Infant and Early Childhood Mental Health

Interventions: From Consultation to Complexity

Joaniko Kohchi, LCSWTherapist, Complete Counseling NorthAdjunct Faculty, Tulane University &

UTK College of Social Work

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Places to learn about IMH include

– World Association of Infant Mental Health (WAIMH) www.waimh.org

– Zero to Three www.zerotothree.org

– National Child Traumatic Stress Network www.nctsn.org

– Infant Mental Health Initiative of Tennessee (IMHITENN) www.imhitenn.wordpress.com

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In the context of infant mental health,

• Your client is the caregiver-child relationship, rather than an individual baby.

• Donald Winnicott, 1947:

“There is no such thing as a baby.”

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Relationship-Based Assessment

Working Model of the Child Interview (Zeanah & Benoit, 1995)

• Face-to-Face Still-Face Paradigm (Tronick)

• Modified Parent-Child Relationship Assessment (Crowell et al.)  

• Diagnostic Classification Manual for Infants/Toddlers - DC: 0-3R (Zero to Three, 2005)

• Parent-Infant Relationship Global Assessment Scale (PIRGAS)

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• PIRGAS– Like the Global Assessment of

Functioning (GAF), a number is assigned that describes how well the attachment relationship functions.

– Relationship qualities, such as security, challenges, perturbations or disturbances, can be referenced quickly.

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Interventions Are Relationship-Based

• Infant-Parent Psychotherapy

• Child-Parent Psychotherapy

• Circle of Security

• Cognitive-Behavioral Interventions with Dyadic, Familial or Systemic Structure, Participation and Support

…and contextual

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Community-Based Care and Consultation

Reaching outSupporting systemsBuilding relationshipsStrengthening

networks

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From Consultation…

• IMH clinicians may provide support and consultation to

• Physicians• Nurses• Teachers• Caregivers• Parents• Child Welfare Workers• Law Enforcement• Judges and Attorneys

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…in existing settings…

• Primary Care• Acute Care• Allied Health• Mental Health• Child Care / Head Start• Prekindergarten, Kindergarten, etc.• Family Support• Foster Care• Law Enforcement• Judiciary

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…to specialized mental health practitioners

• Clinicians with core competencies– Familiarity with relevant bodies of

knowledge, such as infant and child development, psychopathology, and socio-cultural influences and resources

– Observation abilities– Collaboration with systems– Self-reflection– The capacity to act as a conduit

between parent and child

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…who practice in…

• Agencies

• Schools

• Centers of training and education

• Private Practice

…. and…

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…who bridge the gap between the clinic and natural environment.

• Visit and observe infants and children in their natural settings

• Maintain healthy boundaries between self and client systems

• Use reflective supervision to hone skills and recharge

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Case Studies

• Setting

• Age

• Issue

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IMHITENN

Look for surveys to come, followed by information about programs and providers

Website is under construction as we build momentum for this important work in Tennessee

Visit us!

www.imhitenn.wordpress.com

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• Thank you!

Joaniko Kohchi, LCSW