Tn iecmhi 2.10.2011

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  • Feed the baby?
  • Tn iecmhi 2.10.2011

    1. 1. Infant and Early Childhood Mental Health Tennessee Infant and Early Childhood Mental Health Initiative Second Meeting February 10, 2011 Nashville, TN Joaniko Kohchi, LCSW and Mindy Kronenberg, Ph.D
    2. 2. How do you address mental health when your “client” cannot yet speak? <ul><li>Why is infant mental health important? </li></ul><ul><li>Is there anything significant about effectuating change in the earliest years? </li></ul><ul><li>Can you diagnose a mental health problem in infancy? </li></ul><ul><li>What can you do with an infant, and who can do it? </li></ul>
    3. 3. Infant Mental Health is Not :
    4. 4. Infant Mental Health Is : <ul><li>Focused </li></ul><ul><li>on the </li></ul><ul><li>Relationship </li></ul>Picture from http://humanecology.syr.edu/MarriageFamilyTherapy/Default.aspx
    5. 5. Brain Basics <ul><li>At birth, an infant’s brain weighs approximately 1/3 of an adult’s brain weight. </li></ul><ul><li>83% of dendritic/synaptic growth occurs after birth. </li></ul><ul><li>Much of this growth occurs before age 3. </li></ul><ul><ul><li>What do children need to grow brains? </li></ul></ul><ul><ul><li>Good nutrition, protection from toxins, stimulating environment/typical sensory experiences, secure attachment relationships. </li></ul></ul>
    6. 6. WAIMH’s Definition of Infant Mental Health <ul><li>The ability to develop physically, cognitively, and socially in a manner which allows them to master the primary emotional tasks of early childhood without serious disruption caused by harmful life events.  Because infants grow in a context of nurturing environments, infant mental health involves the psychological balance of the infant-family system. </li></ul><ul><li>WAIMH Handbook of Infant Mental Health, vol 1, p. 25   </li></ul>
    7. 7. So Infant Mental Health Is.. <ul><li>The developing capacity of the young child to experience, regulate, and express emotions </li></ul><ul><li>The ability to form close and secure relationships </li></ul><ul><li>The ability to explore the environment and learn </li></ul><ul><li>All occurs within the context of family, community, & cultural expectations for young children </li></ul><ul><li>Focus is on healthy social and emotional development rather than psychopathology </li></ul><ul><ul><li>Infant Mental Health Task Force, Zero to Three </li></ul></ul>
    8. 8. Relationship-Based Practice <ul><li>Values early developing relationships between parents and young children as the foundation for optimal growth and change; </li></ul><ul><li>Directs all services to nurture early developing relationships within families; </li></ul><ul><li>Values the working relationship between parents and professionals as the instrument for therapeutic change; </li></ul><ul><li>From http://www.mi-aimh.org/ </li></ul>
    9. 9. Relationship-Based Practice… <ul><li>Values all relationship experiences, past and present, as significant to one’s capacity to nurture and support others. </li></ul><ul><li>From http://www.mi-aimh.org/ </li></ul>
    10. 10. Who is an Infant Mental Health Professional? <ul><li>“ It may be most helpful to define the Infant Mental Health Specialist not as a member of a particular discipline, but rather as someone with a distinct set of core beliefs, skills, training experiences, and clinical strategies who incorporates a comprehensive, intensive and relationship-based approach to working with young children and families.” </li></ul>http://www.oaimh.org/peer/
