Intervention with Adoptees and Their Families: Part 2/

Interventia cu cei adoptati si cu familiile lor: Partea a doua

Becky Bernstein, MSSA, LISW-S

Holli Ritzenthaler, MSSA, LISW-S

OhioGuidestone

Agenda

Review of the Intervention Goals/ Revederea obiectivelor interventiei

Relational Paradigm of Intervention/ Paradigma relationala in interventie

Intervention Techniques / Tehnici de interventie

Main Goals of Intervention with Adoptive Families/ Scopurile principale ale interventiei cu familiile adoptive

1. Attachment/ Atasamentul Stabilize child in the family and build relationships/ Stabilizarea copilului in

familie si construirea relatiilor

2. Family Identity Development/ Dezvoltarea identitatii familiei Normalize/reframe feelings of ambivalence/ Normalizarea si redefinirea

sentimentelor de ambivalenta Help family system re-stabilize & find new equilibrium/ Sprijinirea sistemului

familiei sa se restabileasca si sa-si gaseasca un nou echilibru Validate parent’s decision to adopt/ Validarea deciziei parintelui de a adopta

3. Grief & Loss/ Suferinta si pierdere

1. Both child and family/ Atat copilul cat si familial Communication/ Comunicarea

Open and honest about history, risks & strengths/ Deschisa si onesta cu privire la istoric, riscuri si aspecte pozitive

1. Empathy & Understanding/ Empatie si intelegere

1. Child’s emotional & behavioral challenges/ Provocari emotionale si comportamentale ale copilului

2. Core Issues & all adoption constellation members/ Teme principale la toti membrii constelatiei adoptiei

Foundational Principles of Intervention/ Principii fundamentale ale interventiei

The parent is the primary agent of change/ The parent is the primary agent of change/ PParintele este agentul arintele este agentul primar al schimbariiprimar al schimbarii

The role of the therapist is to serve as a bridge between the child The role of the therapist is to serve as a bridge between the child and parent’s experiences/ and parent’s experiences/ RRolul terapeutului este acela de punte olul terapeutului este acela de punte intre experienta copilului si aceea a parinteluiintre experienta copilului si aceea a parintelui

Interventions are flexible, responsive and meet all family Interventions are flexible, responsive and meet all family members where they are/ members where they are/ IInterventiile trebuie sa fie flexibile, nterventiile trebuie sa fie flexibile, responsive si sa vina in intampinarea tuturor membrilor familiei, responsive si sa vina in intampinarea tuturor membrilor familiei, in punctul in care se afla eiin punctul in care se afla ei

Relationships are the key to success/ Relationships are the key to success/ RRelatiile sunt cheia elatiile sunt cheia succesuluisuccesului

Relational Paradigm of Intervention/ Paradigma relationala in interventie

Every session SHOULD address 3 critical relationships/ Fiecare sedinta TREBUIE sa abordeze 3 relatii critice

1. Therapist – Child/ Terapeut- copil

2. Parent – Child/ Parinte - copil

3. Therapist – Parent/ Terapeut- parinte

*Sessions may also include siblings, extended family and other caregivers/ Sedintele pot include si fratriile, familia extinsa sau alte persoane cu responsabilitati in ingrijirea copilului

Effective, well-rounded intervention:/ Interventie eficienta

Empowers- encouragement of independent problem solving/ Capaciteaza- incurajarea solutionarii independente a problemelor

Builds on strengths- starting where the client is and building on things they already possess/do well/Construieste bazat pe punctele forte- incepe in punctul in care se afla clientul si construieste mai departe mergand pe lucrurile pe care acesta le face bine

Focuses on the family- children learn what they live!/ Se centreaza pe familie- copiii invata ceea ce traiesc! (din experienta)

Improves parent-child relationship- this relationship is the foundation for all social-emotional development/ Amelioreaza relatia parinte-copil- aceasta relatie este fundamentul oricarei dezvoltari socio-emotionale

Uses reflection- assists in developing understanding and insight into problems/issues/ Foloseste reflectia- asista dezvoltarea intelegerii si a revelatiilor asupra unor probleme sau teme

Effective, well-rounded intervention:/ Interventia eficienta

Provides empathy- promotes respect for the client and builds rapport/ Asigura empatie- promoveaza respectul fata de client si construieste raportari

