BRiEF REPORTS PREVENTIVE MENTAL HEALTH SERVICES FOR FAMILIES NEW TO THE COMMUNITY
Mary
Heller,
A.C.S.W.
#{149}Theproblems for a family relocating to a new cornrnunity are many: parents know little about community resources and services, children must adjust to new schools, and both parents and children must make new friends. Such problems cause pressures that create intrafamily disturbances, which may have adverse effects on the children’s educational, emotional, and social growth. In recent years the Staten Island Mental Health Society has been increasingly concerned with the problems that confront families who are adjusting to a new community. A federal staffing grant, made in 1973 for the establishment of the Staten Island Children’s Community Mental Health Center, enabled the staff to consider indirect, preventive services for such families. It was felt that group sessions for parents would provide a practical method of intervention and prevention of problems. Through the group process, parents would be helped with concerns about their children that, although problematic, were not severe enough to warrant psychiatric evaluation of the child. The sessions would help parents become sensitive to their children’s needs and feelings, and ease day-to-day aggravations and frustrations. The goal was to prevent the need for costly, long-term help that might become necessary if problems were not dealt with immediately. The center staff felt that the most effective method of reaching the target population was through the public and parochial school systems in the area of Staten Island where most of the new population had settled. They contacted the district superintendent of schools and the district director of guidance to explain the proposed program and to request their permission to reach families through the schools. After receiving their approval, staff held meetings with individual school Mrs. Heller is a psychiatric social worker at the Staten Island Children’s Community Mental Health Center, 657 Castleton Avenue, Staten Island, New York 10301.
principals and guidance counselors in three public and two parochial schools. Over a four-month period letters describing the program were distributed to 2400 children in the first through fifth grades. The letters were to be taken home. They had a tear-off section on which parents who were interested in the program could record their name, address, and telephone number. Those parents who were interested were to return the tear-off section to the school with their children. In addition center staff members described the program to PTA groups at the schools. The latter proved to be a better method of recruiting group members. It gave staff a chance to answer questions, clarify the purpose of the program, and dispel parents’ anxieties about associating with a mental health facility. Approximately 150 parents responded to the letters and the presentations. Ninetyfive per cent of the respondents were new residents. Two churches near the schools provided meeting rooms for the groups. Each church had a parking lot and was fairly accessible to public transportation. During the initial eight-month program a total of nine groups were run. Each group had approximately ten members and met for a 90-minute session once a week for ten weeks. The sessions were held two mornings, two afternoons, and one evening each week. The hours of the morning and afternoon sessions were planned so that parents would be away from home only during school hours. The evening group was for parents who worked during the day. A psychiatric social worker led the groups. Supervision was provided by the center’s director of psychiatric social work and the director of consultation and education. At the initial meeting of each group the leader briefly reviewed the goals and objectives of the sessions, making it clear that the time was to be used for childcentered discussion by the parents, not for a lecture by the leader. To facilitate interaction among group members who generally were unacquainted with each other, each member filled out a placard with his name, his child’s school, and the ages of his children, and placed it so that others could see it. Each parent was asked to verbalize his particular concerns and reasons for joining the group. Areas of concern included sibling rivalry, child’s difficulty with
VOLUME
26
NUMBER
8 AUGUST
1975
493
peer relationships, discipline as differentiated from punishment, and the building of trust. The leader then developed an agenda for each subsequent meeting, allowing the parents to choose the concern they wished to discuss at each session. The leader tried to structure the discussion so that the parents gained useful knowledge at each session. The goals were to help each parent feel that he was an integral part of the group and to discuss as many of the parents’ concerns as possible. The parent who voiced the concern was asked to give specific examples, thus providing a context for the situation. In that way general philosophical discussions were avoided and a parent had the opportunity of looking at solutions that related directly to his family constellalion. If the parent had a problem that required more intensive help than the leader could give, the leader referred him to an agency that could provide that help. Group members often insisted on having concrete answers to their questions. In such situations the leader pointed out that because of the varied personalities and home situations involved, each member should work out his own solutions. It became apparent to the members that solutions that were appropriate for one family could be inappropriate for another. The parents were enthusiastic about the discussion groups; they felt they were gaining insight into their children’s behavior and support from each other. Thus the program’s goal of helping parents become aware of and sensitive to their children’s specific needs and feelings was achieved. An additional benefit was strengthening relationships among those parents who found they had similar concerns and problems. Parents were asked to evaluate the sessions by responding to a questionnaire administered during the final session of each group. Ninety-five per cent of the parents stated they got as much out of the discussion groups as they had anticipated. The most satisfying aspect of the discussions for many parents was finding that so many of their concerns were shared by others. The parents felt they benefited from the honesty, openness, and support of other group members. Other positive outcomes of the discussions for the parents ineluded gaining new insights into child development, becoming more secure in the role of a parent, and finding an opportunity for structured ventilation. The most disliked aspect of the program was that time went by too quickly. As for suggestions for change in future discussion groups, a few parents asked for more time and more discussions. (Many of those who made this request had missed several sessions during the ten-week period and may have felt less frustrated had they been able to attend all sessions.) The schools involved in the program have requested that it continue. One school asked that it be expanded to include parents of older children, specifically those in the sixth to eighth grades. A guidance counselor in another school requested that the program be introduced there. Because of the initial response, the program has been made an integral part of the work of the consultation
494
HOSPITAL
& COMMUNITY
PSYCHIATRY
and education division of the center. Staff have been added to the division so the program can be expanded. In addition, plans are being made to hold discussion groups for parents of nursery and kindergarten children, and for parents of pre-adolescents.
