patria weston-lee, lcsw consuelo foundation honolulu, hawaii
TRANSCRIPT
Help for Vulnerable Infants and Toddlers:
The ABC Pilot ProjectPatria Weston-Lee, LCSW
Consuelo FoundationHonolulu, Hawaii
Consuelo FoundationMission: To
operate or support programs in the Philippines and Hawai`i that prevent and treat abuse, neglect, and exploitation of children, women and families.
Foundation Role in the Community of Service Providers Bring innovative ideas
to the community in areas of identified need
Demonstrate efficacy of services in a given community
Educate decision makers
Support community providers in developing successful services
Supporting vulnerable infants & toddlers
Philippines HawaiiHealthy Start exampleAdapted for environment
and culture
Attachment and Biobehavioral Catch-up Intervention (ABC) pilot
Attachment & Biobehavioral Catch-up Intervention
Mary Dozier, PhD. University of DelawareEvidence based
Consuelo Foundation Pilot 2009-2011
Community Pilot 2012-2013
AttachmentChildren develop
within context of relationships
Need a relationship with at least one primary caregiver
Sensitivity and responsiveness in social interactions
Attachment PatternsSecureInsecure
AvoidantResistant Disorganized
3 Key Issues Identified for Children who Experienced Adversity:
Tendency to push caregivers away
Need for nurturing care
Often dysregulated at behavioral and biobehavioral levels
Cortisol AM and PM LevelsMary Dozier PhD data
What is ABC?
Attachment is crucial to child’s healthy developmentGeared for ages 0-2 years with history of neglect 10 sessions
Providing nurturanceFollowing child’s leadNot frightening
Providing Nurturance when distress: Examples: discomfort with child crying, bottle propping, fear of spoiling, time outs for crying
Following Lead with Delight: Examples: emphasis on teaching child, struggle with expressing delight
Not Frightening Child: Examples: threatening the child when s/he misbehaves, scaring the child as a game
ABC Targets
Powerful tools:Video tapingBreaking down
interactions and their effects
ScaffoldingManualized
Strengths Based InterventionUses gentle suggestionsIn-the-moment comments
are done in a natural, conversational fashion
Quickly builds rapport through positive comments
Does not focus on what parent is doing “wrong” but highlights the small positives
Use of VideotapingEnsure fidelity to
model and clinical supervision
Videotaped observations extremely helpful in providing parents with feedback they need to develop strengths as parents
Enhancing Cultural RelevanceProvide food/meals
where appropriateProvide referrals or
other assistance when needed
Adjust modes of communication (texting)
Offer to compile footage into home movie DVD
Overall FindingsABC model well
accepted by targeted families
Possible to deliver the model with high fidelity in Hawai`i
Positive data trends for ABC group
Demand created for intervention to be made available in community
ABC Trainees in Hawai`i1 Keiki O Ka `Aina, Kalihi 1 Catholic Charities – Mary Jane Home
transitional shelter for new mothers in Kailua1 Queen Lili’uokalani Children’s Center on
Kaua`i Enhanced Healthy Start Clinical Specialists:
Family Support Services, Kona Catholic Charities, Oahu PACT, Oahu Child and Family Service, Ewa Beach
Community pilot
33 families have completed session 10
25 in progress10 dropped out or cannot classifyPilot ends in June 2013Exploring future sustainability or
expansion
SENSITIVITY
Before ABC After ABC1
1.5
2
2.5
3
3.5
4
4.5
5
INTRUSIVENESS
Before ABC After ABC1
1.5
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2.5
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4.5
5
DETACHMENT
Before ABC After ABC1
1.5
2
2.5
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3.5
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POSITIVE REGARD
Before ABC After ABC1
1.5
2
2.5
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4.5
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