Promotes social play- play is the foundation for learning and relationship skills/ Promoveaza jocul social- jocul este fundamental pentru deprinderile de invatare si relationare

Uses creative techniques- therapeutic story-telling, art and play therapy/ Foloseste tehnici creative – povestiri terapeutice, artterapie si terapie prin joc

Educates- interpreting behavior and development, parenting techniques/ Educa- interpretarea comportamentului si a dezvoltarii, tehnici parentale

Provides modeling and coaching- allows for teaching and practicing of techniques/ Asigura modelarea si coachingul (antrenarea)- ingaduie invatarea si practicarea tehnicilor

1. Therapist-Child Intervention/ Interventia terapeut-copil

The Power of Play/ puterea jocului “You can discover more about a person in an hour of play than

in a year of conversation.”/ “Poti descoperi mai multe despre o persoana intr-o ora de joc decat poti descoperi intr-un an de conversatie”

~Plato Play is how children explore, learn, problem solve and socialize/

Jocul arata modul in care copilul exploreaza, invata, solutioneaza probleme si socializeaza

Fosters warm and responsive relationships/ Promoveaza caldura si responsivitate in relatii

Increases communication/ Sporeste comunicarea Promotes insight/ Promoveaza intelegerea de tipul revelatiilor Provides opportunity for repeating OR correcting past

experiences/ Asigura oportunitati pentru repetarea sau corectarea experientelor trecute

1. Therapist – Child Intervention/ Interventia terapeut-copil

Child-Directed Play / Jocul directionat spre copil The goal is to follow the child’s lead to strengthen their ability to solve problems

and make positive choices/ Scopul este de a urmari sporirea capacitatii copilului de a rezolva probleme si de a face alegeri pozitive

The child leads the play interaction/ Copilul conduce interactiunile in joc Freedom to explore and express/ Libertatea de a explora si exprima Openly communicate their thoughts, feelings and ideas/ Comunicare

deschisa a gandurilor, sentimentelor si ideilor The therapist allows the child to lead without criticism or interpretation/

Terapeutul ingaduie copilului sa preia conducerea fara criticism sau interpretari Focuses on strengths/ Se centreaza pe punctele forte Reflects feelings to promote insight/ Reflecta trairi care promoveaza

revelatiile; Recognizes the power of total acceptance of the child/ Recunoaste puterea

acceptarii totale a copilului; Stays in the moment/ Se centreaza pe moment;

Child-Directed Interventions/ Interventii directionate spre copil

Follow the child’s lead/ Urmeaza conducerea facuta de copil View the world as the child does/ Vede lumea cu ochii copilului

Get on the child’s level/ Ajunge la nivelul copilului Interact and communicate like the child/ Interactioneaza si

comunica la fel ca si copilul Make a conscious effort to understand the world as the child

does/ Face eforturi constiente pt a intelege lumea in felul copilului

Respond to the child in a way that is compatible with their activity and intention/ Raspunde copilului intr-un mod compatibil cu intentiile si activitatile acestuia Animation/ Animatie (insufleteste) Be more Interesting than distractions/ Mai mult sa starneasca

interesul decat sa distraga When in doubt IMITATE/ Cand ai dubii, IMITA

Therapist-Directed Interventions/ Interventii directionate de terapeut

Safety and Security/ Siguranta si securitatea Practice/Role-Play use of personal safety skills/ Practicarea/ jocul de rol

valorizand deprinderile personale de siguranta Coping and Social Skill Building/ Coping si construirea deprinderilor

sociale Deep Breathing - smell the cookie and blow out the candles or Bubbles for

small children/ Respira adanc – miroase prajiturile si sufla lumanarile sau balonasele pentru copiii mici;

Visualization and Imagery – guide child through imagining a “Happy or Safe Place”/ Vizualizare si imaginare - ghideaza copilul sa-si imagineze “un loc fericit si sigur”

Progressive Relaxation/ Relaxare progresiva Mandalas/ Mandale

Feeling Identification and Expression/ Trairea identificarii si a exprimarii Tell or draw a time when you felt (insert feeling)/ Spune sau deseneaza

momentul cand ai simtit (insereaza trairile) Drawings for power/ Desene care sa sporeasca puterea

1. Therapist-Child Intervention / Interventia terapeut-copil

Group Practice:/ Practica de grup Create a picture of something scary/ Creaza

o imagine infricosatoare Crumple and Destroy/ Aduna-o si distruge-o Create a picture of something Happy or

