slide1
Download
Skip this Video
Download Presentation
HISTORICAL CONTEXT AND THE BIRTH OF A MOVEMENT

Loading in 2 Seconds...

play fullscreen
1 / 58

HISTORICAL CONTEXT AND THE BIRTH OF A MOVEMENT - PowerPoint PPT Presentation


  • 159 Views
  • Uploaded on

NEW DIRECTIONS TOWARD AN INTEGRATION OF EARLY INTERVENTION AND INFANT MENTAL HEALTH Jane D. Hochman, Ed. D. Gilbert M. Foley, Ed.D. HISTORICAL CONTEXT AND THE BIRTH OF A MOVEMENT. EARLY CHILDHOOD: A FIELD IN FORMATION (1860s-1940). Philanthropy and Social Reform

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' HISTORICAL CONTEXT AND THE BIRTH OF A MOVEMENT' - dexter-kennedy


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

NEW DIRECTIONS TOWARD AN INTEGRATIONOFEARLY INTERVENTION AND INFANT MENTAL HEALTHJane D. Hochman, Ed. D.Gilbert M. Foley, Ed.D.

early childhood a field in formation 1860s 1940
EARLY CHILDHOOD: A FIELD IN FORMATION (1860s-1940)
  • Philanthropy and Social Reform
  • Advances in Medicine and Public Health
  • Government Actions
  • The New Science of Child Study
  • The Progressive Education Movement
  • Behaviorism
  • Psychoanalysis
  • Mental Hygiene and Child Guidance
developments in psychiatry medicine and special education 1940 1960
DEVELOPMENTS IN PSYCHIATRY, MEDICINE AND SPECIAL EDUCATION (1940-1960)
  • Infant Psychiatry/Infant Mental Health
  • Pediatrics and Rehabilitative Therapies
  • Special Education
1960s early federal initiatives laws and policies
1960s - Early Federal Initiatives, Laws and Policies
  • 1961: Federal Office Established (BEH)
  • 1965: “ War on Poverty” – Head Start
  • 1967: Early and Periodic Screening Diagnosis and Treatment Program (EPSDT)
  • 1968: Handicapped Children’s Early Education Program ( HCEEP)
the 1970s early programs and policies
The 1970s - Early Programs and Policies
  • Early 1970s: A controversy of Models
  • 1975: PL 94-142
  • Late 1970s: Good Practice Models Emerge
the 1980s early childhood becomes law
The 1980s - Early Childhood Becomes Law
  • Early 1980s: Outreach Replication Networks and Personnel Preparation
  • PL 99-457
  • Late 1980s: Collaboration
the 1990s idea and later revisions
The 1990s - IDEA and Later Revisions
  • Americans with Disabilities Act (ADA)
  • 1990: PL 99-457 renamed Individuals with Disabilities Education Act (IDEA)
  • Early 1990s: Early Intervention Implemented
  • 1995: Early Head Start
  • 1997: Family-Centered > Family-Directed
21st century revisions refinements and challenges
21st Century - Revisions, Refinements, and Challenges
  • Revisions to IDEA
  • Economic Challenges
  • New Technology
  • Personnel
meet martin
MEET MARTIN
  • 26 Months Old
  • Charming
  • Dreamy
  • Autistic?
  • Uneven Language Development
  • Weak Pragmatic Skills
tumult at home
TUMULT AT HOME
  • Stormy
  • Father Left
  • Mother Depressed and Searching
  • Babysitters
the child will always tell you sally provence m d
“THE CHILD WILL ALWAYS TELL YOU”Sally Provence, M.D.
  • Martin Tells a Story to his Occupational Therapist
  • What might it mean?
  • How to React?
  • What to Do?
  • Who may be able to help?
  • Implications for the Service Delivery Paradigm itself?
slide15
THE INTEGRATION OF INFANT MENTAL HEALTH (IMH) AND EARLY INTERVENTION (EI): Concepts, Characteristics & Rationale
a holistic synergistic frame of reference embrace complexity sally provence m d
A HOLISTIC SYNERGISTIC FRAME OF REFERENCE~“Embrace Complexity! ”Sally Provence, M.D.
models of development
MODELS OF DEVELOPMENT
  • Architectonic
    • Hierarchical
    • Linear
    • Epigenetic
  • Organic
    • Unfolding
    • Plastic
  • Transformational
    • Holistic
    • Dynamic
a developmental biopsychosocial transactional model
A DEVELOPMENTAL-BIOPSYCHOSOCIAL-TRANSACTIONAL MODEL
  • “Infant as a Work in Progress”
the nature of derailment
THE NATURE OF DERAILMENT
  • Cumulative Adversity: A Cascade of Multiple Misfortunes vs. Single Incident/ Disease/Natural History Model of Derailment
  • Healing the Organic-Functional Split
  • Context…
slide20
PARITY FOR PSYCHOSOCIAL DOMAIN OF DEVELOPMENT & MENTAL HEALTH IN DEFINING ELIGIBILITY & DELIVERING SERVICE
slide21
Infant mental health refers to the multifaceted formative process impacted by myriad forces, including:
  • Totality of development itself
    • Organized as the structure and content of the inner life
    • Arising both from within and without and
    • Expressed in functional behaviors used to mediate between the internal and external world of self and other with affective range, intensity and color.
infant mental health includes
Infant mental health includes:
  • Formation of attachments
  • Inner construction and emerging portrayals of the self and love-objects with feeling
  • Ability to regulate impulse, affects and the seeds of self-esteem
  • Capacity to manage anxiety and form flexible and adaptive mechanisms of coping and defense
  • Ability to form and sustain relationships beyond the immediate attachment system
  • Ability to experience the world with a range and intensity of feeling.
infant mental health includes con t
Infant mental health includes: (con’t)
  • Appropriate assessment of social-emotional functioning and the well-being of the family
  • A role for mental health members of the team to function in therapeutic as well as assessment and referral capacities
the centrality of relationships
THE CENTRALITY OF RELATIONSHIPS

