Infant & Early Childhood Mental Health Consultation

On Wondering Together: The virtue of reflective practices

noreply@blogger.com (George Wesley Dannells) — Wed, 08 Feb 2012 00:17:00 +0000

In their recent book, Mental Health Consultation in Child Care, Johnston and Brinamen (2006) capture the principles and practices of the consultative stance essential for the collaborative and capacity building elements of early childhood mental health consultation. They describe the consultative stance as a "way of being" that highlights the mutual responsibilities and "shared endeavor" of the consultant and the staff, caregivers, or family members. By "wondering together", the consultant assists caregivers in understanding a child’s behavior and participating in changes that may promote, prevent, or intervene in the social emotional development or challenging behavior of young children. The consultative stance helps those involved with the child to explore their understanding of the child and family and consider new information or ideas. Through patience, perspective, and reflective learning, consultants use their relationships with the caregivers to build the capacity of the caregivers so that they can become empathic and responsive to a child in new and effective ways.

Early Childhood Mental Health Consutation
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I presented at the Head Start Conference at Fort Worden this year on "Case Consultation to Support Reflective Practice in Home Visitation" to an audience of mostly Early Head Start homevisitors. Reflective practice sounds so mysterious, but it really is "wondering together." In EHS there is a commitment to line staff having the benefit of reflective supervision. Interestingly, in my faith community we come together for Reflection Meetings every three months. Reflective practices are widespread outside of the EHS community and are widely practiced within the human community. How many societies gather aroud a fire to wonder together before coming to make collective decisions? Wonder together is what we do as well at the Pennisulas Early Childhood Mental Health Consultation group meetings. -gw

Practices Associated with the Consultative Stance

Observing

Understanding different perspectives

Identifying and accepting feelings

Information gathering

Acknowledging and valuing the experience of others

Sharing ideas clearly

Soliciting ideas from others

Developing hypotheses in collaboration

Avoiding the "expert" posture

Encouraging reflection

Building on relationships

Supporting step-by-step change, enduring set-backs, and holding out hope

(Adapted from Johnston & Brinamen, 2006)

Early Childhood Mental Health Consutation

On the Impact of the Father on Early Childhood Mental Health: Strategies for engagement

noreply@blogger.com (George Wesley Dannells) — Tue, 07 Feb 2012 23:11:00 +0000

My friend Jay-Dub and his daughter

What is the impact of the father on early childhood mental health?
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At the end of his moving testimony, Chuck told the committee, “I attribute much of who I am to the Head Start program and my life mission to be the father to my children that I never had in part is a result of the life‐lessons I learned while in Head Start.”

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http://my.nhsa.org:8080/wordpress/?p=126
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There are wonderful "fatherhood strategies" incorporated in this comprehensive and fairly recent powerpoint. -gw
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http://www.nciom.org/wp-content/uploads/2011/02/ECMH-6-24-11_Carmody-Quinn.pdf

On a 35-fold Increase in Children with Severe Mental Illness: Why?

noreply@blogger.com (George Wesley Dannells) — Tue, 06 Dec 2011 17:44:00 +0000

Robert Whitaker raises a disturbing question, but not so uncomfortable that we won't be taking it up at upcoming consultations -gw
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The number of children who receive a federal payment because of a severe mental illness rose from 16,200 in 1987 to 561,569 in 2007, a 35-fold increase.

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I wrote Anatomy of an Epidemic to investigate this epidemic, and this pursuit necessarily raises a very uncomfortable question. Although we, as a society, believe that psychiatric medications have "revolutionized" the treatment of mental illness, the disability numbers suggest a very different possibility. Could our drug-based paradigm of care, for some unforeseen reason, be fueling this epidemic?

