WHAT WORKS?
A Series on Effective Early Childhood
Mental Health Consultation
Preparing and Supporting the Workforce, Part 2
Training and Supervision of ECMH Consultants
June 30, 2010
Deborah Hirschland, MSW
Together for Kids – Worcester, MA.
SETTING THE STAGE
Massachusetts in the Nineties
A BEGINNING
A friendly overture, some impassioned
conversation, and the start of a training initiative
THERE WERE MANY QUESTIONS
TO ANSWER…
WHO WOULD ATTEND?
A mix of participants…
1. TFK (AND PARTNER AGENCY) CLINICIANS doing
ECMH consultation
2. GRADUATE LEVEL INTERNS doing their placements at
TFK/partner agencies with a specialty in ECMH/ECMH
consultation
3. TFK SUPERVISORS who felt a need for additional
training in the specifics of consultation
4. TFK STAFF TRAINERS working with the early care and
education community, who wanted to more fully understand
and partner with the work of TFK’s ECMH consultants.
HOW SHOULD COURSE CONTENT
BE FRAMED?
Given the complexity of the work and the wide ranging
knowledge base on which it relies, how could we
balance a focus on:
(1) the consultative process,
(2) the knowledge base needed to understand
children, families, early care and education staff,
and the relationships between them, and
(3) approaches to intervention for specific behavioral,
emotional, and developmental issues?
WHAT MIX OF TEACHING STYLES AND
APPROACHES WOULD WORK BEST?
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Didactic presentation
Discussion of readings
Open-ended check-ins
Discussion and
deconstruction of
observational and
journaling assignments
• Spacious conversation
about the work as it
“lives and breathes” on
the ground
• Case presentations
• Guest speakers
• Experiential exercises
• Dissemination and
exploration of relevant
resources
HOW MUCH READING WOULD
BE REQUIRED?
Required reading:
•Mental Health Consultation in Child Care (Johnston and Brinamen)
•Collaborative Intervention in Early Childhood (Hirschland)
Strongly recommended texts:
•Unsmiling Faces – How Preschools Can Heal (Koplow)
•Hope and Healing – A Caregiver’s Guide to Helping Young Children
Affected by Trauma (Fitzgerald Rice & McAlister Groves)
•Working with Families of the Poor (Minuchin, Minuchin, & Colapinto)
•DC-O3 Casebook (Lieberman, Wieder, & Fenichel, Eds.)
•First Feelings: Milestones in the Emotional Development of Your Baby
and Child (Greenspan & Greenspan)
Supplementary readings
Extensive annotated bibliography
WHAT ADDITIONAL WORK WOULD BE
REQUIRED IN ADVANCE OF SESSIONS?
In preparation for each session, participants are
required to do an observational and/or journaling
assignment that asks them to look at the session’s
targeted content through the lens of:
•What is happening with a child/family/care-giving
program “on the ground,”
•How they understand what they see, and
•What their questions and thoughts are about
possibilities for/challenges of collaborative
intervention.
AT WHAT LEVEL SHOULD
MATERIAL BE PRESENTED?
The seminar offers a mix of approaches, and targets a mix of
learning needs.
•Didactic material is presented at a high level – in the hopes of
meeting the needs of the most experienced attendees, while
challenging interns to integrate material that deepens course
content they’re getting in graduate school.
•There are many opportunities for small group sharing and case
discussion – which allow participants to encounter material at
whatever level works for them.
•The observational/journaling assignments offer many
opportunities for individualized learning.
•Our experience has suggested that a mix of participant levels
offers significant invitations for and experiences of “cross
fertilization.”
WHAT WOULD BE THE OPTIMAL SIZE
FOR THE GROUP?
•Ten to twenty participants is ideal.
•Twenty-five participants is doable.
•Above that number, the learning in the room isn’t
as spacious or richly textured as we hope to see.
HOW WOULD WE THINK ABOUT THE CONTEXT IN
WHICH THE SEMINAR WOULD BE TAKING PLACE?
•Supervision: All (clinician) participants receive individual supervision.
Interns also participate in weekly group supervision.
•Team Meetings:Staff clinicians also participate in an “early childhood
mental health team” facilitated by a team leader who is
one of the agency’s senior clinicians.
