AICAFMHA:
promoting mental health for young Australians
Australian Infant, Child, Adolescent and Family Mental Health Association Ltd
ABN 87 093 479 022
Connect-a-Kid; a mental health iniative with primary and
secondary schools
Carolyn Aston , Social Worker and Child Psychotherapist, Royal Childrens Hospital Mental
Health Services for Kids and Youth
© 2001. This paper is subject to copyright and may not be reproduced in part or as a whole without prior permission from the author.
Introduction
The Program
Now and Future
Introduction
How does a "mother" present her "baby" to the broader
community when she has very limited time to introduce it , and even though she thinks her
"baby" has a lot to offer, sleep deprivation resulting from its recent intensive
needs leaves her wondering? These are some of my thoughts as I prepare to speak to you
today about my Project "Baby" the MHSky Connect-a –Kid Program designed to
help at-risk primary and secondary students connect more with parts of themselves , their
peers , teachers and families.
This "baby" was conceived in the fertile learning space provided by my work on location (June 98-Dec,99) as a Mental Health Clinician at a large co-educational Secondary School. It was there that I saw many teachers providing ongoing excellent intuitive support to the group of more "worrying" students who were referred to our Service ; students presenting with mental health issues and /or those at risk of prematurely leaving school.
We began to experiment by formalising the teacher’s role as a teacher mentor ; that is someone who" looked out" for this student , who supported them during crises, and who met regularly with them to identify and think about the various barriers (from an individual , familial and school system’s perspective) which prevented them from maximising their schooling opportunities. Put simply we built on the existing goodwill and commitment of staff by helping them to provide a nurturing and at times confronting relationship to students whose own attachment and developmental history often led them to sabotage or reject potentially positive input. They often described feelings of aloneness and isolation or anger at perceived "injustices" whose origins on investigation , were frequently from much earlier experiences. Karen (P.185) describes how Sroufe et al‘s Minnesota Pre-schooler Study suggests that children with secure attachment and therefore positive expectations of others were seen to have greater social skills and popularity , self-esteem ,ego resiliency empathy and independence than their peers. By contrast ambivalent children were more likely to present as either (op cit , P.186) ‘preoccupied fidgety and tense and easily upset by failure or as fearful , hypersensitive and clingywho lack initiative and give up easily’.He noted that these children were vulnerable to bullying or overidentification with a distressed peer.
He identified three types of avoidant children at this age: ‘ the lying bully who
blames others ; the shy spacey loner ‘ with flat affect and ‘ the obviously
disturbed child with repetitive twitches and tics ‘ who withdraws through
daydreaming’. Of particular interest to our Project is Sroufe’s observation of
teacher reactions to these particular groups of children. He found that teachers generally
did not expect avoidant children to co-operate or follow rules and often felt hostility
towards them (not unlike these children’s parents , I suspect ) and appeared to
underestimate the capacities of the ambivalent group whom they were more likely to
indulge. Although this study targeted children much younger than those in our Project it
will be interesting to consider any similarities in our work.
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© 2001. This paper is subject to copyright and may not be reproduced in
part or as a whole without prior permission from the author.
The Program
Our Program is exciting I believe as it demonstrates the capacity for trained
Connect-a-Kid Teacher Mentors as ‘potential attachment figures’ to offer
‘at risk’ students "an opportunity to be redirected emotionally"
(Karen ,1998 P.424) ; thereby allowing the student to begin to feel accepted despite
his/her difficult behaviours.
As Mental Health Clinicians , Corinne and I are sensitive to the demands and possible valency issues around this role , both of which can be considered in the ongoing secondary consultation offered to Teacher Mentors. This together with the expertise of the Senior Project Officer and Senior Student Support Officers (Catholic and D.E.E.T schools respectively as Co-Leaders should hopefully provide a rich partnership of containment.
