1. Founder and Developer, PRAXES
The praxes model: Empowerment and wellness for the consumer parent in recovery
November 17, 2016
Presented by
Dan Thorne, LMFT
Founder and Developer, PRAXES

2. Goal & Objectives
Identify challenges and solutions for the consumer parent
Demonstrate stress management skills for parent
The three core principles of the praxes program
How program complements the recovery model

3. Background of Developer
40 years in mental health, including over 30 years as Licensed Marriage and Family Therapist
25 years as director of outpatient and inpatient mental health and substance abuse programs
Parent of three adoptive children with mental health problems
Challenged dog owner
Click to add notes

4. Quiz

5. What is parenting stress?
Parenting Stress Index (Abadin, 1990)
Parental Distress – emotional pain parent experiences in role as parent
Parent-Child Dysfunctional Interaction – perception that child doesn’t meet parent’s expectations
Difficult Child – ability of child to manage behavior

6. What is a Special needs child?
A child with impaired functioning in the community, home, or school due to mental health, intellectual, and/or physical challenges

7. Levels of parenting Parents have problems with children- typical
Parents with “special needs children” have more stressors and not necessarily the skills
Parents with lower socioeconomic means have less resources for their children
Parents with own mental health disorder
Three layers of parents and their problems

8. Why is parenting stress so important?
Relationship between parenting stress and:
Child development status
Child cognitive delay
Is also biodirectional (goes back and forth)
Cousino and Hazen (2013)

9. Why is parenting stress so important?
Relationship between parenting stress and:
Martial conflict
Poor physical health
Parent depression
Neece et al (2012), Hassall et al (2005)

10. Challenge for consumer parent
White & McGrew (2013) – at least 50% of all persons with severe mental illness are parents.
Bauer et al (2015) – Consumer parent have a higher than average chance of losing their child into foster care.

11. Theory
Parents of children with special needs (mental health, intellectual disability, and/or physical) have higher levels of stress than other parents
Prolonged stress has health consequences for parent and child
Use a multi-mode approach
Parent-focused, strength-based
What’s behind the PRAXES?
In continuum, empowerment is at the opposite spectrum of victims

12. PRAXES MODEL Can be done in field or clinic 12 Lesson Modules
Emerging practice to reduce parenting stress with special needs children
Can be done in field or clinic

13. Criteria for praxes parent
Poor view of self as parent
Stress
Poor view of child
Behavior problems of child
Unrealistic expectations of child

14. PRAXES session components
Check-in
Conversation
participation
practice

15. Fidelity Measures
Fidelity Checklist
Has Practitioner provided required items in lesson plan?
Quality Assurance Checklist
Has parent demonstrated knowledge through questions during lesson?

16. Engagement and Evaluation
Listen first to parent
FAQ’s and questions for parent
PSI and ECBI
My Program Plan

17. Praxes core components
Parent self-care – how I view and help myself
Parent awareness – how I view my child
Parent ability – how I help my child grow

18. Stress reduction NIMH info on parent stress Stressed parent quiz
Relaxation exercises
My stressors
Exercise- come up with one solution to stressor
Stress Plan
Example- Kim in store

19. Grief and Loss Loss of child as typical Grief questionnaire
How I see my child
My relapse plan for grief

20. Assertive Communication
Styles of Communication
Fair fighting
DESC
Kernel of truth
Broken record

21. Support systems Assertive Bill of Rights- I can ask for help
Social engagement quiz
Supportive tree
How to ask for help

22. Child Development Review My Program Plan and update as needed
Review CDC Levels of Development
Developmental age progression
Talking to child
Exercise-Pick one age group and review with parent

23. Mental Health Education
Information about child’s illness, avoid labeling and blame
Our Struggle letter
What I Want You to Know about My Child

24. Parent Advocacy Assertive Bill of Rights Student Support Team
IEP Meeting Tips and Questions
Medical Professional Questions
Practice talking to school
Exercise-Look at Conversation and go over with parent

25. Promoting Positive Behaviors
Consequences and Reinforcements Tool Kit
Give Kids a Choice
Picking Your Battles
Modeling Behavior
Taylor-going to school

26. Clear Expectations Rules are for adults and for children, too
Our House Rules
What behavior means
Behavior contracts

27. Solving Problems Styles of communication Managing Escalating Behavior
10 Positive Comments

28. Final Session and Maintenance
Review accomplishments
PSI & ECBI
Compare pre and post test results with parent
Graduate Certificate
Next steps

29. Praxes & recovery model
Individualized
Based upon parent’s goals
Strength-based
Format similar to WRAP with problem solution emphasis

30. Research: Initial Effectiveness Study
Study Design: Single group, Pre/Post
Results:
Parental Stress behavior reduced by 33%
Child’s behaviors reduced by 40%
Parents identification of problem reduced by 40%

31. What’s next in 2017? Southern Ca. – onsite trainings
Outside Southern Ca. – Webinars
Ongoing research on PRAXES efficacy

32. What Makes PRAXES Unique?
Grassroots based- developed in community mental health setting, not in university
Conducted in English and Spanish
Practitioners- peer specialists, care coordinators, and master’s level

33. Answers to quiz

34. References
Robinson, C., York, K., Rothenberg, A., & Bissell, L. (2014). Parenting a Child with Asperger’s Syndrome: A Balancing Act. Journal of Child & Family Studies, 24,
Hassall, R., Rose, J., & McDonald, J. (2005). Parenting Stress in Mothers of Children with an Intellectual Disability: the Effects of Parental Cognitions in Relation to Child Characteristics and Family Support. Journal of Intellectual Disability Research, 49 (6),
Cousino, M., & Hazen, R., (2013). Parenting Stress Among Caregivers of Children with Chronic Illness: A Systematic Review. Journal of Pediatric Psychology, 38 (8),
Bennett, C., Barlow, J., Huband, N., Smailagic, N., & Roloff, V. (2013). Group-Based Parenting Programs for Improving Parenting and Psychosocial Functioning: A Systematic Review, Journal of the Society for Social Work and Research, 4 (4),
Abidin, R. (1990). Introduction to the special issue: The stresses of parenting. Journal of Clinical Child Psychology, 19(4),
Neece, C., Green, S., & Baker, B. (2012). Parenting stress and child behavior problems: A transactional relationship across time. American Journal of Intellectual Developmental Disabilities, 117(1);

35. Questions? Thank you Dan thorne, LMFT Dan.Thorne@praxesmodel.com