Working with Families with small children

David Bayer, September 30, 2009

What great questions, Peggy.  Our group is embedded in an agency that also has the head start contracts in our community.  We are the “mental health” component.  As such, we are asked to be in the position of “expert” constantly, by teachers, parents, providers, DCF, etc.  We find ourselves, as do so many therapists, complicit in this expectation that we be expert, by providing expertise! (even if we lack confidence that our expertise is expert expertise).  After all, there is much that is known about attitudes, understandings and practices of teaching and parenting that can have great impact on outcomes for children when understood and applied.  I.E., there is much to have expertise about!  Over the years it has been a continual challenge for me and others I work with to reign in the tendency to “know” in favor of  cultivating tendencies toward exploration and “withness.”  Part of the dilemma is that some small portion of the people we consult with want and use specific information.  They seem to be ready, willing and able to hear, accept and use the knowledge of the expert.  But in my experience there are not too many people for whom that works too well, whether we are talking about teachers, children or parents.  (If helping people were simply a matter of sharing  perspective and “knowledge” and making some suggestions, ah how simple it would be.)  And then there is the problem that exploring the landscape, the context of the “problem” and applying narrative ideas – so rewarding and aesthetically pleasing when done well – involves skills that I have not yet developed sufficiently to have confidence in – making disseminating knowledge the default position.

So, I imagine families I work with would hope for me to develop comfort and skill in being with them in ways that elicits their knowledge, strengths and expertise, even when parents (or teachers) are in the grip of abusive or oppressive tendencies, and their children have been traumatized.  I hope that a sub-group on working with this population would foster mutual learning, support and confidence and through it’s influence, even impact the perspective of the wider community of those who work with children…and all people, such that our world be a kinder place.  (Why not go for the whole thing?)

November 5, 2009

HI Peggy,

We’re sitting around the computer trying to figure this all out.  Making some headway.  So this post is from all of us.

As I said in an email to you, we are discussing using Playful Approaches to Serious Problems, which we are all reading.  We are through chapter 4.  Does this make sense to you?

Jen posed a question: How to respond “narratively” when trauma is current and the way life is for a child, which applies to many of our kids (which is not directly related to our reading), but collectively we feel some frustration that the examples given of narrative practice usually involves loving parents who are working tirelessly, (if also unproductively), to help the child.  I know our job as narrative practitioners is to elicit the alternative story of the parents in which we may find embedded many expressions of love, commitment, etc.  Usually our referrals come teachers and it can be difficult to engage the parents at all.

This could go on, but for starters…

Regina, November 5, 2009

Hi Peggy, David and friends

I would be delithed to join this group. I am also going through this book “Playful approaches…” with a few students and I would be glad to share – your comments with them and their comments with you.

I had just very recently a case…It is a 8yo boy sent to our university clinic by the school and the child council. He is said to have major anger attacks at school such as to put in danger the physical integrity of other kids and the teacher. I had him examined by our child psychiatrist to clear up any organic/ neurological influences. The psychiatrist gave him some medication but she could not close any diagnostic as to explain the over angry attacks.

The boy and his mother were seen by two of my students. In the meanwhile he was suspended from school – that is forbidden to go to classes. Discussing the case I agree with the students that it should be a good idea to celebrate a grupal commitement involving child, mother, therapist, teacher and director of the school before his return to the classes.

i was invited to coordinate the encounter. I have to go…I will finish later

kind regards, Regina jardim

Peggy: November 6, 2009

Hi David, Jen, Regina and others,

Great! I am on the run right now, but first chance I get, I’m going to work on organizing a section around the book “Playful approaches.” I hope I don’t sound like a name dropper by telling you Jenny Freeman, David Epston & Dean Lobovits are all friends of mine. I am quite certain they will be delighted to hear we are studying their work here, and when the time is right, we can invite their reflections on our reflections.

