Perhaps, one of the hardest aspects of this work is connecting and empathizing with the parents and caregivers I work with.  As with so many of us, connecting with the kids I work with comes second nature to me.  Most days it’s easier than breathing.  That feeling of connection to children reminds me of my favorite parts of myself.  However, really connecting to a caregiver or family member often takes a real conscious effort on my part. 

​When I first began this work, I often would skip over this.  I’d often think something along the lines of, “My client is the child, I don’t really have to connect to the families.”  Or, “I work in schools with kids, and parents almost never come in so why even try to connect to them?”  It’s an insidious line of thinking largely because it’s certainly a lot easier to stay grounded in that line of thinking than to challenge it and work with difficult caregivers.  However, it became more and more apparent how essential it was to work with parents the longer I did the work.  Gains we made in session or at school would quickly be lost in the instability and struggles clients would return home to. 

​This lesson struck home for me after finishing my first school year with my clients.  I remember the look on my client’s face when he realized he had to go home to his unstable family system for a whole summer and somehow had to find ways to meet with me over the summer in the midst of that.  At the end of the day, we are always only going to be a very small part of a client’s life.  Hopefully, we will be a powerful part of our client’s life as well.  However, a child’s relationship to their parents is something that will affect them for the rest of their life.  If we have any small chance of shifting that relationship in any way, I believe it is imperative that we attempt to help heal and grow this relationship.

Here are some tools I’ve found helpful in building empathy with the caregivers and parents I work with:
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1. Remember that the caregivers we work with are often just adult versions of the children we work with.   

We spend so much time in our field contemplating generational trauma and how this generational trauma impacts the children we work with.  However, this trauma also lives on in the parents and caregivers we are working with! And they often have more of their brains developed and more ability to heal this trauma in the family system than anyone.  So frequently the caregivers we work with had no therapy or other supportive figure in their lives who helped them process and work through the generational trauma they were holding as children and thus they still carry this with them into this moment.

One of the most important and transformative conversations you can have with a parent is exploring how they were raised.  It becomes a beautiful opportunity to build empathy for them as well as a chance to begin to connect patterns we see in our client with the parent.  Just this conversation alone will often begin to open the parent’s heart, to seeing how the very things that frustrate them the most about the child happened in their childhood in a slightly different way.
 
2.Learning to see the person and pain behind the behaviors.

Just as we spend time learning how to see the pain and deeper needs behind the behaviors of the children we work with, so too must we learn how to do this with the parents we work with.  When a step father expresses feeling like your client is never able to follow directions and is always manipulating to get what she wants, can we ask ourselves “what is the step-father trying to express with this?”  “What feelings is the step-father feeling in this moment as he expresses this?”
One of my family therapy teachers once assigned me to find the parent or caregiver who it was toughest to connect with and spend a whole session just connecting and empathizing with this caregiver.  When the stressed mother begins to berate her son again for staying out late with his friends, I would challenge myself to say to the mother, “Wow.  I really hear that you’re trying all you can to help your son stay on track and it’s overwhelming!” 

So often this connection building activity will immediately drop the energy in the room and open up the space towards more love and connection.  It can provide this caregiver some much needed empathy so that she can better use empathy to connect to her son in a real way.
 
3.Reminding ourselves that the parents are a literal and embedded part of our clients.

When working with family members they are a literal part of our clients.  They are the most powerful resources we have in understanding and healing our clients because they literally make up our client’s day to day life as well as their biological make up.  Even when there might be a parent who the child expresses hate towards (and the parent might have engaged in some real harmful behaviors) it’s so very important that we remind ourselves that this parent is still a basic part of this child.  That hate the child might be expressing is also an internalized hatred because that parent is a literal part of them.  So when we join with that hate we are often just joining the child in a place of self-hatred.  It’s still super important to validate and acknowledge the realness of our client’s feelings but we have to ask ourselves what would it be like to so strongly hate someone who makes up so much a part of yourself?  How can I open my client to exploring all of these complex feelings they have about their parents?  Our first step towards helping our client explore these feelings is being open to seeing this parent in an open and non judgmental way ourselves. 
 
