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family

There’s no such thing as Infant Mental Health

It’s interesting when I speak with others about the work I do, and their faces look quizzingly at me when talk about providing mental health services to infants and children.

“But babies don’t have anything to worry about! Why are you counselling babies? And who on earth can hold a decent conversation with a 2 year old that doesn’t end in a tantrum or consist entirely of playing dolls/cars?”

I enjoy these conversations, as it provides an opportunity for someone to learn about this incredibly important, and largely overseen area.

Some facts about Perinatal, Infant, and Early Childhood Mental Health:
• Perinatal and Infant Mental Health go hand in hand to describe the mental health and emotional wellbeing of women, their infants, partners, and families. This includes DADS 
• To support the infant and young child to develop the capacity for experiencing, expressing, and regulating emotions; forming close and secure relationships; and exploring the environment to enhance learning
• It is typically the period from conception to about 3 years after the end of the pregnancy.
• It is important to note that this area can cover parents who have also lost a child, including through termination, miscarriage, and stillbirth.
• The most common mental health concerns for this group are anxiety and depression
• The mental health and wellbeing of parents is critically important to the emotional and physical development of the infant. Untreated concerns have significant impacts on the parents, infant, and whole family
• Treatment is available and can be highly effective. This ranges from counselling to medication, and extra supports from health professionals where necessary

What psychological support can look like for families seeking help:
• Working directly with the parent/s to support their wellbeing
• Observe, role model, coach, and provide feedback around supporting their infant/child
• Be part of targeted groups and workshops, such as Circle of Security, Bringing Up Great Kids
• Supporting the child (if older) directly to work through their areas of difficulty. This is done through the use of games, play, and child-led interests
• This is all done in a strengths-based, collaborative, warm, engaging and supportive space

Some tips for supporting your mental health and wellbeing during this period:
1. A good routine goes a long way. This allows you and your child to have a certain level of certainty about your day
2. Fuelling your body with healthy meals. This will give you the right type of energy needed to be a very busy mum/dad
3. Sleep, rest, and nap at every available opportunity. Your body and brain need many times to re-energise and re-cooperate
4. Enjoyable physical activity. This can be a simple stroll with bub, heading to the playground and playing ‘chasy’, yoga, or going for a swim
5. Using techniques to de-stress. This can be relaxation training, meditation, or mindfulness
6. Doing something ‘selfish’ each day. This means setting time aside where you can take a breather and do something special. This could be as simple as reading a chapter in a good book, looking through a magazine, catching up on last night’s episode, or calling a friend
7. Vent and debrief. It can feel so good to just talk about everything happening, and have someone be a ‘soundboard’ for you. Problem solving with a trusted person can have wonderful positive outcomes
8. Adult time. Some give and take with you nurturing your partner, but also them providing some TLC for you too. We tend to forget or not have enough time for other halves, however making the effort is essential
9. Delegate. Involve your partner or family members in the daily care of your child
10. Develop a support network. It can be hard to ask for help, but it can be even harder accepting help too. Start to build a community around you

“There is no such thing as a baby. There is only a baby and someone.”
Donald Winnicott

Adapted from Children’s Health Queensland

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When Children Lie
 When Children Lie

A number of parents have been asking me about lying over the last few months. Whilst the below information is useful for parents who are currently experiencing this frustrating issue, it’s also a good resource for those who wish to be proactive.

Emotional intimacy with our children is a fragile gift that can easily break when we erode trust through punishments, shame, blame, scolding, or manipulation. When our children’s behaviour is off-track, they need us to calmly stop them, help them, and guide them. They need to know we’re always in their corner (rather than sending them off to one), and that we will create safety – not only physical safety, but also safety in our regard for them – safety in our love and our “like,” a 100% safe relationship.

Alternatively, shaming or punishing children for lying creates distance and mistrust, which only encourage kids to lie better.

As for consequences, with the respectful parenting approach, consequences aren’t tactics to be “implemented” like just another form of punishment. If there are consequences, they are honest sharing of our own truths as parents. So, if there was a consequence in the case of a 6-year-old lying, it might look something like this (shared calmly and nonjudgmentally): “I am not going to be able to let you go to Juliet’s house again if you can’t tell me the truth about what you two did. I’m just not comfortable.”