Peaceful/ Creaza imaginea a ceva fericit si calm;

2. Parent-Child Intervention/ Interventia parinte-copil

Modeling/ Modelare Coaching and Guidance/Coaching (antrenare) si ghidare Maintenance and Support/ Mentinere si sprijin Building Attachment/ Construirea atasamentului

Build trust, security and warmth between adoptive family members/ Construieste incredere, siguranta si caldura intre membrii familiei adoptive

Repair maladaptive attachment patterns, behavior and history/ Repara tiparele maladaptative de atasament, comportament si istoric

Promoting Attachment/ Promovarea atasamentului

How/ Cum Positive interaction cycle/

Ciclul intercatiunilor pozitive Claiming behaviors/

Comportamentele reclamate

Eye contact/ Contact cu ochii

Appropriate touch/ Atingeri adecvate

Open Communication/ Comunicare deschisa

When/ Cand When the Child is calm &

open/ Cand copilul e calm si deschis Fear/ Teama Fatigue/ Oboseala Illness/ Boala

Theraplay (Jernberg & Booth)/ Joc terapeutic

Theraplay looks to the healthy parent-child interactions as a guide./ Jocul terapeutic vede interactiunile sanatoase dintre parinte-copil ca pe un ghid

Use of intimate, physical, personal, focused fun!/ Foloseste amuzamentul in intimitate, in intercatiuni fizice, personale

Adult directed, structured but responsive./ Directionat spre adult, structurat dar responsiv

Goals: / Scopuri

1.Enhance attachment/ Sporeste atasamentul

4. Improve regulation/ Amelioreaza reglarile

2. Build trust / Construieste increderea

5. Improve Self-esteem/ Sporeste stima de sine

3. Replacement of negative behavioral cycles/ Inlocuieste ciclurile comportamentale negative

Theraplay/ Jocul terapeutic Through Theraplay, parent and child become eager to please,

protect, and cherish one another./ Prin joc terapeutic parintele si copilul devin dornici sa-si faca placere, sa se protejeze si sa se valorizeze unul pe celalalt

Theraplay breaks apart the negative interactional cycle and replaces it with a new cycle composed of enjoyment, optimism and acceptance./ Jocul terapeutic rupe ciclul interactional negativ si-l inlocuieste cu un nou ciclu compus din bucurie, optimism, acceptare

Theraplay fortifies children with a sturdy sense of self./ Jocul terapeutic fortifica copilul dandu-i un puternic sens al sinelui

Theraplay provides the building blocks for attunement in the parent-child relationship/ Jocul terapeutic asigura caramizile care construiesc sincronizarea in relatia parinte-copil.

Theraplay/ Jocul terapeutic Sample Theraplay Activities/ Activitati simple de joc

terapeutic Take turns applying lotion to each other/ Pe rand isi

aplica diferite lotiuni unul altuia Build something together with blocks/ Construiesc

impreuna ceva din cuburi Blow up a balloon, create a game and play together/

Umfla baloane, creaza jocuri si se joaca impreuna Check ups/ Verifica Take turns doing something silly to make each other

laugh/ Pe rand fac lucruri caraghioase menite sa-l faca pe celalalt sa rada

3. Parent-Therapist Intervention/ Interventia parinte-terapeut

Active Listening/ Ascultare activa Normalizing/ Normalizare Psychoeducation/ Psihoeducatie Examining Family of Origin/ Examinarea familiei de

origine Explore Grief and Loss/ Explorarea suferintei si a

pierderilor Identify Current Level of Openness and process

anxiety/fears/ Identificarea nivelului curent de deschidere si procesele de anxietate/frica

3. Parent-Therapist Intervention/ Interventiile parinte- terapeut

Addressing parental self care/ Abordarea grijii de sine a parintelui How do you know when you need to take a break?/

Cum stii cand ai nevoie de o pauza? Do you have supports to help when you need a

break?/ Ai la indemana un sprijin atunci cand ai nevoie de o pauza?

What do you do to take care of yourself daily?/ Ce faci pt a avea grija de tine insuti zi de zi?