CAMPING
AS
A THERAPEUTIC
EXPERIENCE FOR AND SCHIZOPHRENIC Robert
M. Shearer,
DEPRESSED PATIENTS A.C.S.W.
UThe staff of the day treatment center at the Veterans Administration Hospital in Atlanta used camping as a therapeutic activity through which patients could reveal their characteristic behavior patterns. Two separate groups were involved in the camping experience. One consisted Qf four chronically depressed patients, the other of ten chronically disturbed schizophrenics; all were men. The depressed group camped at a state park about 60 miles from the center, while the schizophrenic group camped at a mountainous national forest about 90 miles away. Although.members of both groups voluntarily agreed to participate, the responses were notably different for each group before, during, and after the two-day trip. The schizophrenic patients organized quickly and planned the excursion smoothly. They stayed organized during the trip, and after their return initiated plans for another, longer trip. The depressed group became fragmented during planning and maintained a degree of fragmentation throughout the trip. Its members frequently manifested overt anger toward each other and accompanying staff members. Two staff members were primarily involved in planning and executing the trip, and a third staff member joined each group for the excursion. Members of both groups experienced anxiety and apprehension before and during the initial phase of the trip, primarily because the trip represented a radical departure from daily routine and life style. Most group members had never camped before or had not done so for several years. In order to come to terms with their anxieties, patients were encouraged to get involved in the planfling and task-oriented aspects of the trip. The four depressed patients had been meeting together for about three months before the trip. Each had experienced a significant loss in his life and had strong feelings of guilt, worthlessness, loneliness, and self-anger. Each shared the belief that he did not deserve to experience success and pleasure but rather should expect pain and failure. Depressed patients typically avoid activities and involvement with experiences that might lead to failure. That behavior was manifested during planning and execution of the trip. Mr. Shearer is a clinical social worker at the day the Veterans Administration Hospital in Atlanta. Sanden Ferry Drive, Decatur, Georgia 30033.
(Continued
treatment center of His address is 1345
on page
497)
Mary
Heller,
A.C.S.W.
#{149}Theproblems for a family relocating to a new cornrnunity are many: parents know little about community resources and services, children must adjust to new schools, and both parents and children must make new friends. Such problems cause pressures that create intrafamily disturbances, which may have adverse effects on the children’s educational, emotional, and social growth. In recent years the Staten Island Mental Health Society has been increasingly concerned with the problems that confront families who are adjusting to a new community. A federal staffing grant, made in 1973 for the establishment of the Staten Island Children’s Community Mental Health Center, enabled the staff to consider indirect, preventive services for such families. It was felt that group sessions for parents would provide a practical method of intervention and prevention of problems. Through the group process, parents would be helped with concerns about their children that, although problematic, were not severe enough to warrant psychiatric evaluation of the child. The sessions would help parents become sensitive to their children’s needs and feelings, and ease day-to-day aggravations and frustrations. The goal was to prevent the need for costly, long-term help that might become necessary if problems were not dealt with immediately. The center staff felt that the most effective method of reaching the target population was through the public and parochial school systems in the area of Staten Island where most of the new population had settled. They contacted the district superintendent of schools and the district director of guidance to explain the proposed program and to request their permission to reach families through the schools. After receiving their approval, staff held meetings with individual school Mrs. Heller is a psychiatric social worker at the Staten Island Children’s Community Mental Health Center, 657 Castleton Avenue, Staten Island, New York 10301.