4.Parents and caregivers are the most powerful resource we have in helping our clients heal

When I first began doing family therapy, my colleagues and I used to say that parents are “the medicine.”  That no matter what kind of pain or anguish our clients expressed that the parents were the ones who could most heal this pain.  Of course, one parent astutely pointed out that this also meant that she was the poison.  That she was most likely to be the one causing the client pain.  It can be difficult for a parent to really open up to how much influence they have on their children, however when a parent can really open up to this truth they can then begin to really use love to heal the wounds in their children. 
 
The better we can understand and connect with the parents and caregivers we work with the stronger our work we will be.  Some truths and moments of love truly do resonate out into a lifetime and can profoundly change our clients.  There are so many moments with my own parents that stick with me and keep me strong in tough times, moments of love and care that meant the world to me.  If we can facilitate even one small moment of connection and care like this with the families we work with, who knows how powerful of an effect it could have?  It’s the love and care we all want on a very deep and basic level and most of the time it’s just waiting for a chance to come out and flow between the parent and the child.  All we have to do is remind them that it’s there.

Written By:
​Patrick Schirmer

Providing Mental Health services to school students requires patience, consistency, and a therapist who recognizes they are “a passenger on their journey”.  An effective therapist must show up to every session flexible and optimistic -- even when the youth is consistently resistant to talking, when all they want is to use your office as a retreat from the classroom -- the greater goal of supporting student success must always be in mind. A Better Way’s school-based therapists are striving to help youth become successful students, while addressing the impediments to their success.

I had the opportunity sit down and speak with two of our school-based clinicians, Helenia and Jorge. Both therapists offer services in middle schools in Alameda County, serving up to 25 students a year. During this meeting, I learned the value of providing mental health services to young people during school hours.

Clinicians working with youth between the ages of 11-14 are witness to a  critical developmental moment in this young person’s life. According to an article on All Pro Dad The Top Five Problems Tweens Face are:  

1. "The Awkward Phase: Their bodies feel out of control and so life is full of feelings of embarrassment. Then you have those who develop quicker or later than others, which breeds insecurity and instability.” 
2. Changing Friendships: The relationships they had in elementary school start to change. Many kids experience having less and less in common with their childhood friends.” 
3. “Living In A Culture Of Meanness: …In their angst caused by the uncertainty around them, they are looking to reacquire some sense of control. Putting down someone else or even bullying gives them a sense of the power they are lacking.”
4. “Alone In Groups: Due to the mean environment, middle school friendships are generally formed out of a need for protection. Their groups offer a safe haven, as long as the group is strong.” 
5. “The Independence vs. Dependence Paradox: In the tween phase, kids move towards independence from their parents. However, they still crave the security and support parents offer.” 

In addition to the typical tween problems as mentioned above, some youth may be dealing with Anxiety, PTSD, Depression, and problems at home. Having therapists on campus can create a more nurturing environment for the youth to process and prosper through the changes they might be experiencing and the challenges they face within their daily lives.

Based on our conversation, I gathered that we need more therapists on campus and a greater interest in nurturing the mental health of our youth. School-based therapists possess valuable insight into the challenges students face, that school staff and faculty may not have the time, training or expertise to address. Because therapists meet with students one-on-one each week, they get to see the young person as they truly are. They are “more intimately involved in their stress and triggers”; therapists are aware whether the parents are involved or not, which greatly influences a student’s success in school.

​Additionally, according to an article in the Washington Post: 
“…Children under stress have difficulty focusing on the curriculum and retaining what they learn. When schools address these kids’ emotional needs, train the staff to spot signs of trouble, and intervene early, students feel safe and secure in their learning environments. This, more than anything else, can help students thrive in school.”

​Major Takeaway:
To my surprise, Jorge and Helenia report the youth have totally bought in to receiving therapeutic services. While students may not want to talk right away, they recognize their need for a safe place outside of the classroom, where they can be heard and just be themselves without judgement or punishment.