“A baby cannot exist alone, but is essentially part of a relationship.”

D. W. Winnicott

  • The Family is a Network of intimate Relationships
  • The development of the baby is to large extent dependent on the well being of the relationships that compose the cradle of “holding” and nurturance.
a self family centered copernican universe
A Self-Family/Centered Copernican Universe

Community

Relationship Network

Family

Child

family stress distress
FAMILY STRESS & DISTRESS
  • Loss-Grief
  • Personal Mythology
  • Reframing the Representation of the Child
family stress distress con t
FAMILY STRESS & DISTRESS (con’t)
  • Damage and Reparation/Fear and Wish: Unseen Forces in the Family Psyche
  • Uncertainty About the Future
  • Amplified Demands of Daily Life
relationship based psychotherapeutically informed approach to service delivery
RELATIONSHIP-BASED, PSYCHOTHERAPEUTICALLY INFORMED APPROACH TO SERVICE DELIVERY
  • Identifies the relationship as the “Unit of Service”
  • Provides comprehensive, intensive, continuous, supportive and engagement-focused services
  • Addresses the expected and unexpected stress, coping and adjustment reactions and general well being of families
relationship based psychotherapeutically informed approach to service delivery con t
RELATIONSHIP-BASED, PSYCHOTHERAPEUTICALLY- INFORMED APPROACHTO SERVICE DELIVERY (con’t)
  • Addresses the meaning the child holds for the family
  • Works through the alliances of caregivers to the child and support systems to the caregivers
  • Works from the inside out:
    • addressing history, representation, affective states and the forces of fantasy
relationship based psychotherapeutically informed approach to service delivery con t1
RELATIONSHIP-BASED, PSYCHOTHERAPEUTICALLY- INFORMED APPROACH TO SERVICE DELIVERY (con’t)
  • As well as the outside in:
    • Addressing resources, knowledge, skill, coping and concrete services
    • Multi-Modal
relationship based psychotherapeutically informed approach to service delivery con t2
RELATIONSHIP-BASED PSYCHOTHERAPEUTICALLYINFORMED APPROACH TO SERVICE DELIVERY (con’t)
  • Embraces parenthood as a developmental process
  • Supports every member of the team to deliver his or her discipline-specific services in a relationship-based psychotherapeutically –informed style
a multi cross disciplinary team model of staffing the transdisciplinary approach
A MULTI-CROSS-DISCIPLINARY TEAM MODEL OF STAFFING~The Transdisciplinary Approach
  • Role Extension
  • Role Release
  • Reflective Supervision
    • Intervention as Enacted Thought
  • A Cardinal Feature of an Integrated Model
demands of the work
DEMANDS OF THE WORK
  • Hopefulness
  • Readiness to Cope with Negative or Troubled Experiences of Both Parents and Practitioners
  • Preparedness Concerns
  • Range of Reactions
  • Availability of Resources
transference and countertransference
TRANSFERENCE AND COUNTERTRANSFERENCE
  • “ Transference consists of the ‘experiencing of feelings, drives, attitudes, fantasies and defenses toward a person in the present which do not befit that person but are a repetition of reactions originating in regard to significant persons of early childhood, unconsciously displaced onto figures in the present ‘ ” ( Greenson, 1967, p. 155)
transference and countertransference con t
TRANSFERENCEAND COUNTERTRANSFERENCE, con’t.
  • Communicated via the infant through the care-giving style
  • Identified via Inappropriate Attributions
transference and countertransference con t1
TRANSFERENCE AND COUNTERTRANSFERENCE con’t.
  • Intensity
  • Ambivalence
  • Capriciousness
  • Tenacity
optimal distance 1
OPTIMAL DISTANCE, #1
  • There is NO absolute optimal distance
  • A relative position influenced by history, culture, and temperament
  • Differs family to family
optimal distance 2
OPTIMAL DISTANCE, #2
  • A Range Between Remoteness and Excessive Closeness Relatively Free of Ambivalence
  • Reality-Based Middle Ground
  • Ongoing Self-Regulating Relational Range
optimal distance 3 remoteness
OPTIMAL DISTANCE, #3:REMOTENESS
  • Unconscious Desire to “Shield”
  • Illusion of Safety in Distance
optimal distance 4 too much closeness
OPTIMAL DISTANCE, #4:TOO MUCH CLOSENESS
  • Over-Identification and Fusion
  • Excessive Nurturing
  • Defense Against Guilty Feelings
optimal distance 6 practitioners must
OPTIMAL DISTANCE, #6: PRACTITIONERS MUST….
  • Tolerate Anxious Uncertainty
  • Use Own Emotional Experiences as a Guide
  • Have Capacity to Observe, Listen and Reflect
  • Ask oneself two important questions………..
optimal distance 6 con t
OPTIMAL DISTANCE, #6con’t
  • “ Am I Maintaining an environment of safety, security, compassion, and support for the infant and parents?”