principals and guidance counselors in three public and two parochial schools. Over a four-month period letters describing the program were distributed to 2400 children in the first through fifth grades. The letters were to be taken home. They had a tear-off section on which parents who were interested in the program could record their name, address, and telephone number. Those parents who were interested were to return the tear-off section to the school with their children. In addition center staff members described the program to PTA groups at the schools. The latter proved to be a better method of recruiting group members. It gave staff a chance to answer questions, clarify the purpose of the program, and dispel parents’ anxieties about associating with a mental health facility. Approximately 150 parents responded to the letters and the presentations. Ninetyfive per cent of the respondents were new residents. Two churches near the schools provided meeting rooms for the groups. Each church had a parking lot and was fairly accessible to public transportation. During the initial eight-month program a total of nine groups were run. Each group had approximately ten members and met for a 90-minute session once a week for ten weeks. The sessions were held two mornings, two afternoons, and one evening each week. The hours of the morning and afternoon sessions were planned so that parents would be away from home only during school hours. The evening group was for parents who worked during the day. A psychiatric social worker led the groups. Supervision was provided by the center’s director of psychiatric social work and the director of consultation and education. At the initial meeting of each group the leader briefly reviewed the goals and objectives of the sessions, making it clear that the time was to be used for childcentered discussion by the parents, not for a lecture by the leader. To facilitate interaction among group members who generally were unacquainted with each other, each member filled out a placard with his name, his child’s school, and the ages of his children, and placed it so that others could see it. Each parent was asked to verbalize his particular concerns and reasons for joining the group. Areas of concern included sibling rivalry, child’s difficulty with
VOLUME
26
NUMBER
8 AUGUST
1975
493
peer relationships, discipline as differentiated from punishment, and the building of trust. The leader then developed an agenda for each subsequent meeting, allowing the parents to choose the concern they wished to discuss at each session. The leader tried to structure the discussion so that the parents gained useful knowledge at each session. The goals were to help each parent feel that he was an integral part of the group and to discuss as many of the parents’ concerns as possible. The parent who voiced the concern was asked to give specific examples, thus providing a context for the situation. In that way general philosophical discussions were avoided and a parent had the opportunity of looking at solutions that related directly to his family constellalion. If the parent had a problem that required more intensive help than the leader could give, the leader referred him to an agency that could provide that help. Group members often insisted on having concrete answers to their questions. In such situations the leader pointed out that because of the varied personalities and home situations involved, each member should work out his own solutions. It became apparent to the members that solutions that were appropriate for one family could be inappropriate for another. The parents were enthusiastic about the discussion groups; they felt they were gaining insight into their children’s behavior and support from each other. Thus the program’s goal of helping parents become aware of and sensitive to their children’s specific needs and feelings was achieved. An additional benefit was strengthening relationships among those parents who found they had similar concerns and problems. Parents were asked to evaluate the sessions by responding to a questionnaire administered during the final session of each group. Ninety-five per cent of the parents stated they got as much out of the discussion groups as they had anticipated. The most satisfying aspect of the discussions for many parents was finding that so many of their concerns were shared by others. The parents felt they benefited from the honesty, openness, and support of other group members. Other positive outcomes of the discussions for the parents ineluded gaining new insights into child development, becoming more secure in the role of a parent, and finding an opportunity for structured ventilation. The most disliked aspect of the program was that time went by too quickly. As for suggestions for change in future discussion groups, a few parents asked for more time and more discussions. (Many of those who made this request had missed several sessions during the ten-week period and may have felt less frustrated had they been able to attend all sessions.) The schools involved in the program have requested that it continue. One school asked that it be expanded to include parents of older children, specifically those in the sixth to eighth grades. A guidance counselor in another school requested that the program be introduced there. Because of the initial response, the program has been made an integral part of the work of the consultation
494
HOSPITAL
& COMMUNITY
PSYCHIATRY
and education division of the center. Staff have been added to the division so the program can be expanded. In addition, plans are being made to hold discussion groups for parents of nursery and kindergarten children, and for parents of pre-adolescents.
CAMPING
AS
A THERAPEUTIC
EXPERIENCE FOR AND SCHIZOPHRENIC Robert
M. Shearer,
DEPRESSED PATIENTS A.C.S.W.
UThe staff of the day treatment center at the Veterans Administration Hospital in Atlanta used camping as a therapeutic activity through which patients could reveal their characteristic behavior patterns. Two separate groups were involved in the camping experience. One consisted Qf four chronically depressed patients, the other of ten chronically disturbed schizophrenics; all were men. The depressed group camped at a state park about 60 miles from the center, while the schizophrenic group camped at a mountainous national forest about 90 miles away. Although.members of both groups voluntarily agreed to participate, the responses were notably different for each group before, during, and after the two-day trip. The schizophrenic patients organized quickly and planned the excursion smoothly. They stayed organized during the trip, and after their return initiated plans for another, longer trip. The depressed group became fragmented during planning and maintained a degree of fragmentation throughout the trip. Its members frequently manifested overt anger toward each other and accompanying staff members. Two staff members were primarily involved in planning and executing the trip, and a third staff member joined each group for the excursion. Members of both groups experienced anxiety and apprehension before and during the initial phase of the trip, primarily because the trip represented a radical departure from daily routine and life style. Most group members had never camped before or had not done so for several years. In order to come to terms with their anxieties, patients were encouraged to get involved in the planfling and task-oriented aspects of the trip. The four depressed patients had been meeting together for about three months before the trip. Each had experienced a significant loss in his life and had strong feelings of guilt, worthlessness, loneliness, and self-anger. Each shared the belief that he did not deserve to experience success and pleasure but rather should expect pain and failure. Depressed patients typically avoid activities and involvement with experiences that might lead to failure. That behavior was manifested during planning and execution of the trip. Mr. Shearer is a clinical social worker at the day the Veterans Administration Hospital in Atlanta. Sanden Ferry Drive, Decatur, Georgia 30033.
(Continued
treatment center of His address is 1345
on page
497)