There are a variety of reasons a child might lie in the early years (most of them so perfectly harmless that describing them as “lies” seems too strong a word). They are all motivated by the same thing: lying feels preferable to that child. In that particular moment, they may be experiencing:

  • • Fear – the unfortunate result of our past anger and other emotional responses or punishments when our children have erred. It seems better to them to not admit they did it.

Remedy: Respectful, empathic guidance (for much more detail on this particular part, please refer to the webpage)

  • • Shame, blame, embarrassment – because our focus has been “teaching our kids a lesson” rather than understanding the behaviour. The real lesson has been our lack of empathy for their immature stage of development.

Remedy: Create safety with nonjudgmental responses like, “I hear you saying you didn’t hit your brother. It seems that he was hit. Please let me know whenever you feel like hitting, so I can be there to keep you safe.”

  • • A need to test our leadership – children might “try out” mistruths to see if they have the power to ruffle their leaders’ feathers. If we fail this test, they might need to try it out again. And again.

Remedy: Diffuse these tests by taking them in stride and connecting lightly and knowingly. “Hmm… you didn’t let the dog out, and yet out he is… Verrrry mysterious.”

  • • Enjoyment of imagination and fantasy – children can become absorbed in their fantasies, even to the extent that it can be difficult for them to separate fantasy from reality. This a healthy stage of development children pass through, and they certainly don’t need us to jar them out of it.

Remedy: None. No need to worry, just enjoy with them. “You’re a purple dragon? Ah, yes, I can totally see that now.”

  • • Wishful thinking, projecting, and visualizing success – children might imagine themselves succeeding at a task that, in reality, they didn’t even attempt. These projections can help them shore up the courage to do it the next time.

Remedy: Again, visualization is positive and healthy, so I would connect rather than correct. “You felt yourself going down the highest slide today. How did that feel?”

In all cases, our openness, curiosity and unruffled, unthreatened, patient responses are the best way to diffuse the need to fabricate. And they also go a long way in forging a relationship that forever eliminates the need for avoidance of the truth.

No lie.

By Janet Lansbury

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Grief and loss in children with intellectual disabilities

 

Grief and loss in children with intellectual disabilities

Pamela L. Harding,

Psychologist (B Psych; P Grad Dip Psych)

Children grieve the loss of someone special in many different ways. For children with developmental delay, concepts such as death can be difficult to understand and the implications of that loss (permanence) can vary accordingly. It is important for parents and carers to take the time to explain loss in ways that are developmentally appropriate, taking into account the child’s emotional maturity as well as the child’s language and intellectual development.

Reactions to grief vary in every child however typically these can be physical, psychological, behavioural, and spiritual in nature. In young children as well as in children who have developmental delay, these reactions are often difficult to identify as the ability to express complex emotions is still largely under developed.

It is therefore important to pay close attention to children’s behaviours following a loss, being aware that reactions can vary in intensity, frequency and duration depending on the type of support the child receives.

Typical grief reactions observed can include:

Behavioural 

  • Regression and temporary loss of skills previously mastered such as toileting, or getting dressed independently.
  • Becoming more clingy
  • Lacking a reaction due to difficulties understanding the permanent nature of loss
  • Withdrawing from activities or others
  • Loss of interest in food
  • Difficulty sleeping or not wanting to sleep alone
  • Disruptive behaviours such as tantrums
  • Becoming more sensitive to others’ emotions and repeating those emotional behaviours seen in other people who are grieving around them.

Emotional

  • Appearing sad or crying often.
  • Separation anxiety
  • Needing constant reassurance that things are ok.
  • Trying to make sense of what has happened by showing curiosity and interest in details / facts (lots of questions about death)
  • Confusion about what has happened: asking repetitively after the person who has passed away, or wanting to see the person.
  • Fear (of the dark, of being left on their own, of noises)

Somatic

  • Physical pains stomach aches or other complaints
 
What can help?

Strategies that can be helpful in supporting children during times of loss:

1. Ensure that basic needs are met (food, drink, sleep, affection)

2. Routine: keeping things as normal as possible is important in that it provides the child with a sense of safety and predictability which allows him/her to regain some control over their environment.

