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by Melinda Strauss, LICSW
March, 2003
Pediatric care providers are often the first to observe a parent's worries, sadness
or disappointments, or to hear about the concerns
and challenges that arise in the first years of parenting, in the
families they serve. Some examples include a parent's worries about a
child inheriting the depression or hyperactivity of a relative, difficulties
in the marital relationship during the child's first year of life, coping with
the loss of a job, etc.
Each pediatrician, family physician and nurse practitioner will decide
what is the most congenial way to approach the evaluation and management
of psychosocial issues for their pediatric patients and families.
Community resources, such as mental health clinics, early intervention programs
and domestic violence prevention services, are essential "good medicine" for the
present and future health of children and families. Pediatric health care includes
knowledge about community resources as well as sensitive and timely referral when
families are in need.
How can we expand the walls of our offices to meet the emotional needs of our
youngest patients, and to prevent the problems that we see in older children
and frustrated parents? Your medical practice may find it advantageous to develop
a two-way relationship with a community agency, receiving consultation on
psychosocial problems and referring families to programs that can prevent
or solve those same problems.
Jewish Family & Children's Service (JF&CS) is a nonprofit, nonsectarian
agency serving over 80 communities throughout greater Boston,
Massachusetts. Many American cities have a JF&CS that serves all populations
with a broad range of services for children, adults and elders.
Boston's JF&CS also serves all ages, and offers specialized programs for parents of
newborns and very young children. The JF&CS Center for Early Relationship Support
provides group and home visiting services that meet the needs of parents for support,
connection and treatment of early relationship vulnerabilities:
Parent Consultations
Parent Consultations provides any parent of an infant or
young child with a professional parent consultant who will
provide guidance, information, skills, resources and support for one
time or throughout the early parenting journey. Issues such as control,
communication, discipline and self-esteem are among the many areas that
parents may choose to share and explore. Each family determines the number
and schedule of visits.
Early Connections
Early Connections is a therapeutic service, in the home setting, for new
families experiencing emotional difficulties in the transition to parenthood.
The new mother may be experiencing a postpartum mood disorder or may be
recovering from a psychiatric hospitalization. The baby may have special
needs or be particularly difficult to soothe. Some families are seen
for brief consultation while others are seen over the long term.
Sleep Consultations
Trained parent educators observe parent(s) and baby in their home environment
and develop individualized support and guidance. Discussion includes the
child's development, temperament, the parents' efforts and involvement, and
familial sleeping patterns. Four week Sleep Groups are offered for parents
of infants who are are struggling with sleep issues.
Feeding Support Program
Feeding Support staff are certified lactation nurse consultants who share
information on all feeding experiences (breast and bottle) in the context
of the mother's experience and her developing relationship with her infant.
Home visits and/or office visits may also build the bridge to other
Center programs such as Early Connections or support groups.
Visiting Moms Program
Trained Visiting Moms volunteers are matched with new mothers who have a
particular need for a supportive connection, to help them cope with the early
months of parenthood. In providing a consistent, committed home visitor
who offers ongoing support and guidance during early parenthood, the program
focuses on fostering healthy parent-infant bonding and positive patterns
of interaction. The program also provides weekly support groups for mothers
to discuss concerns and problem-solving approaches.
Parenting Stories
Parenting Stories is a four week group for parents of young children to
explore their own experiences with recurrent parenting themes such as
separation, anger and self-esteem. This mutual support and exploration
fosters an understanding of how the parents' own experience affects their
lives as parents. Groups run continuously throughout the year.
I would encourage physicians to contact JF&CS by phone or make a visit, to familiarize
themselves with the programs prior to recommending them to parents in their practice.
Among the issues they may wish to inquire about are the professional staff and their
training, the agency's experience in dealing with specific problems, and fees. Physicians
may also want to discuss how to make referrals and what information they may want to
receive in return.
Physicians may also wish to explore the possibility of a special arrangement for an agency
clinician to come to their practice and meet with small groups of interested parents.
Parents will want to be sure that the information they share with both physicians and
agencies remains confidential. It may be worth reviewing with the agency what type of
release forms parents would sign. This is particularly pertinent in view of HIPAA
requirements.
For more information on the Center for Early Relationship Support and other programs
at Jewish Family & Children's Service, call the Center director, Peggy Kaufman, LICSW,
at (617) 558-1278, or visit www.jfcsboston.org on the web. Jewish Family & Children's
Service agencies are located in most major U.S. cities.
Other programs that serve children and families, such as child guidance clinics, family
service agencies or early intervention programs may be located by contacting your hospital's
pediatric department social worker.
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