Based on the classroom teacher’s concern about Sandra’s frequent crying, Dr. Stuart was scheduled to observe Sandra in her classroom. When he discovered that she was no longer in the program, he realized that she was the fourth child to leave suddenly. The Head Start program is located near a public housing development that is being relocated. Neither the program director, nor staff, families, nor children have addressed this issue.
Dr. Stuart convened a meeting for staff to discuss separation and loss. Together, they designed a way to talk about “goodbyes and missing friends” with children in the classroom. In a subsequent “make-it/take-it” workshop staff developed a book for each child to take home that had a photo of all of the children and photos of the classroom. An extra book was kept in the reading nook. The program director asked Dr. Stuart to come to the next family meeting and staff meeting to share ways to prepare children for moving to new homes and child care or Head Start/Early Head Start programs. As a consultant to the program and as someone only a step removed from the classroom experience and community events, Dr. Stuart was able to observe the situation from a different perspective. He helped program staff and families recognize how changes in the community can impact children and their families — one at a time or as a large group. He also helped them to develop specific preventive intervention approaches and strategies to deal with a community issue that had an impact on all children and families — those who were moving and those who remained behind.
This is Programmatic Consultation.Dr. Stuart’s approach to the concerns in this scenario included all three levels of intervention — promotion, prevention, and intervention. He considered the culture of the community and selected services and strategies that included observing and inquiring about the frequency of children leaving the center; helping both the team and families learn about and understanding of the impact of separation and loss on children, staff, and families; and collaborative planning of specific strategies for intervention. The intervention strategies were concrete – building on the strengths of children, families, and staff to deal with these issues of separation and loss. Engaging both staff and families as well as creating classroom strategies and “hands on” practical picture books, helped to ensure consistency across home and classroom settings. Dr. Stuart’s high quality ECMHC services led to a staff and families who were more effective in addressing the concerns related to loss and separation on individual, family, staff, and community levels. (Hepburn & Kaufmann, 2005)
A 16-year-old mother, Wanda, complained to the Family Services Worker that Juanita, her 18 month old was a stubborn, “bad” little girl who did not listen to her. Wanda expressed frustration and anger, saying that she is afraid that she might lose control one day. She went on to say that she has tried talking to her, threatening to put her to bed, and taking away toys. Nothing seems to make difference in Juanita’s willful behavior.
The Family Services Worker suggested that Wanda speak with Dr. Gregory, the mental health consultant, about her frustration and concerns for Juanita. They arranged a home visit where Dr. Gregory could observe Juanita at play and mealtime. Afterward, Dr. Gregory met with the Family Services Worker and Wanda, helping both to better understand typical 18-month-old behavior. He also helped her structure their daily routine, set reasonable limits, and build in time for Wanda and Juanita to play together. By joining with Wanda in her concerns about her daughter’s development, Dr. Gregory was able to help Wanda find new strategies to feel more in control and to enjoy her daughter and their relationships. By including the Family Services Worker, Dr. Gregory was able to help the worker support Wanda in her new understanding and behavior during future home visits.
This is Child and Family Centered Consultation.Dr. Gregory’s approach to the concerns in this scenario included all three levels of intervention — promotion, prevention, and intervention. She selected services and activities that included making a home visit to gather additional information and complete first-hand observations; building an alliance with Wanda and reinforcing the working relationship between Wanda and the Family Services Worker, helping Wanda and the Family Services Worker to understand the developmental nature of Juanita’s behavior, and collaboratively planning specific strategies for intervention. The intervention strategies considered Wanda’s values and perspective and were concrete — building on Wanda new understanding of her daughter’s behavior, the home environment and their day-to-day activities, and the continued support from the Family Services Worker. Dr. Gregory’s high quality ECMHC services intervened in a way that impacted Wanda’s understanding of Juanita’s behavior, promoted a more positive relationship between Wanda and Juanita, and prevented increased frustration and difficulties. (Hepburn & Kaufmann, 2005)