Instituto Familiar de La RazaInstituto Familiar de La Raza Early Childhood Mental Early Childhood Mental

Health ConsultationHealth Consultation

San Francisco, CASan Francisco, CA9/27/109/27/10

Presented byPresented by

Cassandra Coe, LCSWCassandra Coe, LCSWEarly Intervention Program ManagerEarly Intervention Program Manager

Elia Dominguez, MAElia Dominguez, MAIFR Mental Health ConsultantIFR Mental Health Consultant

www.ifrsf.orgwww.ifrsf.org

IFR Philosophy IFR Philosophy

• La Cultura Cura - La Cultura Cura - Culture HealsCulture Heals

– All healing practices occur within a cultural All healing practices occur within a cultural framework where healing is about community framework where healing is about community building and empowerment.building and empowerment.

– Each sub-culture in the trajectory of the Each sub-culture in the trajectory of the Latino/Chicano/Indigenous experience has a set of Latino/Chicano/Indigenous experience has a set of healing practices and coping mechanisms healing practices and coping mechanisms embedded in it which should be strengthened and embedded in it which should be strengthened and celebrated. celebrated.

Program History Program History • IFR’s ECMH program grew out of work being done with IFR’s ECMH program grew out of work being done with

family child care providers(1986), an effort to support family child care providers(1986), an effort to support primarily monolingual/monocultural family childcare primarily monolingual/monocultural family childcare providers to recognize, value, and trust their own providers to recognize, value, and trust their own intuitive caring practices.intuitive caring practices.

• These efforts led to supporting the providers develop These efforts led to supporting the providers develop bicultural practices and integrate multiple approaches to bicultural practices and integrate multiple approaches to childcare. childcare.

• The Infant Parent Program (UCSF) with support from The Infant Parent Program (UCSF) with support from Foundations implemented in the late 1980’s the first Foundations implemented in the late 1980’s the first formal Mental Health Consultation Program in SF. formal Mental Health Consultation Program in SF.

• Model expanded in 1999 when there was an effort by Model expanded in 1999 when there was an effort by infant-parent clinicians in the provider community that infant-parent clinicians in the provider community that resulted in Foundations supporting citywide funding.resulted in Foundations supporting citywide funding.

Program ModelProgram Model• Well being (mental health)Well being (mental health)

is viewed through the interplay of cultural and is viewed through the interplay of cultural and clinical lenses. clinical lenses.

• Mental health consultation practiceMental health consultation practicettakes place within multiple settings and akes place within multiple settings and

relationships which have relationships which have the healing potential within.the healing potential within.

• Relationship-based developmental approachRelationship-based developmental approachfocusing on strengths within the cultural context focusing on strengths within the cultural context

of the family of the family and the childcare centerand the childcare center

• Client-centered, child-focusedClient-centered, child-focusedpromoting promoting reflective practicesreflective practices with consultants with consultants

and care and care providers. providers.

• Consultation is understood as it is Consultation is understood as it is experienced experienced and contingent on relationships and ever changing and contingent on relationships and ever changing

dynamicsdynamics. .

What is Culture?What is Culture?

• Set of values, beliefs and experiences that Set of values, beliefs and experiences that guide how we relate to each otherguide how we relate to each other

• Way of communicating that is beyond Way of communicating that is beyond languagelanguage

• Relationships are formed within the context of Relationships are formed within the context of these values, beliefs, etc….these values, beliefs, etc….

• Example, from Latino experience - the “we” Example, from Latino experience - the “we” (collective) is more prevalent than the “I” (collective) is more prevalent than the “I”

Appreciation of DifferencesAppreciation of Differences

Dime, qué es aqua?

Tell me, what is water?

What is Culture as the Field?What is Culture as the Field?• La Cultura Cura - La Cultura Cura - Culture HealsCulture Heals

– the belief that each culture has a set of healing the belief that each culture has a set of healing practices and coping mechanisms embedded in it.practices and coping mechanisms embedded in it.

• Tu eres mi otro yo - Tu eres mi otro yo - We are oneWe are one– recognition that we are all interrelated and recognition that we are all interrelated and

interdependent and you are the mirror of my own interdependent and you are the mirror of my own experience. Thus, the subject is not the “I” but experience. Thus, the subject is not the “I” but the “We”.the “We”.

