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Infant Mental Health Care Gaining Spotlight

February 6, 2013
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If you feed the parent with support and understanding, the parent will be able to feed the baby with the same.

Sara Grunstein

Mental health specialist

Children's Hospital of Oakland

When a primary caregiver, typically the mother, is depressed or is dealing with issues like homelessness or addiction, she may not be able to interact much with her newborn. If a child has a disability that makes him difficult to hold, this can also make bonding difficult.

That’s when infant mental health can play a positive role. Infant mental health focuses on and supports the relationship between babies and their primary caregivers.

A consistent, warm relationship with primary caregivers creates a basis for infants’ future ability to form other relationships.

That’s why the focus of infant mental health programs is to “identify relationship issues at the point where they begin to emerge, and not wait until the child is school-aged and the problem is full blown,” says Deborah Bremond, family services director at the Alameda County Children and Family Commission.

Although infant mental health programs are still scarce, some pioneering institutions, like Children’s Hospital of Oakland, and some county mental health departments, like Fresno’s, have developed relationship-based infant mental health services.

Defining infant mental health care

According to Sara Grunstein, a mental health specialist at Children’s Hospital of Oakland, the relationship-based approach to infant mental health looks at three factors: the baby, the primary caregiver (usually the mother) and the “fit” between the two.

When Grunstein visits parents at home, they try to figure out what might be getting in the way of a positive, healthy parent-child relationship.

The idea is to create a “parallel process,” Grunstein says. “If you feed the parent with support and understanding, the parent will be able to feed the baby with the same.”

Strengthening ties between parent and child

Samantha Axsom, 32, had her youngest daughter, Skylar, taken into county custody just two days after she was born, along with her 2-year-old sister, Mystic.

While the children were in foster care and Axsom was receiving treatment for addiction, a judge ordered her to participate in Fresno County’s Infant Family Mental Health Program to help her develop healthy bonds with her children.

According to Program Director Arlene Costa, “strengthening and improving the parent/child attachment” is the focus of the program. Half the families are referred by clinics or schools; the other half have court orders to participate.

Fresno’s program is comprised of three elements:

In the Parent Therapy Group, parents “can talk about how they were parented as a child and can compare their methods of parenting with the other moms,” Costa says.

When one mother revealed that she never spanked her child, Axsom was surprised.

“I thought that spanking was the answer to solving problems,” Axsom says. “My parents were very strict with me so that’s how I was with my kids.”

In the group sessions, Axsom learned to discipline her children with consistent routines and give them choices with clear consequences.

“Bedtime is at a certain time every night,” Axsom says. “If Mystic won’t clean her room when I ask her to, she knows she’ll have a time out.”

In the Parent/Child Play Therapy Group, parents learn how to nurture and engage their babies in a positive way through activities like massage and simple games.

“We ask parents who their child feels safe with and who they felt safe with as a child to help parents to understand what makes a person emotionally safe,” says therapist Peggy Thompson.

When Skylar cried during an activity, Axsom went to get a snack to soothe her.

Thompson complimented Axsom by saying, “It’s good that you remembered to take care of the child first.”

Individual Therapy offers parents the one-on-one attention they may need to deal with their own emotional problems and assists them in coping with the day-to-day struggles that challenge every parent.

Today, Mystic and Skylar have been reunited with Axsom, who works at Spirit of Women in Fresno, the same substance-abuse program she graduated from last month.

Originally written by Candace Diaz.