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http://www.huffingtonpost.com/robert-whitaker/anatomy-of-an-epidemic-co_b_555572.html

On a Parent Speaks: I was told by doctors that I didn't know what I was talking about

noreply@blogger.com (George Wesley Dannells) — Tue, 06 Dec 2011 17:21:00 +0000

Being told by doctors I didn't know what I was talking about

She was there constantly advocating for him and supporting me

A new professional in the field who is also the parent of two children with autism shared her experiences at our October meeting. -gw

I always credit Blues Clues for my son's speech

They've learned more from technology than flashcards

On Paternal Depression: Babies with depressed dads are at risk of developing behavioural and social problems by the time they start school

noreply@blogger.com (George Wesley Dannells) — Tue, 06 Dec 2011 16:51:00 +0000

http://www.smh.com.au/national/health/newdad-depression-hurts-child-20111206-1oh9e.html

You do home visits. One house is always dark, curtains pulled, hardly any light except that coming from a movie on an enormous screen TV that dominates the living room. Both parents are there, but only physically. They are both in the throes of depression. -gw

On Learning to Relax: Guided imagery online

noreply@blogger.com (George Wesley Dannells) — Tue, 06 Dec 2011 16:37:00 +0000

How do you get the parent of a young, challenging child to relax? How do you get anybody "who needs it" to relax?
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When he ws 12, my middle son, high strung by nature, learned to relax by listening to nature tapes on his shoebox cassette player. It was his discovery. It became how he went to sleep.
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At Kitsap Mental Health yoga is offered for employees during the noon hour twice a week. Our yoga instructor, Kathleen, starts each session with calming, soothing guided imagery. Yoga's original purpose, after all, was to prepare a person for meditation.
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Lucy Berliner of the Harborview Center for Sexual Assault and Traumatic Stress recommended this YouTube video with "great audio (with clouds) for relaxation with kids." Guided imagery on demand as close as your computer. -gw
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On How Low Can You Go: 4 years for ADHD meds or 2 years for time out

noreply@blogger.com (George Wesley Dannells) — Mon, 28 Nov 2011 17:53:00 +0000

The minimum age for treating Attention Deficit Hyperactivity Disorder in children has been lowered to 4 years of age by the American Academy of Pediatrics, according to this item in the current issue of the Brown University Child & Adolescent Psychopharmacological Letter. Thanks Kellye, ARNP, for bringing this to our attention.
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At what age to use particular interventions with children comes up frequently in consultations with parents. Consider the question of when to use time out. Therapists drawing on any of several discipline programs will often use two years of age as the earliest time out can be used. Yet some care providers consider that as highly inappropriate for children that young (or for children any age). Of course, there can be an enormous difference developmentally between a child at just two to a few months later when closer to three. Two children the same age can vary tremendously in terms of their development and readiness for certain experiences. There is always a judgement call to make and still controversy to be found.
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To have pediatricians operating with a lower minimum age in mind for treating children with medication and hearing about it from parents will take some getting used to for some therapists. That controversy, too, is hardly resolved. -gw

On the Use of the iPad As an Assistive Technology For Children With Autism: Show and tell

noreply@blogger.com (George Wesley Dannells) — Thu, 24 Nov 2011 14:08:00 +0000

At our last meeting Catharine demonstrated the use of an iPad as an assitive technology for children with special needs in her classroom. The particular app was the Art of Glow. We were all mesmerized. -gw
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Turn-taking was amazing

A child with down syndrome was skilled at matching

I show them the video of themselves being a good student

On Autism, ADHD & Disruptive Behavior: Triumvirate for services

noreply@blogger.com (George Wesley Dannells) — Sun, 20 Nov 2011 16:21:00 +0000

http://sunfieldcenter.com/
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Are autism, ADHD, and disruptive behavior the Big Three concerns for child mental health these days? I was looking at the website for an Ann Arbor MI-based agency that markets itself by invoking these concerns. Certainly these have been topics we have been addressing consistently in our monthly consultations, too. By the way, I really like the description used on the Sunfield site for Parent Child Interaction Therapy. -gw
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Parenting is not always easy, particularly when a child’s temperament negatively affects his or her ability to adapt to the demands of daily life. Parents of children with behavioral difficulties, often experience increased frustration and higher levels of depression, particularly mothers. Parent Child Interaction Therapy (PCIT) is an empirically-supported treatment approach designed to help parents manage problem behaviors while building a stronger relationship with their child.