3. Provide reassurance: regardless of whether or not the child’s reaction is as you would expect, provide reassurance that their feelings are normal and that the sadness will eventually decrease.

4. Help understanding: explain what has happened as honestly as possible, using simple factual language. “Poppy has died and won’t be coming back”

5. Explain death: be concrete, use age appropriate visual resources such as books, social stories and play to help understanding.

6. Allow opportunities for the child to express their grief: this can include reading and telling stories, playing, drawing, making a memory box.

7. Be consistent in your answers: children may want to ask questions over and over again. It is important for you to provide answers that are consistent, simple and factual as this allows the child to make sense of what has happened.

8. Make use of rituals and symbols at home: prepare a farewell ceremony. Have photographs of the person and take turns talking to him/her to say farewell.

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The Arrival of the New Baby and the Adjustment to Parenting

Having your first baby and the subsequent adjustment to parenting roles is a major transitional period. Although very rewarding, many will find the initial adjustment period, and particularly the first year to be difficult. The birth of your first child is likely to result in major lifestyle and emotional changes, including lack of sleep, changes to your values, identities and how you relate to each other due to the new roles and responsibilities. Other changes may include financial and work related changes, potential loss of recreation time, ‘me time’ (well that is well and truly gone), and overall changes to mental health and wellbeing. Sometimes these changes can be made worse by expectations and myths that you (or others around you) may have about the pregnancy, birth, and expectations around the parental roles (who does what), and what motherhood in general ‘should’ look like. For example, if breast feeding is important to you and for whatever reason, you experience difficulty breastfeeding or are unable to breastfeed, this may lead to disappointment and unpleasant negative feelings.

All of these changes can then potentially lead to reduced relationship satisfaction, exhaustion, frustration and increased conflict with your partner as you try to juggle all the new responsibilities and demands of the new role. In Australia, there is data suggesting that almost a quarter of women will experience post natal depression (PND) in the 12 month period following birth (Buist & Bilszta, 2006; Yelland, Sutherland, & Brown, 2010) and it’s not just women!! The incidence of dads getting depressed in the first year following child birth may be as high as 50%, particularly for those whose partners have had PND (Goodman, 2004). Anxiety can also be a problem with about 10% of women experiencing anxiety after giving birth or a combination of anxiety and depression (Austin, Hadzi Pavlovic, Priest, Reilly, Wilhelm et al.,2010). Sometimes this will be the first time you may experience symptoms of anxiety and/or depression.
So what can you do about it? Well the first thing is to talk your partner, your family and/or friends - tell them how you feel and what is going on for you. Sometimes it can help just to talk and at other times you may need to ask for extra help. Many mums will say that they don’t want to inconvenience their friends but sometimes it might just be that you want a friendly ear, you would listen to them if they asked wouldn’t you? Also, if they are offering it usually means that want to help you so why not take them up on it? If on the other hand, you think you may be feeling low or anxious then perhaps it might be good to have a chat to your GP or Child Health Nurse. You may also want to talk to someone about what is happening for you, to get help for you and/or your partner or to get help with overwhelming feelings, sadness or anxiety. As well as talking to your GP, you might also benefit from a visit to a psychologist. I have worked with many women either on their own or with their partners about related parenting issues –helping them navigate the joys and difficulties of the adjustment to parenting. The main thing is to get help.

It’s important to connect and seek help when you are feeling down, alone, overwhelmed, confused and/or frustrated with your new role, so that you can have a more rewarding relationship with your partner and baby. There are also quite a few community organisations that offer support, friendships (e.g., through meeting other mums who are in the same boat), playgroups, education programs, home visiting, family support, parenting programs (for e.g., the Benevolent Society ‘s Early Years Centres on the Gold coast). You can also visit your local Community Child Health clinics where you can drop into various baby clinics or make an appt to see one of the child health nurses to talk about issues you are having with your child (e.g. sleep, breastfeeding). They have wonderful caring child health nurses there that can provide you with support and information about your baby’s development and needs. If you are interested, I’ve listed the phone numbers and websites of the above organisations in case you would like to contact them.

The Benevolent’s Society Early Years Centre, phone number: (07) 56449400
Community Child Health, Child Health Clinic – to make an appointment: (07) 5687 9183 or (07) 5680 9540

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The Tough Teen Years

Modified from Dr Lauran Kastner book ‘Getting to Calm’ she is a very cleaver lady and one of my favourite work authors.

