their own challenges in the future.


  • Skillfully blend relationship-based and reflective practice approaches in their daily work
  • Understand what's behind children's challenging behaviors
  • Learn specific tips for helping families solve key challenges, from feeding issues to meltdowns
  • Work sensitively and effectively with families facing difficult situations, including domestic violence, substance abuse, and mental illness
  • Equip families with practical caregiving skills they'll use long after the home visit is over
  • Set appropriate boundaries with families and mend any breaks in the provider–caregiver relationship
  • Use self-care strategies to address symptoms of burnout and secondary trauma

PRACTICAL MATERIALS: Helpful sample dialogues and vignettes to use as models, plus reproducible blank forms on exploring challenging behaviors, discussing difficult topics, reflecting on practices, helping parents improve their skills, and more.

About the Authors
Deborah Weatherston, Ph.D., IMH-E® (IV)


Getting Started

1. Connecting and Keeping Connected: Relationships Matter

2. Looking Inside: Reflective Practice and Relationships for Learning

3. PAUSE - A Problem Solving Framework: Blending Relationship and Reflective Skills
Appendix 3A: PAUSE Worksheet
Appendix 3B: Reflection Worksheet

4. What's Going on in There? Understanding Causes of Behavior
Appendix 4A: Exploring Challenging Behaviors Worksheet

5. When Parents Say…Calm Down! Early Regulation: Sleeping, Eating, and Calming
Appendix 5A: Tips for Calming Your Baby

6. When Parents Say…Stop That! Biting, Hitting, Throwing and Meltdowns
Appendix 6A: Timely Tips for Tolerating Challenging Behaviors

7. When Parents Say…Why Won’t You Listen? Cooperating and Following Directions
Appendix 7A: Practice Reframing Commands

8. When Parents Say…Don't be Such a Baby: Fears and Separation Issues

9. What Else Might This Be? Family Challenges

10. You Can't Do this Alone: Boundaries, Self-Care and Supervision

Last Reflections



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Lisa Hodges, IMH-E (II), Developmental Specialist, Sitka, AK - October 26, 2016
"As a home visitor working in early intervention, I often come across complex families and difficult situations where I feel "stuck." Tackling the Tough Stuff-A Home Visitor’s Guide to Supporting Families At Risk by Tomlin and Viehweg (2016) gave me a framework to process and reflect upon my interactions and relationships with children and families. In particular, the PAUSE worksheet required me to "slow down" and ponder about what is really happening from the perspective of the caregiver, the child, and myself. Tomlin and Viehweg's concrete format allowed me to effectively implement a plan for future visits with the families. This book also interwove real-life scenarios that were helpful to learn from and kept me grounded in the IMH principle of "it’s all about relationships." I highly recommend this essential guide to all providers working in this ever growing field of infant and early childhood mental health."
Julie Summers, Midwest Book Review - June 20, 2016
"Exceptionally well written, organized and presented, 'Tackling the Tough Stuff' is very highly recommended for professional and academic library, Early Childhood and Family Support instructional reference collections and supplemental studies curriculums."
Lori Roggman, Professor in the Department of Family, Consumer, & Human Development at Emma Eccles Jones College of Education and Human Services, Utah State University - November 24, 2015

"The skills of reflective practice and problem solving are critical for effective work with families and are described here in specific concrete detail with many examples and realistic vignettes of common and challenging situations."

Maureen Greer, Leadership Consultant, Emerald Consulting - November 11, 2015
“Tackling the Tough Stuff goes beyond theory and supports the ability of the home visitor to intervene with the family in an appropriate and meaningful way.”
Linda Wollesen, Director, Life Skill Outcomes, LLC - October 26, 2015
“A well thought-out blend of theory, developmental frameworks for parent/child situations, and practical examples of the PAUSE tool in action. It belongs in every field supervisor's "turn-to" references.”