I also get a quite a kick out of imagining the Brattleboro group and you, Regina – from Brazil, joining together. A few days ago, I had dinner with Anne Wallace from our local Parent/Child Center and enthused to her about the possibility of her and others joining us all of whom who share the keen interest in segues between narrative practice and working with families with very young children.
Something is emerging…I can feel it. Peggy

David: November 6, 2009

Great to hear from you Regina and Peggy,

I think you may be right to feel something emerging, Peggy.  A “section around …”Playful Approaches,” that’s exciting.  I look forward to it.  I hope that suits you too Regina.  I look forward to hearing about your coordination of the encounter.

Have a good weekend all,
David

Hi Peggy, David and friends

How nice to hear from you guys. Sorry it took me so long to continue the story. By the way, a linguistic question. Are there still a distinction (in English) between “story” and “history”? Is that a post-modern question?

So, back to the story…I was invited to coordenate the meeting. So, I borrowed a David Epston´s tip from one of his cases and I rang the school and I said I could do the meeting but I needed the teacher and the school principal to answer a question to me prior to the meeting. The question was: What do you admire or appreciate in this boy? Why are you investing on him?

The meeting was espetacular. In fact I was sad I did not filmed it.  The boy could name “the good guy” and “the bad guy”. He decided he liked the good guy best. He declared he didn´t agree with the  plans of the bad guy for his life.  He design some strategies to weakens the influence of the bad guy in his life at school. All together  the boy, Mom, Teacher, principal and the psychologist student that was assisting him made a pact around supporting the boy´s efforts to keep the bad guy “in his place”.

I left school feeling so good. I was effectively narrative. All went smoothly.  I wonder how many cases we see in the literature that ended in a point such as that. But here comes what follows:  The week after They didn´t  come to their next appointment at the university clinic  and we rang the school to discover that there has been a new episode early that week and the boy was again not attending the classes.  When they finally  manage to come to they appointment  we are informed that the mother has no more confidence in that school and she will be trying to move him to another one.
We raised many questions:
1-   Why the school staff did not make any contact with us after the last episode?
A very good help in reflecting over this question came through an article I found on David Epston site. It is called: A proposal for an interview format and practices of appreciation that value teachers and students´knowledges in schools by Maria Kecskemeti & David Epston.

2-   Why mother and child gave up the alternative story if it was all built by themselves?

A carefull look reveals the fact that the boy  we are talking about is the only one in his class that still can not read. In fact he is quite behind the other kids in regard to certain contents. Is it possible that he is telling us that he rather be in another school?  ( and although asked he could not sustain such opinion in front of so many “important people “ at that meeting?) Was he making for us a nice alternative story with a politically correct content?  Is there any other way of thinking besides the dominant  though..children has to be at school?

Whatever, sorry to write such long comment. I hope it can contribute to further reflections.

kind regards, Regina

Peggy: November 8, 2009

Hi Regina (David, Jen, Annie, Doug, Elly, Tamara…and anyone reading this who shares interest in working with families with young children…)

Thanks for sharing more of your story – you write well so I could very much imagine myself in your shoes. No need to apologize
about the length. I only wish it was longer. I really appreciate how you offer us not only the events but your list of questions.

I love that you prepared people by asking “What do you admire or appreciate in this boy? Why are you investing on him?” And it sure sounds like that meeting was greatly influenced by how you positioned yourself and others: a moment of narrative pride!

I think I am right with you with your questions. I only wish there were quick answers.

1 – Regina, can you share with us more of what you learned in reading “A proposal for an interview format and practices of appreciation that value teachers and students´knowledges in schools” by Maria Kecskemeti & David Epston. How did this help you accept that the school did not contact you after the last episode? Have you had an opportunity to use some of the questions proposed by Maria and David? Are there any that intrigue you most of all?

2 –
Quote
Why mother and child gave up the alternative story if it was all built by themselves?