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http://sunfieldcenter.com/for-families/blog/parent-child-interaction-therapy/

On ADD 200 Years From Now: You would never be called someone with a disorder.

noreply@blogger.com (George Wesley Dannells) — Sun, 20 Nov 2011 15:05:00 +0000

They do respond to context, and they do respond to medication, but the sad thing is they get labeled with a disorder instead of with a temperamental variation that doesn't match the absolutely sick environment we're having people grow [up] in. "You gotta go there, so you'll take this pill." That's what I tell people. Whenever I prescribe medication for ADD, I say, "Look, if you were 200 years from now, you would never be called someone with a disorder. You'd be mentored by somebody, and you'd be learning, you know, by example. And that would be all fine. You wouldn't be sitting in a classroom until you are 18 years of age, for God's sake, sitting on your butt. You just wouldn't. And no one would think you had a disorder."

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I was only able to attend two hours of a webinar offered on campus at Kitsap Mental Health Services. Anita said I would enjoy every minute of it. She was right. Dan Siegel's presentation offered many insights as cutting to the quick as this one on Attention Deficit Disorder. It was in a section of the day-long training that addressed temperament, the biological differences -- the hard-wiring -- that we enter the world wtth. -gw

On Meeting Anita: The luxury of a month-long assesment of a child

noreply@blogger.com (George Wesley Dannells) — Thu, 17 Nov 2011 21:12:00 +0000

We do something a little unusual at our meetings. We do video as it relates generally to our work and post it on our blog. We're all on first name basis here. Meet Anita. -gw

I started to notice children's reactions when their parents came to pick them up

We had a whole month with the child

The rocking helped the body to calm down

On a Child Psychiatrist's Answer to the Question: Could We Treat These Kids Without Medication?

noreply@blogger.com (George Wesley Dannells) — Fri, 14 Oct 2011 02:02:00 +0000

Those who attended last month's exhilerating consultation will remember this discussion thread, which we intend to carry forward at our October meeting. Interested in the subject? Want to offer your 2 cents? Come on down. -gw

On the Power of the Internet to Magnify Discourse: From around the table to around the world

noreply@blogger.com (George Wesley Dannells) — Fri, 14 Oct 2011 01:46:00 +0000

This little blog based in not-exactly-backwater Bremerton WA had 73 pageview hits on Oct. 1st, it had 262 on Oct 2nd, 463 on Oct. 3rd, and 134 on Oct. 4th. Almost a 1000 pageviews in four days, a nice way to start the month. -gw

On Observations of a Behavioral Pediatrician: Facilitating children’s healthy emotional development

noreply@blogger.com (George Wesley Dannells) — Fri, 14 Oct 2011 01:20:00 +0000

What is infant mental health? A case of a hitting toddler http://t.co/Zv0Lx2wO via @BostonDotCom
about 12 hours ago
Keeping Your Child in Mind - A Book Review http://t.co/4ynY5ZIP
1 day ago
Experts debate proposed child mental health disorder diagnosis http://t.co/7VHQoedT
3 days ago
Pediatrician Claudia Gold urges parents to see world as kids do - Berkshire Eagle Online http://t.co/6yTVHfCJ via @BerkshireEagle
4 days ago

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Claudia Gold's Twitter feed, from which the four items above are drawn, is an indication of her focus. Here is a paragraph from her blog describing her new practice.
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There are two major problems with the term "infant mental health." First of all, it implies that there is such a thing as infant mental illness, which is, in my opinion, not the case. Second, when say that I am a pediatrician who treats behavior problems in children under age five, most people are puzzled. I tell them that I give parents space and time to reflect, and to be curious about the meaning of behavior, with the aim of getting development back on a healthy path. Still the blank look. I have found that the best way to explain it is through stories, as I do in my book Keeping Your Child in Mind.