    11. 11. Key Components to Practice of IMH <ul><li>Concrete service support </li></ul><ul><li>Emotional support </li></ul><ul><li>Advocacy </li></ul><ul><li>Developmental guidance </li></ul><ul><li>Infant-Parent Psychotherapy </li></ul><ul><li>Reflective supervision or consultation </li></ul><ul><li>( http://www.mi-aimh.org/) </li></ul>
    12. 12. Core Competencies for Assessment and Treatment in IMH (Van Horn) <ul><li>Familiarity with relevant bodies of knowledge </li></ul><ul><ul><li>Child and Adult Development, Child and Adult Psychopathology, Sociological and Cultural Influences </li></ul></ul><ul><li>Ability to observe behavior </li></ul><ul><li>Capacity to engage in collaboration with service systems </li></ul><ul><li>Capacity for self-reflection </li></ul><ul><li>Capacity to act as a conduit between parent’s and child’s experience </li></ul>
    13. 13. Infant Mental Health Theoretical Perspectives <ul><li>Developmental </li></ul><ul><ul><li>Child and Adult Individual Factors </li></ul></ul><ul><li>Systemic </li></ul><ul><ul><li>Dyadic Relationships </li></ul></ul><ul><ul><li>Family Relationships </li></ul></ul><ul><ul><li>Community Resources </li></ul></ul><ul><ul><li>Cultural Factors </li></ul></ul><ul><li>Attachment Theory, Trauma Work, Psychoanalytic Theory, Learning Theory </li></ul>
    14. 14. Basic Assumptions/Early Theorist: Donald Winnicott <ul><li>“ there is no such thing as a baby. . .” </li></ul><ul><li>Winnicott, 1947. </li></ul>Winnicott, Donald. (1964) Further thoughts on babies as persons. In his The child, the family, and the outside world (pp. 85-92). Harmondsworth, England: Penguin Books. (Original work published 1947)
    15. 15. Relationship-Based Assessment <ul><ul><li>Working Model of the Child Interview (Zeanah & Benoit, 1995) </li></ul></ul><ul><li>Face-to-Face Still-Face Paradigm (Tronick) </li></ul><ul><li>Modified Parent-Child Relationship Assessment (Crowell et al.)   </li></ul><ul><li>Diagnostic Classification Manual for Infants/Toddlers - DC: 0-3R (Zero to Three, 2005) </li></ul><ul><ul><li>Parent-Infant Relationship Global Assessment Scale (PIR-GAS) </li></ul></ul>
    16. 16. Interventions Are Relationship-Based <ul><li>Infant-Parent Psychotherapy </li></ul><ul><li>Child-Parent Psychotherapy </li></ul><ul><li>Circle of Security </li></ul><ul><li>Cognitive-Behavioral Interventions with Dyadic, Familial or Systemic Structure, Participation and Support </li></ul>
    17. 17. Community-Based Care and Consultation <ul><li>Child Welfare System </li></ul><ul><ul><li>Family Support </li></ul></ul><ul><ul><li>Foster Care </li></ul></ul><ul><li>Education </li></ul><ul><ul><li>Child Care/ Head Start Centers </li></ul></ul><ul><ul><li>Pre-Kindergarten </li></ul></ul><ul><li>Medical Settings </li></ul><ul><ul><li>Primary Care </li></ul></ul><ul><ul><li>Mental Health </li></ul></ul><ul><ul><li>Allied Health </li></ul></ul><ul><ul><li>Acute Care </li></ul></ul><ul><li>Law Enforcement/Judiciary </li></ul>
    18. 18. How do you address mental health when your “client” cannot yet speak? <ul><li>Why is infant mental health important? </li></ul><ul><li>Is there anything significant about effectuating change in the earliest years? </li></ul><ul><li>Can you diagnose a mental health problem in infancy? </li></ul><ul><li>What can you do with an infant, and who can do it? </li></ul>
    19. 19. What do we need to do first? <ul><li>Assess needs of professionals? </li></ul><ul><li>Focus training energy in one area (such as child welfare, early education, etc.)? </li></ul><ul><li>Make a central clearinghouse to collect and disseminate information for and about Tennessee? </li></ul><ul><ul><li>Professionals </li></ul></ul><ul><ul><li>Programs </li></ul></ul><ul><ul><li>Training Opportunities </li></ul></ul><ul><ul><li>More…. </li></ul></ul>

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