BUILDING A RELATIONSHIP BASED ORGANIZATION PUTTING OUR KNOWLEDGE BASE INTO PRACTICE

Michele Myers-Cepicka, Executive Director Erin Troup, Mental Health Specialist Jilan Hawk, Clinical Director

Helping Families Raise Healthy Children Beginnings…. Helping Families Raise Healthy Children

Relationship Based Intervention A way of being with children and families that includes: Being in the moment Mindfulness Observation

Why? Relationship-based practices in early intervention are aimed at supporting parent-child relationships. All learning takes place in the context of relationships and is critically affected by the quality of those relationships (Norman-Murch, 1996).

Relationship-Based Approaches Help establish: Secure, safe place for families Trust Collaboration Which leads to: The story and…

Engagement

Parallel Process How you are is how others will be Nurturing yields nurturing How you are is as important as what you do (Jeree Pawl)

Parallel Process The primary goal is to facilitate optimal parent-child interactions by focusing on individualized parent- professional relationships as the practitioner mirrors the attributes and attitudes that need to be fostered between parent and child. M. Jeanne Wilcox, Carolyn A Weber, Infant Child Research Program Arizona State University Parallel Process

What?

What we know about relationships Young children need a primary relationship with an adult to optimize development in all domains. It is best when this relationship is stable, predictable, and nurturing. Young children are always part of some kind of family system. Interventions cannot be implemented successfully outside of that system. What we know about relationships

A caregiver and child will display both the healthy and conflicted parts of their relationship through their behavior together

Every family we visit is struggling the only way they know how to do the best they can for their children They may not know how to get to where they want to be, but they are traveling.

Caregivers probably know the answers to most “parenting” questions we are asked to address Our challenge is to provide a safe environment for caregivers to recognize barriers and identify the solutions that they already own, or create the space for them to express freely where they need help.

Promoting First Relationships Consultation Strategies Join with caregivers through trust relationships Engage in reflective observation with caregivers Give verbal feedback – both positive and instructive Ask reflective questions/comments to identify feelings and needs

A process of establishing an emotional connection with a caregiver that allows us to become a safe haven for her or him Joining

Reflective Practice: Enhancing our Skills in the Joining Process It is important for you as a provider to reflect on the joining process. This helps to keep you present in the relationship and allows for better growth in the relationship. Makes joining questions much easier to generate.

Reflective Observation Is careful observation of the child and caregivers’ interactive behavior paired with sharing ideas and thoughts with the caregiver on what is being observed Aim is to help caregivers become good observers of their child’s behaviors as well as their own behaviors, and to reflect on what they notice about them and how they feel about them.

Reflecting Questions What are the concerns? What might caregiver be feeling? How does the child feel? What might caregiver be needing? What is the child needing? How can you help her meet her needs? How can you help her meet the needs of her child? **Ask These Same Questions for Yourself**

Verbal Feedback Strategies *Feedback is specific to the relationship, contingent and positive* Positive comments on interactions in the moment Enhancing caregiver feelings of confidence and competence

Creating a relationship Based Agency What do you need?

Training and support Training should address areas of need not only for families you are working with but also areas of need for the employees doing the work. All disciplines can feel comfortable addressing emotional supports within a family. Good reflective supervision is KEY!

Coaching Caregiver asks a specific question, and the provider answers it directly. Caregiver has identified a specific segment of her lived experience that needs a specific answer, and provider answer may or may not fit into her routines. Has potential to fit into already established brain architecture

Teaching Provider introduces unsolicited information that was not previously in the realm of the caregiver’s lived experiences The synapses that have previously “wired together” will not easily integrate this information (Also called the “WA WA, WAWAWAWA” Factor)

Mentoring A caregiver wonders about a problem or issue and is able, with the provider’s support and guidance, to think of a good solution Solution already part of caregiver’s lived experiences, and makes sense. Already part of brain wiring!

Outcomes and Services Family would like for Jimmy to use his words to make requests for more food and to tell them he is done during mealtimes so that mealtime as a family is more enjoyable and they are able to help him understand what he wants.

Outcomes and Services continued Family would like Lauren to comply with requests that her parents make without a tantrum so that the family can enjoy evening playtime together with her and easily put her to bed.

How?

Rebecca Shamoon-Shanok Reflective Practice Reflection is the stepping back to consider the work from multiple perspectives including: What one and others, observe, feel think and say. Rebecca Shamoon-Shanok

Practice Case Studies: Melissa, Sandy and Joshua Writing Relationship based Outcomes Toolkit Introduction

Relationship-Focused Enter the World of the Child What is this child’s experience? What is he feeling? What is he needing? Enter the World of the Caregiver What is this caregiver’s experience? What is she feeling? What is she needing? Reflect on Own Feelings What are my feelings? How are my feelings and actions impacting my relationship with this caregiver and the caregiver-child relationship?

Use your handouts

Lessons Learned Support for Staff – Training Shifting Early Intervention Culture – Super Helpers, Experts, Supervision

Perhaps, if we are very fortunate…we will have the opportunity to learn more at the feet of parents, who have known so much all along, and from the babies themselves, who have been talking to us long before we knew how to listen -Michael Trout, 1980

Resources Harvard Center for the developing child http://developingchild.harvard.edu Child Trauma Academy http://www.childtrauma.org Promoting First Relationships www.ncast.org Center for Social Emotional Foundations in Early Learning http://csefel.vanderbilt.edu/index.html