Bringing evidence-based early childhood mental health models to Durham agencies
It is widely recognized that what happens in early childhood is one of the most powerful drivers of health and well-being across the full arc of a person’s life. Increasingly, major structural initiatives are underway at the state and local level to support healthy development during those critical years, such as North Carolina’s Early Childhood Action Plan. And yet, there is still a significant lack of evidence-based treatment options for mental health needs in children age 0-6.
Through the READY Project, CCFH is addressing that shortfall by increasing the number of agencies in Durham able to provide two highly effective treatment models for very young children: Attachment and Biobehavioral Catch-up (ABC) and Parent-Child Interaction Therapy (PCIT).
Through ten one-hour sessions with a parent coach, ABC builds the connection between parents and children age 6 months to 4 years old while supporting healthy social and emotional development. Even though it is a relatively brief intervention, training for ABC is rigorous. In addition to the instructional content, trainees meet with supervisors twice a week to review a video of their session with a family and receive feedback on how to best meet their clients’ needs in future sessions. Training grew even more challenging when COVID closures forced CCFH to pivot to virtual – both for training and for the family sessions conducted by trainees – just before the first of three learning sessions was to start.
One unique aspect of the ABC model is that parent coaches are not trying to correct behaviors within a family, but to add to what parents are already doing well. This means coaches and families see positive changes very quickly, even from virtual sessions.
“With every single family, around session four or five, the parent coach will say, ‘It’s like we’re with a different family,’” says READY Project Program Manager Shristi Tiwari. She notes that parents are calmer, children are having fewer challenging behaviors, and moms say they better understand what their child is communicating through his behavior.
“We’re helping parents see their strengths and how to continue developing those,” says trainee Mackenzie Hayes, a family therapist at Exchange Family Center. “I’ve seen parents, when I jump in with a comment, light up and say, ‘Oh, I didn’t realize I’m doing that!’ It’s really uplifting to parents to point out how they’re engaging with their child and how that can have long-term benefits to the child and their relationship.”
At Families Moving Forward, Children’s Services Coordinator Rachel Taylor has been providing ABC to Durham families facing homelessness for the last three years. “It centers parents’ natural tendency to want to take good care of their children,” she says, “and connects that instinct with some of the research [on early childhood development].”
CCFH connected Rachel to ABC training from another provider in 2018. Through the READY Project, she is now in training to add Parent-Child Interaction Therapy to her agency’s mental health services. PCIT is for children age 2 to 7 who are experiencing behavioral or emotional difficulties. Like ABC, PCIT emphasizes positive reinforcement and develops closer bonds between parent and child. PCIT is also especially helpful with socialization challenges, which can occur when children experiencing homelessness have not been able to stay in one childcare setting long enough to develop healthy social skills.
Tasha Melvin, the Director of Partnerships and Programs at Families Moving Forward, is in a parallel training for senior leaders on supporting implementation of the PCIT model within their agencies. For her, the value of any service they offer is in its potential to prevent families from experiencing homelessness again, and they have seen that reducing a child’s disruptive behavior and strengthening the parent-child bond are important factors in that.