The role of the teacher mentor draws on Greenspan’s ( 1997 , P.187 ) developmental theory of mental health with its emphasis on the process of ‘continuing growth ,deepening intimate relationships , and developing more meaningful inner reflection , particularly in terms of the ability to tolerate the frightening , painful , bitter ,emotions of life."and its recognition of the wide variability of what constitutes mental health .It describes a hierarchical model of mental development in which the degree and depth of attainment of each developmental level such as the baby’s earliest task of attending and staying calm influences his/her mastery of the next developmental level .His focus on the child’s need for ‘empathic sensitive nurturing combined with clear, firm limits" to facilitate this development has informed our Training Program for Teacher Mentors.
As all students in the Program present with attachment difficulties underlying their reasons for referral , their appointed Teacher Mentors are encouraged to begin their work by offering an alternative relationship to what is generally anticipated ; an accepting , nurturing and reflective one where concerning behaviours are considered and responded to thoughtfully, rather than punitively. In addition they are asked to assist their student to gradually develop a vocabulary of "feelings’ to begin to articulate intense reactions to difficulties , rather than impulsively acting out. This may take considerable time and the ease with which teacher mentors embrace different aspects of their role is likely to vary according to individual styles and strengths and the extent to which their own anxieties and concerns are contained by those of us offering secondary consultation.
Another component of our Program is the design and provision of Parent Information Sessions and Parenting Programs designed to help parents of students in the Program enhance their relationship with their child and like Karen’s (1998 ,P.421) description of Lieberman’s work will focus on aspects of these parents’ own childhood experiences which have impaired their attachment to their child. Our Teacher Mentors are encouraged to respect the student’s relationship with his/her parents in recognition of the inherent pain shared by both parent and child alike with attachment difficulties. This may be a struggle for all of us at times when there is a clear history of abuse or severe deprivation.
Our Reference Group will soon consider the possibility of a Connect-a-Kid Club to promote "play’ and recreational activities for participating families many of whom are living in poverty and therefore have minimal access to leisure pursuits and the benefits associated with these. Corinne and I will be interested to hear of existing programs designed to enhance the lifestyle of these families in our participating schools , such as The Meeting Point Project of Marion College ,1998 which worked with local community organisations to assist its low income families.
Our Program has four tiers of intensity according to the level of student need .All students referred to the Program receive a full school-based psychiatric assessment and are asked to nominate a teacher with whom they feel comfortable talking so that his/her future connection with a teacher mentor is built on an existing relationship. Recent experience suggests we ask them to put forward the names of several staff to promote the voluntary participation of his/her teacher mentor and avoid disappointment if a teacher is already allocated to a student in our Program.
This mentor is invited with the parent’s permission to receive a summary of the
clinical feedback to build on his/her current understanding of the student. This process
also facilitates a joint meeting of the teacher mentor parent/s and student and marks the
beginning of a working alliance in which communication about the student and family issues
and concerns are critical.
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© 2001. This paper is subject to copyright and may not be reproduced in
part or as a whole without prior permission from the author.
The Connect-a-Kid Teacher Mentor’s role commences on completion of the initial training day and commitment to attend ongoing group secondary consultation led by the Senior Student Support Officer (in the Department of Education and Training Schools) or Senior Project Officer (in the Catholic Secondary College) and MHSky Clinician based at the school.
The second tier of the Program is a collective approach of key staff (known as the School Treatment Team) who together with input from the Mental Health Clinician design an individually tailored program to enhance the student’s attachment to school and his /her capacity to understand the meaning of his troubling behaviours ; thereby reducing his likelihood of continuing them. A student of considerable concern to both the school and Clinician may also be offered the third tier of the Program ; that is individual therapy at school or other treatments available through our Service. Students of grave concern may be allocated to the fourth tier of our Program in which complex case management across a range of Services is required in addition to provision of a teacher mentor,school treatment team and individual therapy. Cases requiring this level of intervention are reminiscent of Winnicott’s (1984 P.197 ) description of the maladjusted child’s need for schools to act as ‘hostels which provide cover like clothes for a naked child and like the personal human holding of an infant newly born."Our model is flexible in that the level of intensity of treatment changes according to the student’s progress and feedback by parents and staff at reviews.