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Two items of note, the first, her statement that "there is no such a thing as infant mental illness." True? Second, the very fact of her starting a specialty practice of behavioral pediatrics. Is she one-of-a-kind or are there other behavioral pediatricians whose focus is strictly on young children? And then there is this from her blog header description.
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I will show how contemporary research in child development can be applied to support parents in their efforts to facilitate their children’s healthy emotional development. I will address factors that converge to obstruct such support. These include limited access to quality mental health care, influences of a powerful health insurance industry and intensive marketing efforts by the pharmaceutical industry.

Her short list of" factors that ... obstruct" is interesting, citing, as she does, both the health insurance and pharmaceutical industries. The "medicated child" (see the previous post on this blog) is an agreed upon topic for discussion at our next meeting of the Peninsulas Infant & Early Childhood Mental Health Consultation group. -gw

On For Mom's With Postpartum Depression: Support and infant massage

noreply@blogger.com (George Wesley Dannells) — Fri, 30 Sep 2011 18:42:00 +0000

By valentinapowers

Kellye Campbell, ARNP at KMHS, passed on this information about a service available in Seattle but which has roots in the Olympic Peninsula. -gw

I want announce a new referral source for moms with postpartum depression/anxiety and their babies called BabyLink. Groups will start in Seattle this fall. This is a postpartum depression support/ infant massage group developed by Marian Birch, DMH. She and her partner have been running this group in Port Angeles, WA for the past five years. Last year, I observed and evaluated this group as part of my post-doctoral fellowship at the UW Center for Infant Mental Health.

We are really excited to be replicating this group as there are no groups like this in Seattle right now. The program not only helps decrease depression in moms but also has many benefits for babies. Importantly, it can also help improve the relationship between moms and babies.

There will be two groups offered, a pro-bono group and a fee group for moms who can afford to pay. The attached flyer gives more details both groups. They will be on Capital Hill at Cooper House (http://cooperhouse.org/index.html) and led by health care providers trained in infant mental health and infant massage.

Recap:

What: BabyLink: A Postpartum Distress Support Group and Infant Massage.

Who: For moms with postpartum distress and their babies. Babies must not be crawling (they are hard to engage with infant massage once they start to crawl).

When: Groups will start this fall when we have enough referrals.

If you have any referrals please have them contact Lisa Mennet at 206-402-3099. You can also contact me if you have any questions. If you would like to have flyers sent to your office/clinic, please let me know.

Thank you,Michele Kulbel, DNP, ARNP

www.michelekulbel.com

On Why We Come Together: To gain a perspective that is ultimately interdisciplinary

noreply@blogger.com (George Wesley Dannells) — Thu, 15 Sep 2011 23:05:00 +0000

The mission of MI-AIMH is to promote and support nurturing relationships for all infants.

MI-AIMH believes that each infant needs to be nurtured and protected by one or more consistent and stimulating caregivers who enjoy a permanent and special relationship with the baby. This relationship is essential for optimal social, emotional and cognitive growth.

MI-AIMH also believes that the failure to provide and maintain nurturing relationships, at least one, during infancy may result in significant damage to the individual and to society.

Therefore, MI-AIMH supports the following positions:
Early intervention is an essential social policy, important from both a fiscal and a moral point of view.
Early intervention can be effective for the individual infant only if offered in a manner that promotes and supports the infant-caregiver relationship as both the primary source of strength and growth.
Early intervention is effective only when a family's culture is respected and approached as a strength and support.
Support, training and advocacy for early intervention must become a cooperative venture that bridges traditional cultural, disciplinary, administrative and political boundaries.
Action Goals

Educate birth to three and family professionals in relationship-based practice that reflects the mission of MI-AIMH.