When discouragement/disappointment enters my thinking, I often hear Michael White’s voice in my mind, saying some version of, “Remember one unique outcome does not make a new storyline. It will take time and rich story development. Be patient and continue to inquire. What might you ask next?”

Is it at all possible to make actual structural changes for this boy – if not in another school within the classroom?  How are you thinking about enlisting the family members in whatever comes next? And what are you ideas about how to gain credibiity with the school personnel? Do you sometimes experience the effects of  professional jealousy in Brazil, or is that only here in the USA?

What do you folks in Brattleboro, Vermont think – or others?

First chance I get, I am going to set up a place for those of us to gather who wish to further study “playful approaches to serious problems.”
gotta run…Thanks again for this, Regina.

Peggy

Regina: November 8, 2009

Hi Peggy,

Thank you so much for your words. I am loving this conversation.

Quote: 1 – Regina, can you share with us more of what you learned in reading “A proposal for an interview format and practices of appreciation that value teachers and students´knowledges in schools” by Maria Kecskemeti & David Epston. How did this help you accept that the school did not contact you after the last episode? Have you had an opportunity to use some of the questions proposed by Maria and David? Are there any that intrigue you most of all?

I came to see that I was so focus on the boy that I was probably sounding like an expert to the teacher. Although I had praised the teacher´s attitude authentically, I now think it wasn´t enough. Mainly because it is not a matter of praising but actually accessing the inner kwoledge. There is quite a suttle diference between these two concepts. In fact it may have been a good narrative meeting with “Regina´s/trying to be David Epston´s inner knowledge” …next time I will be more aware and curios about the teacher´s inner knowledge of such situations.

.What is still intriguing me is that the article talks about specific training to teachers and in a case such as the one I described I was acting as a consultant for a boy. I mean, I don´t have the time and space required for an approach such as described on the article, Nevertheless I am sure that I  will be thinking on something soon!

Quote:When discouragement/disappointment enters my thinking, I often hear Michael White’s voice in my mind, saying some version of, “Remember one unique outcome does not make a new storyline. It will take time and rich story development. Be patient and continue to inquire. What might you ask next?”

You brougth much confort and movement to my mind and soul…I will use that…”One unique outcome does not make a new  storyline…What is the next question?”

Quote:Is it at all possible to make actual structural changes for this boy – if not in another school within the classroom?  How are you thinking about enlisting the family members in whatever comes next? And what are you ideas about how to gain credibiity with the school personnel? Do you sometimes experience the effects of  professional jealousy in Brazil, or is that only here in the USA?

Professional jealousy, I tell you, It seems to be  universal…worldwide…I am still figuring out what I could do to gain credibility with the school personnel….let´s see what is to come.

I promise I´ll give you informed of the forthcoming..By the way…how to paint the quotes?

Quote: What do you folks in Brattleboro, Vermont think – or others?

I make mine these words…I hope to hear from you soon… Regina

Sarah: November 9, 2009

Hi Regina,

I wanted to let you know of a ripple from your story.  I was in discussion with a colleague yesterday about a family we are both working with. He is seeing the daughter and mom sometimes and I jsut work with the mom alone.  He was saying that he was going to tell the mom – and he went off on this big lecture about what he felt she needed to know about boundaries etc.  I looked away as he was talking as I was uncomfortable with the expert stance he was taking and was sure the woman would not be able to hear this as I was not able to. So I told him the story you shared of having insight into the teacher’s experience as well as the student.  He got this.  He took a step back and realized as a family support worker he does this a lot.  Stands for the children and listens to them and brings forth their skills and knowledges and then turns to lecture the parents on what he knows. He does not want to do this but keeps falling into it.
He said he really appreciated our conversation – it was “energizing” he said.  And we went on to have a great conversation.  I was aware of the parallel and did not wnat me then to become the one giving the lecture.  So I made sure to ask him lots of questions about how he wants to work and it was really good for me too to learn from him.  I am new at this agency and just getting to know people but your story really helped me open up an important discussion. He know wants me to keep asking him questions about how he wants to work.
So thank you!!
Sarah

David: November 10, 2009

Hello everyone!