“ Am I impeding the family’s self-awareness, self-sufficiency, and self-determination?”

begin where the family is
BEGIN WHERE THE FAMILY IS
  • …Not Where you Wish it Would Be
  • Beware of halo effect or tendency for countertransference fantasies
  • Successful Family-Practitioner Relationships Progress from A Base of Security.
presenting yourself to the family
PRESENTING YOURSELF TO THE FAMILY
  • Titles of Address
  • Initial Introduction
  • Dress Code
  • Safety Concerns

…Formality and informality reflect remoteness, excessive closeness, or optimal distance…

sharing information
SHARING INFORMATION
  • Mutual Understanding of the language
  • Definition of Terms
  • Attention to Cultural Mores
guidelines for making mental health referrals
GUIDELINES FOR MAKING MENTAL HEALTH REFERRALS
  • ABSOLUTES
  • Danger
  • Abuse or Neglect
  • Parents with Diagnosed Mental Health Disorders
guidelines for making mental health referrals1
GUIDELINES FOR MAKING MENTAL HEALTH REFERRALS
  • PROFESSIONAL JUDGMENT REQUIRED:
    • Intensity of Symptoms
    • Degree of Psychic Suffering
    • Degree of Compromised Functioning
    • Frequency of Occurrence of Conditions or observed symptoms
    • Intractability of Symptoms
    • The Symptoms in Context
slide54

RELATIONSHIP BOUNDARIES

  • Apply Principles of Responsibility and Reciprocity
  • Practitioner>Family>Child>Practitioner
  • Administration > Team
  • Within team

(Relationships Among Staff Reflect Demands and Stress)

idea still supports
IDEA STILL SUPPORTS
  • Supra-organizational perspective
  • Interagency Collaboration
  • Teaming
however unity of ei and mh requires
HOWEVER , UNITY OF EI AND MH REQUIRES
  • Closer Alliances among practitioners from both “ worlds”
  • Holistic Organizations
  • Fluid Interchange among the Multiple Disciplines
  • Systems Coordination
a self family centered copernican universe1
A Self-Family/Centered Copernican Universe

Community

Relationship Network

Family

Child

ad