PARTNERS Clinic incorporates Best
Practices for mental health in a model that recognizes individual
differences and the importance of the family in children’s
development. We believe caregivers are the key to the success of
their children. As a result, our therapeutic approaches
include children and their caregivers.
Assessing
Family and Caregivers
To help foster
healthy development in children, clinicians must first understand
the child’s experiences and current functioning. To that end,
families participate in screenings as well as more comprehensive
assessments. This helps PARTNERS Clinic therapists learn about the
families’ histories of stress and trauma and their associated
feelings, thoughts and behaviors.
Our therapists use the information
obtained during assessments to develop a plan for treatment,
including specific ways for children to cope with feelings and
thoughts related to stress and trauma. Adaptive coping
results in fewer problems with school, families, and peers, and can
prevent revictimization.
In addition to the
children,therapists also work with caregivers to help them develop
ways to decrease their own stress and increase their ability to
gain their children’s cooperation.
The Therapy
PARTNERS Clinic
therapists provide trauma-specific cognitive behavioral therapy
(CBT). Two versions of trauma-specific CBT are offered: one
for sexually-abused children and their non-abusive caregivers and
one for physically-abused children and their abusive
caregivers.
CBT builds from
the theory that emotions (e.g., anxiety) are associated with
physiological symptoms (e.g., heart palpitations), cognitions
(e.g., “I am a failure”), and behavior (e.g., avoidance of the cues
that elicit those feelings and thoughts). Thus, CBT consists
of coping skills that address the physiological, cognitive and
behavioral responses.
Children are given
relaxation skills to address the physical reactivity, ways to
challenge the negative thoughts and experiences facing their fears
to learn that they can tolerate the emotions.
Caregivers are
taught the same skills, both because they may be experiencing their
own stress and because they take on the role of coaching the
children to use their skills. Caregivers also are taught
evidence-based parenting strategies that address children’s acting
out and aggressive behaviors.
For children and
adults exposed to trauma, the physiological, cognitive, and
behavioral responses are often reactions to the perception of being
in danger. During a trauma, the danger is real. The problem
is that trauma survivors perceive that they are in danger when they
are not because something reminds them of the trauma.
CBT aims to ameliorate the
psychological effects of trauma, principally through “guided
exposure” to the trauma through the telling of a “trauma
narrative.” First, the cognitions, emotions and physiological
arousal that accompany memories and / or reminders of the trauma
are identified.
Oncechildren demonstrate learning of
more effective coping, the “narrative” is introduced to interrupt
patterns of avoidance, fear and excessive anger. Distorted
ways of thinking about the trauma are then challenged and modified
to facilitate more effective processing and emotional integration
of the
experience.
In trauma-specific CBT, caregivers are taught the necessary coping
skills and parenting techniques. When appropriate, this process is
supplemented with a “clarification process,” in which either the
abuser or the child’s primary caregiver shares his / her own
feelings about the event and then “clarifies” for the child how and
why the event occurred.
Lastly, the
caregivers commit to using what was learned in therapy to keep the
child safe in the future.
How We Work
At the PARTNERS
Clinic, weprovide CBT in an ecological framework, meaning that we
consider the child in the context of their family, community and
culture. Caregivers, teachers, siblings, and others may
inform the therapy. But we don’t stop there. We also
collaborate with other childcare agencies, including schools,
foster care agencies and legal aide.
Our staff works to
beculturally sensitive and linguistically accessible. In
addition to English and Spanish, children and their families have
been treated in French, Hindi and Urdu; we have offered services in
Hebrew and Mandarin: and we have applied for grants to enable
us to continue to translate therapy into whatever languages are
required to meet the needs of the multicultural communities we
serve.
Weekday evenings and Saturdays are available. Snacks and
childcare are also provided
Our assessments
are repeated during and at the conclusion of therapy to ensure that
children and caregivers have benefited from the services.
This also gives us an opportunity to make appropriate referrals for
additional services if warranted. Because our therapy isa
unique integration of science and practice, these embedded
assessments keep the program flexible, dynamic, individualized and,
most importantly, always
improving.