When kids hit the teenager years and the preteen years it’s a HUGH transition for most parents. Our children begin to be heavily influenced by their peer group and that often makes things difficult with the rules of our households.
One the hardest things during this time is that as parents we lose our children automatic respect and we have to start earning it! YIKES Lets be honest when they were younger all had to do was turn up and they thought we were great. Our old style of parenting with punishment to control our children’s behaviours (including timeouts and consequences) is no longer working. In fact, most of the time we are really not too sure what they are up to when they are away from us.
Our job as parents is to lay the groundwork so that our children know right from wrong and start to act on it. Part of that groundwork includes a strong parent-child relationship so the child really does not want to disappoint us and WANTS to cooperate. It also includes teaching our children how to gains the ability to regulate their emotions, which lets them regulate their behaviour. Believe it or not research tells us that children who are lovingly guided to make amends and solve problems, are the ones who develop their internal discipline and gain a strong moral sense. Basically that means for us as parents to be respectful, give positive guidance right from the beginning. That raises our youth to be respectful, considerate, responsible, self-disciplined and delightful. (Just like us  ).
Here are some tips on how to establish that kind of parenting;

1. Agree with your child on non-negotiable family rules. No 1 - Talk in a respectful manner, Establish household RULE that is enforced by everyone. Kids lose respect for parents who yell because let’s be honest if your yelling you have lost control of your own emotions. . There shouldn't be many of them, stick to the important stuff. We need our kids to be involved so they have a sense of control and ownership of their behaviours.

2. Strengthening your relationship with your child so that when you set limits your child actually wants to co operate because of the relationship, not because of what you are asking them to do. To strengthen your relationship you need to make one-on-one time with them. During this time its quality time over quantity therefore do not talk about subjects that you know cause an issue. The purpose is to strengthen so enjoy each other.. listen to their music ask WHY they like it (because good chance you wont) Physical touch works wonders try a should massage or tickle their back/hair. If your child doesn’t enjoy being with you then you cannot hope to influence them.

3. No more Cotton Wool parenting allow them to experience natural consequences. When we worry about our children and FIX things for them we protect them from natural consequences. Eg Did not hand in their permission slip for the class trip, they will learn an invaluable lesson if you don't rescue them.

4. Stop punishing. OOOOH yes this one always hits a chord…. We need our developing adults to learn about self-discipline this will develop when they start to CHOOSE to give up what they want for something they want more. What do they want more? To follow your lead and have a good relationship with you. So focus on the relationship instead of punishment.

5. Focus on teaching your child to repair their mistakes. Worried that your child isn't being "held accountable"? Introduce the concept of reparations. This isn't a consequence (punishment) that you impose. This is when you ask your child if there's something he can do to make the situation better now. For instance, if he says something mean to his sister, he'll need to do some repair work on that relationship. If he breaks something, he'll need to help pay for a replacement. But remember that if you think up the reparation and force it down his throat, it only makes sense that he'll reject it. Instead, let this be an empowering opportunity for him to learn that we all make mistakes -- and we can always take action to make things better.

6. Reinforce their developing “good judgment” by reflecting. Discuss rather than lecture remember as soon as you start lecturing “click” out go the lights – they will no longer be listening. Questions that work 1000 times better than a lecture are –

  • "What were you wanting to have happen when you did this?"
  • "Was there some part of you that said 'Don't do this'?"
  • "What got into the way of you listening to that part of you?"
  • "How did that work out for you?"
  • "How did it work out for other people involved?"
  • "What else could you have done?"
  • "Right, you could have done X...how do you think that would have worked out? What would have happened then?"
  • THEN help them to repair their mistakes. Let’s face it they are going to make a few over this time!. So teach them to start to repair it themselves so they are "held accountable" . This is when you ask your child is… there's something he can do to make the situation better now. They will need to do some repair work on whatever went pear shaped, don’t FORCE them to DO IT instead create an opportunity for them to learn that we all make mistakes -- and we can always take action to make things better.

7. Be kind but firm. It’s an absolute GIVEN that your child will test the limits just to make sure you are serious! Stay Calm and be consistent.

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