Both influence the Both influence the context/fieldcontext/field of of consultation consultation

The Consultant Demonstrates The Consultant Demonstrates

• Cultural empathy/humility Cultural empathy/humility -- checking checking assumptions and engaging families from a assumptions and engaging families from a strengths based perspective.strengths based perspective.

• Appreciation and exploration Appreciation and exploration – of cultural – of cultural values of teachers and families and seeking to values of teachers and families and seeking to support the strengths within those values. support the strengths within those values.

• Fluidity and flexibility Fluidity and flexibility - - within the boundaries within the boundaries of the consultative relationship, of the consultative relationship, attuning to the attuning to the needs of the situation and adapting in response needs of the situation and adapting in response to those needs. (sometimes we are the expert, to those needs. (sometimes we are the expert, but often we are joining as partners in but often we are joining as partners in supporting a community (classroom or supporting a community (classroom or otherwise).otherwise).

Creating a Holding SpaceCreating a Holding Space

Relationships HealCulture Heals

La Cultura Cura

Deeper, trusting and respectful mutual relationships are developed

“Tu eres mi otro yo” : We are one

Cultural affirmation supports holding space for reflection

Relationship-based and Relationship-based and Reflective ModelReflective Model

• Enhancing and promoting positive relationships Enhancing and promoting positive relationships between adult-adult; adult-child; parent-child and between adult-adult; adult-child; parent-child and child-child is at the core of our practice to create child-child is at the core of our practice to create optimal learning and developmental environments.optimal learning and developmental environments.

• Consultation begins with developing positive Consultation begins with developing positive relationships with staff by relationships with staff by BEINGBEING empathic, empathic, respectful, reflective, consistent, and a good listener. respectful, reflective, consistent, and a good listener.

• Assumptions: Assumptions: 1.1. All learning takes place in the context of All learning takes place in the context of

relationships and is strongly impacted by the relationships and is strongly impacted by the quality of these relationshipsquality of these relationships

2.2. All behavior has meaning. All behavior has meaning.

Parallel ProcessParallel Process• Reflection begins with the consultant’s attunement to Reflection begins with the consultant’s attunement to

their own internal process and it’s relationship to the their own internal process and it’s relationship to the experience of consultation. experience of consultation.

• The reflective stance during consultation creates an The reflective stance during consultation creates an opening for teachers to understand their internal opening for teachers to understand their internal experience which we believe leads them to hence experience which we believe leads them to hence begin to reflect upon the internal experience of a child.begin to reflect upon the internal experience of a child.

• Through this process, the child and family begin to Through this process, the child and family begin to build their own capacity for self-reflection.build their own capacity for self-reflection.

• Wondering with care providers empowers their own Wondering with care providers empowers their own knowing and arrive at solutions that resonate from knowing and arrive at solutions that resonate from within and are not externally imposed.within and are not externally imposed.

• Empathic listening and reflection through supervision Empathic listening and reflection through supervision impacts consultants to do so with teachers and thus, impacts consultants to do so with teachers and thus, teachers with children.teachers with children.

Program ReadinessProgram Readinessfor Consultation Practices for Consultation Practices

• Consultants that represent the culture and Consultants that represent the culture and language needs of families and staff being language needs of families and staff being served.served.

• Acknowledgement and appreciation that Acknowledgement and appreciation that culture does exist.culture does exist.

• Clear articulated model that grounds Clear articulated model that grounds consultants in the practice.consultants in the practice.

• Ongoing training and weekly supervision to Ongoing training and weekly supervision to consultants, holding their experience in consultants, holding their experience in such a way that the consultants are thus such a way that the consultants are thus better prepared to hold the experience of better prepared to hold the experience of their sites. their sites.

Program ReadinessProgram Readinessfor Consultation Practices for Consultation Practices

• Support and encourage consultant’s Support and encourage consultant’s development of self-awareness and explore development of self-awareness and explore what it is to be the “other”what it is to be the “other”

Resources

• Mental Health Consultation in Child Care by Kadija Johnston and Charles Brinamen

• Abriendo Puertas – an evidence based leadershiptraining program for Latino Parents with childrenages 0-5 based on popular education and draws onreal life experiences and cultural strengths http://www.familiesinschools.org/site/content/view/228/187/

• Divided by Borders by Joanna Dreby, available at Amazon.com

Del dicho al hecho, hay un gran trecho

Actions speak louder than words