Diversify the infant mental health community, engaging professionals who represent many different ethnic groups, cultures and communities and who work in a variety of settings with or on behalf of infants, toddlers and families.

Advocate for the social, emotional and cognitive well being of all infants and toddlers within the context of their caregiving families.

Endorse the infant and family work force, using standards that reflect competency and best practice promoting infant mental health.

The mission statement of the Michigan Association for Infant Mental Health
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The action goals as stated in this mission statement consitute a nice description of what might be the goals of our modest and informal association of professionals that meets each month here in Washington State. To educate professionals -- including ourselves -- in relationship-based practice is fundamental to our efforts. "Diversify the infant mental health community," is the calling. What makes our consultation feel so rich, so unique, is precisely our diversity. Where else can you draw on such diverse backgrounds in reflecting on a case? School psychologist, social worker, disability specialist, Early Head Start supervisor, and mental health counselor, for example -- we come together to gain a perspective that we just can't find within our own specific workplace. We work for school districts, non-profit agencies, and in private practice. We serve military and civilian, native and non-native communities. Our focus is on education, early intervention, and behavioral health. To a man and woman, we are advocates for the well-being of young children, socially, emotionally, and cognitively. We endorse the highest standards, the greatest competencies, and the best practices of this infant and family work force of which we are a part. And there is so much work to do. -gw

On Looking for a Few Good Providers: And who take TRICARE

noreply@blogger.com (George Wesley Dannells) — Wed, 07 Sep 2011 21:58:00 +0000

The program Marilyn works for is looking for "providers who are GOOD at what they do, and take TRICARE." She believes that participants in our infant and early childhood mental health consultation group either fill the bill or know of someone who would. She invites you to provide the following and anything additional about these providers that you feel would be helpful.

1) Name

2) Degree and credentials

3) Specialties

4) Address

5) Phone Number

6) Email

7) Fax

Thanks George. See you at the next gathering.

Marilyn Larrabee

New Parent Support Home Visitor

Fleet and Family Support Program

Naval Base Kitsap

marilyn.larrabee.ctr@navy.mil

On the Medicated Child: Frontline concern

noreply@blogger.com (George Wesley Dannells) — Wed, 24 Aug 2011 18:36:00 +0000

Hey George,

Great consultation last week… Chris thought that I should forward this video on to you. It’s an entire hour long so we probably wouldn’t get a chance to watch it in our group but maybe you could share the link with the others… it is pretty interesting.

Hope you have a great week!

Tana

Program: FRONTLINE

Episode: The Medicated Child

Millions of U.S. children are taking psychiatric drugs, most never tested on kids. Good medicine - or an uncontrolled experiment?

Watch the full episode. See more FRONTLINE.

An issue of concern for a lot of clinicians, certainly. -gw

On New Directions in Infant Mental Health Practice Training: Containment, reciprocity & the stress/trauma continuum

noreply@blogger.com (George Wesley Dannells) — Tue, 23 Aug 2011 19:20:00 +0000

Subject: 14TH Biennial NCAST Institute - Don't miss this event in September! -gw
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http://depts.washington.edu/chdd/ncast_broadcast/14th_Biennial_NCAST_Institute.pdf

On Infant Mental Health Treatment: In bullet points

noreply@blogger.com (George Wesley Dannells) — Wed, 17 Aug 2011 20:40:00 +0000

There is nothing like a powerpoint slideshow to provide a succinct overview of a topic. In this case, the topic is Infant Mental Health. The 74 slides here are from a 2007 presentation by Tomlin & Ryan. -gw

On Hands Are Not For Hitting: Activities designed around popular chldren's books

noreply@blogger.com (George Wesley Dannells) — Wed, 13 Apr 2011 22:58:00 +0000

Hi George and LaiWan,

To find the book nook- scroll down this page, on the right you will see the sun, click on www.vanderbilt.edu/csefel/ When that page comes up click on the apple for teachers and caregivers. When that page comes up you will see the Book Nook, click on that for the books. Thanks for a great two hours yesterday. I admire everyone's skill, knowledge, insight and intuition.