So much great stuff to respond to.  Regina your story is so rich and I really appreciate putting out for us to see/hear and mull over, and Sarah, how you maintained your disciplined composure and didn’t fall into lecturing him, even kindly, would have been a challenge for me.  I’m happy to have your example to learn from.

I too recently had a session in which I fell back on a David Epston teaching about asking the adults to introduce me to their child and tell me about what he’s like when he’s not being visited by the problem behavior.  The boy in question is 2 years old (can you believe that age?).  The parents are both women, one of whom carried the baby.  They recently separated and even though they feel considerable conflict with one another, they were willing to come together to discuss what could be done.  The question had a profound impact on them and the session.  Their appreciation of him and their desire to help him emerged strongly and overcame the negatively charged descriptions of him.

After some exploration it was left that they were going to work out a schedule for him re: visitations and time spent with each of them that would involve many fewer transitions.  It seemed a bit like magic to me in that what transpired turned out to feel so healing…and simple.

But also like in your situation, Regina, the aftermath…not so smooth.  I learned in the next visit that they had, indeed worked out a very sensible and workable visitation schedule and they reported that their son was responding favorably.  But one of the women began rolling her eyes when the other was discussing having been assertive with her employer so that she could spend consistent time with the child.  The eye rolling appeared to be for my benefit, as the one describing her assertiveness (in response to my questions about her commitment to her son) could not see this silent communication; only I could see it.  I asked the one silently communicating if she was having a response to what was being said that would be useful to hear, but she squirmed away, denying any reactions or responses.  I kinda blew her cover, but didn’t want it to be left that she and I were conspirators.

Later that day I got a call from her asking to be seen alone.  After explaining that I thought that could set up distrust and that I would be happy to be part of a conversation between them about what is difficult to discuss without a 3rd party present, this was accepted and such a session is now scheduled.

My point here goes along with what you were saying Peggy, about Michael’s words: ‘”Remember one unique outcome does not make a new storyline. It will take time and rich story development. Be patient and continue to inquire. What might you ask next?”   Those wise words are very useful at this juncture.

It seems that they coalesced to figure out some things to do on the child’s behalf.  Now I feel some pull to referee stuff between them that may or may not be about the child, or have the child at the center.  I’ll have to see what lies ahead.  More later.

It’s great to talk to you all.

Best,
David

Annie Richards: November 24, 2009

Hi everyone. It’s been a while since I’ve submitted anything but our latest staff meeting was devoted to narrative discussions and we generated some interesting thoughts and questions. One scenario I’ve recently come across is with a family whose 4 yo son I see for “extreme shyness”. Both of his parents describe themselves as shy (dad more than mom) and felt that if someone had intervened early on they could have avoided many problems later in life. It’s pretty clear that mom projects much of her own issues onto her son and it influences their relationship. He is pretty shy in school but not to the degree that she describes. Originally she was sympathetic to this shyness but now it irritates her. My question is, how far do I go with exploring her issues and still keep somewhat of a focus on the child? I’ve tried to externalize  behaviors and name them with her to get a sense of how she envisions the “counterplot” of this story. Any thoughts?

Jordi Freixas Dargallo: November 25, 2009

Could you tell us a story about the child’s shyness?
A story about the mother’s irritation with her son’s shyness?
A story about the mother’s being sympathetic with her son’s shyness?
These are questions that have been useful to me in my practice with teenager’s.

——–

Annie: December 26, 2009

In response to Jordi’s questions, here is a story about this mom’s irritation with her son’s shyness. Mother describes a scenario where she will be in a grocery store with her son and people will say hi to him and he’ll turn away or not acknowledge them. At first, she saw his shyness as being part of who he was and felt sorry for the situation but as time went on, she began to feel as though he was doing it on purpose and was annoyed as a result. Her sense was shyness was something he could control and chooses to use it as a way to push her buttons. Thoughts?

