Promoting Reflection Nurturing a Reflective Practice Dr. Lily Cosico

ETTING
WCWC VI Conference
September 18, 2015
Lily Cosico-Berge, PsyD, ATR-BC, RPT, I-F ECMH RPM
Neighborhood House Association Head Start
Learning Objectives
Demonstrate a basic
understanding of how trauma
affects self-regulation and coregulation.
Identify a respectful and traumainformed, relationship-based
approach to early care and
education.
Practice strategies that promote
self-regulation and co-regulation,
as well as foster feelings of
mutual respect and
connectedness.
Review a mental health screening
tool (MHST 0-5) that can be used
by teachers and home-visitors to
assist in further referrals for
mental health consultation and
services.
HHSA’s Trauma-Informed Systems of
Care
• Relationships are the vehicle for healing
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Safety
Trustworthiness
Choice
Collaboration
Empowerment
Trans-disciplinary training
Education and Coaching/Supervision
Peer/Family Support Partnerships
HHSA: Health & Human Service Agency
Core Components
for Trauma
Intervention
Strong therapeutic
relationships
Psychoeducation about normal
response to trauma
Parental support/parent
training
Emotion expression and
regulation skills
Anxiety management and
relaxation skills
Trauma processing and
integration
Personal safety training
Resilience and closure
Video: Adult Theory of Change
Parallel Process
“Do unto others as you would have others do unto others.”
Jeree Pawl
Children
• Young children develop in
relationships.
• Young children use
relationships with caregivers
to:
• Regulate physiological response
• Form internal working
• Provide secure base for
exploration and learning
• Model coping behaviors
Parents
Engagement starts with
rapport.
Relationships with parents
have the potential to:
Regulate physiological response
Create new meaning to “positive
relationships”
Provide a safe environment to
ask questions & express concerns
Model coping behaviors
“It’s all about the
relationship and selfregulation…”
What can I do?
ACTIVITY
Fold paper in half:
• What do I love about my job?
• What stresses me most about
the job?
•
When I’m with family, I’m
expected to…….(HV, Teacher,
Fam Srvc.)
•
What would make my job less
stressful, more fulfilling?
What is your role? Your goal?
Your job requirement?
What is the parent/child role?
What is the goal? What is the
job?
What do you need most right
now?
Do they match or conflict?
What gives you
strength to keep
going?
There is power and meaning in every
story….what’s your story?
The Foundation for Relationships:
Really Listening and Engaging
Pay attention and
minimize distraction
Invite dialogue
Acknowledge feelings
Promote self-regulation
Reserve judgment
Toxic Stress and Trauma
Not All Stress is Bad….
the ‘fight or flight’ vs.
‘tend and befriend’
response.
When we feel supported,
we can begin to find hope
for the future.
Positive Stress
•Refers to moderate, short-lived stress responses, such as brief
increases in heart rate or mild changes in stress hormone
levels. Learning to adjust to it is an essential feature of healthy
development. Examples: meeting new people, getting an
immunization, entering child care.
•Events that provoke positive stress tend to be those that a
child can learn to control and manage well with the support
of caring adults and which occur against the backdrop of
generally safe, warm, and positive relationships.
National Scientific Council on the Developing Child, Excessive Stress Disrupts the Architecture of the
Developing Brain. (2005). Working Paper No. 3., Summer 2005.
Tolerable Stress
• Refers to stress responses that could disrupt brain
architecture, but generally occur within a timelimited period and are buffered by supportive
relationships that facilitate adaptive coping. These
conditions usually give the brain an opportunity to
recover from potentially damaging effects.
• Examples of stressors include death, a serious illness of a loved
one, a frightening injury, divorce.
National Scientific Council on the Developing Child, Excessive Stress Disrupts the Architecture of the
Developing Brain. (2005). Working Paper No. 3., Summer 2005.
Toxic Stress
Refers to strong and prolonged activation of the
body䇻s stress management systems in the absence of
the buffering protection of adult support, disrupts
brain architecture and leads to stress management
systems that respond at relatively lower thresholds,
and increases the risk of stress-related physical and
mental illness.
•Examples of stressors include extreme poverty, physical or emotional
abuse, chronic and serious neglect, enduring maternal depression,
family
violence.
National
onal Scientific
Sciientiifi
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ounciil on tthe
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he
Developing
evellop
piing Child,
Ch
hil Excessive Stress Disrupts the Architecture of the
Dev
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g Brain.
B
Developing
(2005). Working Paper No. 3., Summer 2005.
Tolerable and Toxic Stress
Alarm
Relaxation
Alarm, Alarm
How Stress Harms
• Higher risk for
developing learning
disabilities, emotional
and behavioral
problems, as well as
asthma, immune-system
dysfunction and heart
disease
• Early, frequent, and
intense stress tunes the
brain to set 䇾stress
regulation䇿 at high levels.
What is Trauma?
• An exceptional and dangerous experience
which overwhelm the capacity to regulate
emotions.
• Children䇻s reactions to trauma vary at
different ages. Early intervention can be
very helpful to allow them to get back on
a normal developmental path
Video: First Impresssions
What does
this mean to
us?
• We need to have a new
lens through which to see
and understand where are
families have been and
what they have
experienced
• Recognize that parents are
the most important people
in children䇻s lives
• Relationships and structure
help reframe the world as a
safe place
What affects the way we respond to the
child䇻s cues for attention and nurturance?
What we believe about
attention and
nurturance
What we are told, what
we have heard and read
in the media
External demands of
your job
Your current emotional
state…how you are
feeling at the time…
What affects the way we respond to the cues
parents show us when they need attention and
nurturance?
What we believe about
adults’ need for
attention and
nurturance
What we are told, what
we have heard and read
in the media
External demands of
your job
Our feeling at the
time…
RESPECTFUL &
RELATIONSHIP-BASED
STRATEGIES:
•
•
•
•
ACKNOWLEDGE, ASK &
ADAPT….
Respectful, Responsive &
Reciprocal
WATCH, WAIT & WONDER
How To be, How to
Understand, and How to
Influence
Group Activity
Respectful Strategies
That Build Relationship
CASE STUDY &
GROUP EXERCISE
•
Establishing Rapport
•
Creating a safe space
•
Engaging in Partnership
•
Sharing Concerns and
Addressing Challenges
From: bulletinboardideas.org
MHST 0-5
• Recognizing redflags
• Sharing
observations
• Role of ECMH
Staff/Consultant
Strategies For Teachers
Schedules & Routines
lcosico-berge2014
More Ways to Support Parents
Recognize that parents and caregivers are the most
important people in children䇻s lives
Support parents as their children’s first teachers
Help parents see the power of their relationships w/
their children
Give parents information and community resources
Help with follow-through with referrals and
appointments
lcosico-berge2014
Time to Reflect…
What does this work mean to you
personally?
What are you bringing to your
particular role from your life
experiences?
How do these things help you or
hinder you in your work?
• I WILL IMPLEMENT THIS STRATEGY
RIGHT
WAY________________________
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• I pledge to assist families to
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