Scheduling self care time with parents/ Construirea unui orar al momentelor in care parintii sa se ingrijeasca de ei insisi

3. Parent-Therapist Intervention/ Interventia parinte-terapeut

Increase parental insight into the child’s experiences (Being the bridge)/ Sporeste revelatiile parentale cu privire la experientele copilului (rolul de punte)

How does the environment impact the child’s mood and behavior/ Modul in care mediul influenteaza starea emotionala si comportamentul copilului

Explore the child’s experiences with stressful situations or trauma and how they understand these/ Exploreaza experientele stresante sau traumatice ale copilului si modul in care le intelege parintele

Gain understanding of how the child views their world/ Castiga mai multa intelegere cu privire la modul in care copilul vede lumea

3. Parent-Therapist Intervention/ Interventia parinte-terapeut

Genograms and Ecomaps/ Genograme si ecomape Rules, routine, discipline, praise, and rewards/ Reguli,

rutini, desciplina, premieri si recompense Help parents develop daily or nightly nurturing routines

for client/ Ajuta parintii sa dezvolte rutine de ‘hranire’ zi si noapte a clientului

Develop charts or reward systems for client/ Dezvolta sisteme de inregistrare si recompensa pt client

Documenting behaviors to identify triggers, cycles, or patterns/ Sprijina comportamente de identificare a provocarilor, a ciclurilor sau tiparelor

Creating family rules/ Creaza reguli de familie

Family Interventions/ Interventie cu familia Adoption is a restructuring process where a new person enters the family,

alters the equilibrium and brings about change for every member of the system/ Adoptia este un proces de restructurare in care o noua persoana intra in familie, altereaza echilibrul si impune schimbari pentru fiecare membru din sistem

Intervention to address family formation should work to promote:/ Interventiile menite sa abordeze formarea familiei trebuie sa promoveze:

Entitlement and claiming behaviors/ Comportamente de legitimare (de asumare a drepturilor) si reclamare

Acknowledgment of child and family history/ Recunoasterea istoricului familiei si a copilului

Insight into intergenerational patterns/ Revelatii (intelegeri) ale tiparelor intergenerationale

Identification of strengths and positive characteristics/ Identificarea si intarirea caracteristicilor pozitive

Family Interventions/ Interventii cu familia

Family Portrait/ Portretul familiei Therapist passes out paper and drawing supplies/ Terapeutul paseaza

hartii si desene Asks adoptee and family members to draw a picture of their family/ Cere

adoptatului si membrilor familiei sa deseneze familia lor Each person then describes their family portrait/ Fiecare membru

descrie portretul familiei Allows therapist, client & family to explore:/ Ingaduie terapeutului,

clientului si familiei sa exploreze: Family boundaries/ Limitele familiei Subsystems/ Subsistemele Attachment relationships/ Relatiile de atasament Interpersonal communication patterns/ Tipare de comunicare

interpersonala Each members perception of family/ Perceptia fiecarui membru al

familiei cu privire la familie

Family Interventions/ Interventii cu familia

Life Map/ Harta vietii Similar to a Life Book, but set up like a road on a board game/ Similar cu

cartea vietii dar figureaza in joc ceva ca o cale Therapist & adoptee make a chronological outline of child’s life

including:/ Terapeutul si adoptatul structureaza o constructie cronologica a vietiui copilului incluzand: All places the child lived/ Toate locurile unde a trait copilul Dates of each transition/ Datele momentelor de tranzitie Names of significant people/ Numele persoanelor semnificative Child illustrates each event in symbolic way of their choosing/ Copilul

ilustreaza simbolic, cum vrea el, fiecare eveniment Adoptive family actively joins in when the map is at the point of

placement in their home/ Familia adoptiva participa activ cand harta ajunge la momentul plasamentului in familie

Life Map/ Harta vietii

Example

Group Exercise/ Exercitiu de grup

Select a child or family you work with and complete a Family Portrait or Life Map/

Alege un copil sau o familie cu care lucrezi si completeaza portretul familiei sau harta vietii

Acknowledgements/ Recunoastere

Portions of the this presentation completed in collaboration with Zoë Breen Wood, Ph. D., Case Western Reserve University Mandel School of Applied Social Sciences and the Adoption PARTners Program./ Parti din aceasta prezentare au fost completate in colaborare cu Zoë Breen Wood, Ph. D., Case Western Reserve University Mandel School of Applied Social Sciences and the Adoption PARTners Program.