Happy weekend! Linda

This was the note Linda sent after our last meeting. Linda really likes the Book Nook on the CSEFEL site. -gw

These easy-to-use guides were created especially for teachers/caregivers and parents to provide hands-on ways to embed social emotional skill building activities into everyday routines. Each book nook is comprised of ideas and activities designed around popular children’s books such as Big Al, Hands are Not for Hitting, On Monday When it Rained and My Many Colored Days. Examples of suggested activities include using rhymes to talk about being friends, making emotion masks to help children identify and talk about different feelings, playing games around what to do with hands instead of hitting and fun music and movement activities to express emotions.

http://csefel.vanderbilt.edu/resources/strategies.html

On You Saw It Here First: There is a lot of math in EHS activities ... and football

noreply@blogger.com (George Wesley Dannells) — Wed, 13 Apr 2011 22:27:00 +0000

Yesterday as I observed an Early Head Start home-visitor do her magic with a parent and toddler, I heard her say that the activity she had brought taught concepts of physics and algebra. She had three golf balls in a cardboard box caroming off the walls, in the process making neat designs on a piece of paper in the bottom of the box to which she had added some drops of tempura paint. Boy, was I impressed with her reference to math and science! Kudos to her! I thought, of course, of Bill the Math Man and his presentation at our February meeting about teaching math to preschoolers.

On Introducing Math Concepts At a Very Early Age: Measuring with ribbons

You saw the post here first. It ran on these "pages" but, with some minor changes, was subsequently reposted (I had something to do with it) on two other blogs -- viewed 202 times on one blog and 558 times on the other. A very popular post.! Ah, the power of blogging. Our blog -- this one -- is at 2000 site views, BTW.
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+On Introducing Math Concepts At a Very Early Age: There is a lot of math in football

http://myriadsocialspaces.posterous.com/on-introducing-math-concepts-at-a-very-early

It also ran here. -gw
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http://bahaiviews.posterous.com/on-introducing-math-concepts-at-a-very-early

On High Tech in Kansas: Reaching moms through texting

noreply@blogger.com (George Wesley Dannells) — Wed, 13 Apr 2011 21:36:00 +0000

The way they do it in Kansas. Informing moms about what they need to know to care for their baby by texting. -gw

On Reflective Supervision: Space for providers to become aware of and attend to their own feelings

noreply@blogger.com (George Wesley Dannells) — Wed, 13 Apr 2011 20:07:00 +0000

The ultimate goal of reflective practice is to improve the quality of early childhood services through increasing organizational capacity and enhancing provider competency. Often providers are faced with trauma of the families they work with and this trauma can trigger their own pain and suffering. The experience the provider brings to the relationship can get in the way of working effectively with families unless there is a venue to explore, understand, and distill the negative or difficult emotions elicited from the work...The early years of development...are particularly critical...It is essential that providers have consistent space to become aware of and attend to their own feelings to avoid responses that can lead to unintended and negative consequences.

-- Rebecca Shamoon Shanok, 2009
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http://multiplyingconnections.org/reflective-supervision
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The above excerpt from a piece promoting an upcoming conference on the East Coast reminds us of why supervision is important, and what that supervision should look like. -gw
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Learn More About Reflective Supervision

* Reflecting on Reflective Practice: http://www.multiplyingconnections.org/

* Zero to Three: http://www.zerotothree.org/

* Michigan Association of Infant Mental Health: http://www.mi-aimh.org/

On Who We Are: And what we talk about

noreply@blogger.com (George Wesley Dannells) — Wed, 13 Apr 2011 18:36:00 +0000

Here is a self-spoken profile of a Peninsula's Early Childhood Mental Health Consultation Group participant.
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What do we do at PECMHG meetings? We share insights and information about resources, as below a discussion about working with non-English-speaking families and the use of iPhone apps for language translation. -gw
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