The Project targets students encompassing the "Middle Years ’’ -grades five and six at Primary Level and Years seven and eight at Secondary Level. ( Technically it should also encompass Year nine students , an omission hopefully redressed with additional resources in the future. ) By definition this coincides with the difficult transition from Primary to Secondary School as well as the developmental challenges associated with the onset of puberty and adolescence.
Not surprisingly this age range of students represents particular challenges to
Teachers , Mental Health Clinicians and parents and coincides with a high level of
referrals to our Service.
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Now and Future
Currently my colleague Corinne Hoebert is based at a large Catholic Secondary School one
day per week in the Mid-West Region of MHSky’s catchment area. In addition ,with my
role now dedicated to the Project , I am working at two DEET Primary Schools and two DEET
Secondary Schools.
We recently received some Quality Incentive Funding which together with robust support from the MhSky C.E.O and Senior Management Team and our respective Team Leaders has allowed us to expand the Connect-a-Kid Program in this way and to evaluate it further.
Our Program is contained by a Reference Group chaired by my Team Leader , David Reid. Its task is to support Corinne’s and my work across the five participating schools and the Project generally , to think about issues and difficulties as they arise , to guide the evaluation of the Project and seek funding for its continued development. Currently membership comprises the Principals of three participating schools , the Team Leader of the Senior School Support Officers and one of his team , an Organisational Psychologist and Socioanalyst , Corinne , her Team Leader and myself.
Our Project is guided by socioanalytic thinking in terms of the Consultants’ recognition that ‘all organisations have socially constructed defenses against the anxiety of carrying out the primary task of the organisation which prevent organisational learning ‘( Bain , 1998 P.427) . Moreover the extent to which the consultants and members of the Project Team can contain these and thereby modify them will shape opportunites for new ways of thinking about organisational realities and promote change. Similarly the extent to which the Connect-a-Kid Teacher Mentor can contain and feed back difficult experiences and feelings of the student in a palatable way will largely determine the level of change available to the student in his care.
Our Project is operating on multiple levels with a range of systems many of which are as yet disconnected or only partially connected.We are seeking ways to integrate isolated individuals and systems to maximise the educational opportunities of at risk students. Through this process we also hope to alleviate some of the struggles and isolation of parents , student welfare staff and others not yet identified. There is much to be learned ,but good reason for optimism ; given the collective commitment to our Project.
Like any "parent " I am uncertain of my "baby’s" future. With
thoughtful nurturance , flexible "parenting" and the time needed for its
development, I hope it will grow up and make a meaningful contribution to the broader
community.
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© 2001. This paper is subject to copyright and may not be reproduced in
part or as a whole without prior permission from the author.
BIBLIOGRAPHY
BAIN, A. Social Defenses Against Organizational Learning .Human Relations,Vol.51,N0.3,1998.
GREENSPAN,S.I. The Growth of the Mind and the Endangered Origins Of Intelligence Perseus Books ,1997.
KAREN , R.Becoming Attached First Relationships and How They Shape Our Capacity to Love Oxford University Press,New York 1998
TEACHER LEARNING NETWORK ,Vol.8.N0.1 Autumn 2001
WINNICOTT,D.W. Deprivation and Delinquency Tavistock,London and New York , 1984
Acknowlegements
To Alastair Bain for his continued support and input as Consultant to the Project and contribution to this paper.
To Antoinette Ryan for her continued guidance as my Clinical Supervisor and contribution to this Paper.
To my dear friend and colleague Toni Heron for her guide in references for this Paper.
Lastly but not least to our Reference Group colleagues and families, in our participating schools who have made this Project possible.
© 2001. This paper is subject to copyright and may not be reproduced in part or as a whole without prior permission from the author.
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