Jordi: January 2, 2010

Dear Annie,
sorry not to have read your post before.
My first thought is that I have the impression that there is something odd in this story. I have seen many four years old children who feel shy and when in a store somebody addresses them, they hide behind their mother, often smiling shyly. And everyone understands the situation and react according to it.
I cannot picture in my mind a situation in which, say, the boy walks alone by himself in a grocery store at some distance from his mom, is addressed by a stranger and neither answers, nor runs to his mother for cover.
My second though is that if the mother thinks that her child is pushing her buttons, there are buttons to be pushed. And let aside the fact that the child might be shy, and additional problem might reside in the buttons that his mother has that can be pushed. I remember a very sad case in which I was not consulted at all but that I had to watch, unable to do anything, in which a small girl repeated the sentences her mother told her -as most of the children do in order to improve their linguistic abilities-, and the mother took it as though her daughter mocked her. That automatically reverted in the mother beating her daughter to correct her. Some 40 years later, the daughter is a seriously ill person who, like her mother, tries to keep away from psychiatrist, psychologists, a.s.o.

Annie Richards: January 15, 2010

Peggy: October 28, 2011

Originally, this conversation began in response to a particular article (Strengthening the mother’s voice in working with families with infants and toddlers” (1997). Over the years, I have gotten to know a number of really fantastic people who work with families with infants, toddlers and young children. I’ve also known a number of people (equally terrific – hey sometimes the same people!) who have personal experience parenting a young child with special health concerns, disabilities or other special circumstances.   I am hoping we can now begin a “Special Interest” topic. Who shares an interest in families with very young children? Are there resources that you find particularly helpful? What draws your attention? what are you discovering? What would you most like to find in connecting with others?

Daria Kutuzova: November 8, 2011

Hello again,

thank you for starting this topic. You asked me in the other thread about the moments when I feel stretched to the limits. I had one moment like this, one was when my baby was feeling really unwell and we didn’t know what was wrong with him – he did not gain any weight in the first six weeks of his life, and kept vomiting up almost all he ate. The most difficult moment for me was when the doctors at the hospital kept interrogating me on the basis of the assumption that I am doing something wrong, neglecting the baby, not feeding him enough. This “presumption of parental guilt” was excruciating, and I didn’t feel supported;  in fact I spent up to 18 hours a day feeding and burping him; the sleep deprivation and the worry drove me to visual hallucinations and disordered attention and memory, so I came to the hospital and left the baby there, saying that I was afraid of harming him accidentally. At that moment the guilt was quite strong, but I knew that this hard decision is for the better. So when eventually the diagnosis was given and the proper medication was prescribed, I felt enormous relief. After that everything feels easier – no matter what is happening, it is better than it was before. The baby still can die of his illness, but every day of his life now, every smile and vigorous cry is a gift and a celebration.
I had a little conversation with my friend, a narrative practitioner from Sydney, whose baby daughter had to have surgery at 3 months of age. We spoke about the fears of the parents, and about the normative discourses of the hospitals. I am particularly interested in how narrative practices can be applied in neonatology ward. Nobody expects to go from maternity unit to the NICU; people are not prepared for this, especially the first-time mothers. And there is a lot of chaos, feelings of failure, worry, exhaustion, resentment etc. Some mothers support each other spontaneously, but I am interested in how this can be made more effective: some brochures with questions and stories? When you are alone with your baby in the hospital room and you cannot leave the baby, there is lot of isolation and loneliness in this. I used this time to write in my journal, and this really helped to story my experience. I had the benefit of knowing how to ask myself ‘good questions’, narrative-style. But what about those people who don’t know how to do this?..I am curious, is there anybody here who works in child hospitals?

Cheers,
Daria