1. BUILDING A RELATIONSHIP BASED ORGANIZATION
PUTTING OUR KNOWLEDGE BASE INTO PRACTICE

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

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

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

5. 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).

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

8. Engagement

9. 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)

10. 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

11. What?

12. 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

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

14. 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.

15. 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.

16. 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

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

18. 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.

19. 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.

20. 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**

21. 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

22. Creating a relationship Based Agency
What do you need?

23. 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!

24. 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

25. 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)

26. 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!

27. 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.

28. 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.

29. How?

30. 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

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

32. 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?

33. Use your handouts

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

35. 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

36. Resources Harvard Center for the developing child
Child Trauma Academy
Promoting First Relationships
Center for Social Emotional Foundations in Early Learning