Patria Weston-Lee, LCSW Consuelo Foundation Honolulu, Hawaii.
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Transcript of Patria Weston-Lee, LCSW Consuelo Foundation Honolulu, Hawaii.
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Help for Vulnerable Infants and Toddlers:
The ABC Pilot ProjectPatria Weston-Lee, LCSW
Consuelo FoundationHonolulu, Hawaii
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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.
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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
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Supporting vulnerable infants & toddlers
Philippines HawaiiHealthy Start exampleAdapted for environment
and culture
Attachment and Biobehavioral Catch-up Intervention (ABC) pilot
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Attachment & Biobehavioral Catch-up Intervention
Mary Dozier, PhD. University of DelawareEvidence based
Consuelo Foundation Pilot 2009-2011
Community Pilot 2012-2013
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AttachmentChildren develop
within context of relationships
Need a relationship with at least one primary caregiver
Sensitivity and responsiveness in social interactions
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Attachment PatternsSecureInsecure
AvoidantResistant Disorganized
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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
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Cortisol AM and PM LevelsMary Dozier PhD data
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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
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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
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Powerful tools:Video tapingBreaking down
interactions and their effects
ScaffoldingManualized
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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
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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
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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
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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
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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
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Community pilot
33 families have completed session 10
25 in progress10 dropped out or cannot classifyPilot ends in June 2013Exploring future sustainability or
expansion
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SENSITIVITY
Before ABC After ABC1
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INTRUSIVENESS
Before ABC After ABC1
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DETACHMENT
Before ABC After ABC1
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POSITIVE REGARD
Before ABC After ABC1
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