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The Fundamentals of Infant-Early Childhood Mental Health

The following articles provide infant-early childhood mental health professionals with an understanding of effective promotion, prevention, and treatment strategies.

Core Concepts

The Therapeutic Relationship as Human Connectedness: Being held in another’s mind
Jeree Pawl (Feb/Mar 1995)
Babies develop a sense of security through being noted, noticed, spoken to over distance, rescued, protected, appreciated, and tethered across space and out of mutual sight – in other words, by being held consistently in someone’s mind. In the therapeutic relationship, the therapist tries to be nonjudgmental, respectful, interested, concerned, attentive, practical, realistic, and painstaking in building and articulating the parameters of the relationship.

Promotion of Infant Mental Health

Keeping the Baby in Mind: A critical factor in perinatal mental health
Arietta Slade (Jun/Jul 2002)
Reflective functioning—including the capacity to recognize that the infant or toddler has mental states—enables a mother to facilitate her child’s developing capacity for self-regulation. In normative and therapeutic settings, practitioners can enhance expectant and new parents’ emotional understanding of their child.

New Roles for Developmental Specialists in Pediatric Primary Care
Margot Kaplan-Sanoff, Claire Lerner, and Andrea Bernard (Oct/Nov 2000)
Developmental specialists from a range of professional disciplines use “teachable moments” to help parents understand their child’s temperament, behavior, and development through observation and discussion of shared experiences in the pediatric office.

Infants in Day Care: Reflections on experiences, expectations and relationships
Jeree Pawl (Feb 1990)
Child care must be thought about and seen as occurring in the context of other relationships and as containing relationships. To promote very young children’s mental health, we must understand as much about infants and toddlers as we can and then apply our understanding to the individual child’s experience, including the experience of child care.

Prevention of Infant Mental Health Problems

Relationships for Learning: Early Head Start infant mental health in Jackson, MI
Deborah Weatherston (Aug/Sep 2001)
Early Head Start staff (master’s level social workers or early childhood educators) reduce risks for participating families by learning to look at and listen to the infant, the toddler, and the parent; balancing past with present; and offering families relationship as the primary tool for learning.

Treatment of Infant Mental Health Disorders

Developmental and Therapeutic Aspects of Treating Infants and Toddlers who have Witnessed Violence
Theodore Gaensbauer (Apr/May 1996)
Through a detailed case presentation of his evaluation of a child who, at 2-?, had witnessed the murder of his father, the author illustrates the impact of trauma of young children’s development and offers guiding principles for psychotherapeutic treatment.

Organizational Development, Infrastructure, Systems, and Policy

Organizational Environments that Support Mental Health
Robert Emde, Judith Bertacchi, and Tammy Mann (Aug/Sep 2001)
“Reflective practice” is a term used to describe the establishment and maintenance of an organizational culture that facilitates mental health. Reflective supervision, the availability of a trained infant mental health specialist, and appropriate continuing education are program elements that support reflective practice.

Working with the Written-Off: Building relationships in Grand Boulevard
Portia Kennel (Oct/Nov 1996)
How can one create a relationship-based work environment for staff when the environment of the families served is violent, unpredictable, and threatening to their emotional, psychological, and physical well being? In these circumstances, a staffing plan must reinforce the interdisciplinary nature of the work and replenish leadership from within by giving people an opportunity to learn and grow professionally.

Training and Professional Development

An Integrated Approach to Supporting Professional Development through In-service Education and Supervision
Trudi Norman-Murch and Karen Wollenburg (Jun/Jul 2000)
The authors offer four principles: 1) Think of staff development as a process, not an event; 2) Attend to the emotional components of learning; 3) Use scaffolding to support new ways of being and doing; and 4) Think ecologically.

The Infant Mental Health Specialist
Deborah Weatherston (Oct/Nov 2001)
Clinical studies and practitioner interviews have identified approximately 20 skills and strategies that are fundamental to effective and compassionate infant mental health home visiting practice. More than half of these skills (for example, relationship building; informal and formal observation of a child’s development) are used and valued by all infant-family practitioners who work from a relationship perspective. The remainder (for example, focusing on past and present relationships and attending to the emotional needs of infants and parents) are more clearly specific to the infant mental health specialist.

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