Download Transforming Formative Relationships: Mental Health

The UCSF Daycare
Consultant’s Approach to
Training
Kadija Johnston, L.C.S.W.
Infant-Parent Program, U.C.S.F.
UCSF Daycare Consultants
 A component of the Infant-Parent Program – began
in 1988
 Extended the philosophy of treating young children
in the context of seminal relationships to childcare
 Offers a range of mental health services in settings
where young children (birth to 5 years) reside or
are cared for including: family resource centers,
residential substance abuse treatment, homeless
and domestic violence shelters and, primarily,
childcare centers.
Changes in Child Care
 Increase in number of children
 Greatest expansion of infant care
 Increase in hours spent in care
Increase of Children with
Puzzling Behaviors
Due to:
 Child care envisioned as protective
measure
 As place to repair relationships
 Group care overtaxing for some children
Consultation Approach Based On:
 Understanding current conditions in child
care
 Predicated on an appreciation of the
transactional nature of development
 Acknowledging the growing sphere of
adults
Aim of Consultation:
Improving the quality of relationships
especially the provider-child relationship.
The surrounding adult relationships are
attended to as well.
Intensive Training Program
Developed
 Previous training rarely provides the skills and sensibility
needed for consultation.
 Specifically absent a) an appreciation of early development
from a transactional perspective b) appreciation of the
importance and effect of interpersonal dynamics on
organizational climate and c) appreciation of the
implications/culture of group care.
 Clinicians whose culture and language capacities promote
their ability to connect with the range of providers and
parents with whom we were working.
 In addition to content expertise, a stance must be cultivated
that allows for mutually respectful, reciprocal relationship.
Focus of Intensive Training
 Cultivate a sensibility and the consultative stance
 Early childhood development from a transactional
perspective
 Group care –culture and implications for
consultation
 Relationship focused adult group work and
organizational functioning
 Adapting clinical interventions to serve
consultative role
Elements of Training Program
 Mental Health Consultation Seminar
weekly year long
 Early Childhood Development Seminar
weekly ,year long
 Clinical Conference - monthly presentations on
a rotating basis
 Clinical supervision – individual, 2-4 hrs,
weekly
 Direct consultation experience – 2 to 5
programs
Consultation Seminar
 Observation – several programs with a seasoned staff
consultant, proceeded and followed by discussion
 History of and current conditions in child care
 Cultivating the Consultative Stance –elements of a
positive consultative relationship
 Initiating Consultation –initial request and
considerations, getting to know the program
 Addressing Process through Content –considering
levels of influence
 Adult relationships- consultant - consultee, interstaff and
parent - provider
Consultation Seminar cont.
Case Consultation
 Beginning Case Consultation – gaining entry
and setting the tone
 Gathering Information – creating a picture of
the child
 Co-creating Meaning – interpreting behavior
and developing hypotheses
 Translating Meaning into Action
 Termination
Early Childhood Development
Seminar
 A bio-psycho-social model of development is




introduced.
A focus is maintained on the relational and broader
social/cultural contexts that shape development.
While typical development is the primary focus of
the course, attention is also paid to the range of
things that can complicate, threaten, or negatively
impact optimal development.
Risk and Resiliency
Range of approaches to developmental screening
and assessment
Clinical Conference.
 On a rotating basis, present an aspect of
consultative work
 All clinical supervisors present
 Exchange clinical perceptions
 Share information regarding resources
 Learn about the other consultant’s
experiences
 Commiserate about frustrations, struggles
and disappointments.
Individual Clinical Supervision.
 A place for self reflection
 Understand ones impact on centers,
consultees and families
 Emphasis on parallel process
 Explore conflicting emotions and assist
consultant in maintaining emotional
equilibrium
 Fosters mutual exploration and problem
solving
Who is Trained? Initial Cohort
 Licensed or license eligible mental health
professionals
 Ethnicities and /or language capacities reflected
predominant populations served
 Each member of a 3 agency collaborative hired 2
clinicians
 All continue to work as ECMH Consultants
Who is Trained? Ongoing
 Newly hired consultants – within Daycare
Consultant and mental health agencies in SF and
surrounding California counties
 Graduate level mental health interns– pre or post
doctoral or masters level , from the fields of social
work or clinical psychology.
 Occasionally interns from other disciplines
 All with prior clinical experience with young
children, preferably in group settings.
Training Community Clinicians
 In response to requests from professionals
not in a position to commit 20 hours a week
 Responded to requests on an ad hoc basis
for several years.
 Recently developed a second comprehensive
training program offering classroom-based
training and program development
consultation.
Who Is Training ?
 The training staff represent a number of
disciplines: Clinical psychologists (Ph.D. & Psy.D.),
Licensed Clinical Social Workers (L.C.S.W.), Masters in
Education (M.Ed.) w/, specialization in clinical infant studies
and Marriage and Family Therapists (M.F.T.).
 Each has over a decade of mental health
consultation experience.
Resources
 Description of Daycare Consultants
Intensive Practice Based Training Program
 Sample syllabus for didactic seminar on
consultation
 Johnston, K. & Brinamen, C. (2006).
Mental Health Consultation in Child Care:
Transforming relationships among
directors, staff and families. Washington,
DC : Zero To Three Press.
What
Works ?
Question Review and Response