•Collaborative Case Presentation: In addition, staff meet three to four
times a year with clinicians in subcontracted, partner agencies –
for discussion, case presentation, and exploration.
•Targeted Trainings: Throughout the year, TFK offers targeted trainings
on specific topics (play therapy, trauma, referral to and
collaboration with outside agencies/programs, etc.)
•Evidence-based Practices: A large number of the clinical staff have
been trained in the CSEFEL model (see Vanderbilt.edu/csefel)
and some are now participating in ongoing training on Alicia
Lieberman’s model of child/parent psychotherapy.
WHAT WOULD BE THE BEST TIME FRAME
FOR THE SEMINAR?
The seminar has been run in a number of forms:
•Two hours a week every other week over eight months
•Once a month with two full days (the introductory day and
one midway through) and six three-hour sessions
over eight months.
•In a compressed form with two full days (the introductory
day and one midway through) and six three-hour
sessions over three months.
SEMINAR CONTENT AND PROGRESSION
With a steady mix of conversation, didactic content,
discussion of readings and observational assignments, case
presentations and discussions, experiential exercises and
more…
1.
2.
Session one (full day) includes foundational explorations
about ourselves and our questions – and an in-depth
presentation of an overall framework on which to base our
thinking.
Sessions two to four (three hours each) place developmental
mastery at the “hub” of exploration, and offer a multi-layered
approach to understanding behavior, developmental
mastery, and emotional experience in the context of
relationships – along with an examination of possibilities for
consultation and collaborative intervention in support of
emotional, developmental, and behavioral mastery
SEMINAR CONTENT AND PROGRESSION
3.
Session five (full day) involves a morning exploring the
use of self in consultation/reflective practice and an
afternoon exploring challenges in working with hard-toreach/engage families and early care and education
staff. (Although these challenges are highlighted
throughout the seminar, they’re put center stage here.)
4. Sessions six through eight (three hours each) look at
trauma and loss, examine the power of play and of
creative approaches to helping children “story” their
experiences in the service of emotional and
developmental mastery, and explore approaches to
parent /teacher training and support in group contexts.
Each session includes extensive case presentations and
discussion. In addition, at the latter part of the last
session, there is ample time for reflection and
evaluation.
A FEW HIGHLIGHTS…
A Core Framework
From day one, an important
consciousness…
That we bring all of ourselves to our work –
and all have work to do on ourselves!
A focus on the power of language… and
the importance of an accessible, downto-earth approach to practice
Constant attention to the importance of
collaboration
A joint focus on development and
relationships as the initial “hub” of our
explorations
An emphasis on reflective practice and
the power of asking questions…
And, above all….
As we progress through our multi-layered
explorations, an ongoing look at how we “cocreate meaning”* with our partners in care as
we ask:
• How do we understand what we see?
• How can we join together to open up pathways
for growth, mastery, and pleasurable
connection for children and adults alike?
*With credit and appreciation to Kadija Johnston and Charles Brinamen for a phrase so many of us now use.
CREATING A LEARNING
ENVIRONMENT
The instructor’s role
ranges from:
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Questioner
Facilitator
Lecturer
Co-discussant
Learner
Framer
Challenger
Supporter
Resource provider
The learning environment
includes:
Safety
Encouragement
Allowing questions
Taking risks
Sharing what one doesn’t
know and has to offer
• Identifying what one wants
to learn
• Absence of intimidation
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MOVING FORWARD
Building capacity in the work force, not
just of early childhood consultants, but of
practitioners who can teach this kind of
content - a model from TFK…
SEMINAR RESOURCES
Here’s what you’ll find on-line at: sites.google.com/site/deborahhirschland
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Course syllabus of seminar
Annotated bibliography
List of supplemental readings
Session evaluation form
List of targeted competencies
Template to guide consultant:
– Gathering information
– Understanding the experiences
of child, family, provider and
clinician
– Setting the stage for
intervention
• Template for discussion and
creating action plans in childfocused team meetings
• Several in-class exercises
• Set of observational/
journaling assignments and
required readings
• Additional handouts
distributed over the course of
the seminar
What
Works ?
Question Review and Response