In schools, there is an expectation of youth to sit down, be quiet, listen and learn. What if that young person is struggling and keeping those feelings bottled up? “…We must prepare them with life coping and self-management skills and let them know it is okay to have space to take care of yourself.” 

Therapy during school hours is a preventative resource that can help youth to grow and thrive -- not only in school, but also in life. Mental Health clinicians can also help to shift the culture of an entire school, making it a place where youth feel comfortable being themselves, knowing that the adults around them care about how they are doing.

​This is a “Journey line”. It is a creative activity that helps clients open up. The way it works is you pick out important moments/memories and draw/write them down to give the client a narrative of their life. It shows growth and obstacles they overcame and how such events shaped them into who they are today.

Written By, Taisa Grant

 “Bonding is not an event; it’s a process. It’s never too late to bond,” says Lyle Truscott, a mental health clinician for the 0-5 program at A Better Way’s San Francisco office. Lyle works with children under the age of 5, providing non-direct play therapy and child parent Psychotherapy (CPP). Additionally, she is a Certified Educator of Infant Massage (CEIM). As a CEIM Lyle is able to offer infant massage training to parents and caregivers to improve attachment and bonding within families. She can also present information about infant massage in her community, participate in research studies, and conduct in-service programs.

The infant massage program Lyle offers was created by Vimala McClure and was based on her lived experiences during her travels. However, Ms. McClure stresses that infant massage has been around long before that. The practice is rooted in many cultures around the world. More specifically she states that, “Infant massage is an ancient art that connects you deeply with the person who is your baby, and helps you to understand your baby’s particular nonverbal language and respond with love and respectful listening. It empowers you as a parent, for it gives you the means by which you become an expert on your own child.
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The Benefits of Infant Massage:
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The Benefits include enhanced motor development and reduced cortisol (the stress hormone). It’s especially beneficial to babies born premature or addicted, and HIV+ babies. The bond between the infant and caregiver is increased whether it’s a mother, father, foster parent or even siblings. The caregiver is more confident and it may even help mothers experiencing postpartum depression. Enhanced sleep is also a benefit…if infant massage is included in the bedtime routine it can reduce stress for caregivers.​

The Four Modalities the Massage Strokes are pulled from are:

1. Indian head massage
2. Yoga 
3. Swedish massage 
4. Reflexology

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​A Typical Infant Massage Training with Lyle:

When caregivers participate in an infant massage training with Lyle, they can expect to attend five structured 30 minute to 1-hour sessions. The length of time of each session is dependent on whether or not the training takes place in a group setting or one on one. The caregiver will participate with their infant ranging in age from 6 weeks to pre-crawling.

​Initially you will discuss what infant massage is, when it was founded, its purpose, benefits, and the best oils to use. She also lets participants know that infant massage is baby-led. Throughout the training parents are shown how to ask for permission before administering any massage strokes. Caregivers are also supported in recognizing and picking up on the feedback their baby is giving.

Session 1: Focuses on legs and feet
Session 2: Focuses on stomach
Session 3: Focuses Chest and arms
Session 4: Focuses on face and back
Session 5: Review and gentle movements

Something caregivers should know: as a trainer Lyles never massages your baby. She only demonstrates the strokes using a baby doll, she affectionately named Maisie. This ensures that the trainer, Lyle in this case, does not intervene in the essential bonding and relationship strengthening taking place between caregiver and child.

Every session ends with a discussion, allowing caregivers to talk to each other about the process if in a group setting. Otherwise, a discussion takes place between the caregiver and Lyle, about what they would like to get out of the training. She ends each session with a nice closing, for example a song or whatever is appropriate for the client.

Major Takeaway:
Lyle spoke to walking away from infant massage training's feeling grounded and relaxed. The power of touch can’t be overlooked; it is more valuable than any toy you can buy a child to soothe and entertain them. Infant massage is a holistic process because it is a non-invasive therapy that supports the whole baby. It empowers caregivers and encourages a strong bond built on trust and respect between caregiver and child.

Written By, Taisa Grant