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Ionia County Infant Mental Health program builds, strengthens child-caregiver relationship

Ionia County Infant Mental Health program builds, strengthens child-caregiver relationship

July 31, 2015

By Molly Perez, LMSW
Infant Mental Health Supervisor, Ionia County Community Mental Health

Posted Jul. 31, 2015 at 10:35 PM

In the best of worlds, a mentally healthy adult starts life as a mentally healthy infant. The baby's first important relationship is that with their parent/caregiver. In this first relationship, the infant learns security and trust in others by being nurtured and protected – physically and emotionally. But sometimes there are challenges early in life that threaten this relationship. Intervention early on can make a big difference in the infant’s (or toddler’s) health.

The Infant Mental Health (IMH) program at Ionia County Community Mental Health seeks to promote the infant’s emotional, social, behavioral and cognitive development, as well as their mental health, by building a secure attachment between them and their primary caregiver. The program works not just with the infant or toddler (age 0 to 3) or just with the caregiver. A clinician comes into the home and builds, strengthens or supports the relationship between the two. Services reduce abuse, neglect, developmental delay, and behavioral and emotional disorder.

IMH clinicians may do the following in their work with the child and caregiver dyad:

· Supporting Attachment/Relationship Based Activities (which are play/interactions between an infant/toddler and parent down at the infant/toddler’s physical level, noting and reading eye contact, being emotionally present during everyday interactions, like feeding, diapering, dressing, etc.);

· Modeling (the IMH Clinician is responsive and supportive with the caregiver and in turn supports the caregiver in being likewise with their infant/toddler);

· Speaking for the Baby (the IMH clinician literally describes the emotions expressed in an infant/toddlers cries, giggles and behavior to support the caregiver’s understanding);

· Relationship-Based Therapies (counseling/therapeutic support to a caregiver who may be experiencing a psychiatric illness and noting how that impacts the infant/toddler).

Infant Mental Health was first developed in the 1970s by a social worker and lay analyst, Selma Friaberg, at the University of Michigan as a home-visiting program for families where challenges in the relationship between the infant/toddler and caregiver posed a risk to the infant’s/toddler’s development. Today there are IMH providers in many communities. In Ionia County the IMH program is provided through Community Mental Health, but in other areas it is offered through early childhood centers, obstetricians’ offices and hospitals.

There is a variety of circumstances that can disrupt caregiver-infant/toddler attachment. The caregiver may not be feeling connected to their child, or may be dealing with their own mental illness – major depression, anxiety or a psychiatric diagnosis like bipolar disorder. A parent of a child who was born premature or isolated in neonatal intensive care may need services provided through the IMH program when they find that they are having difficulty bonding with the baby.

We may have a pregnant woman who is struggling with an unexpected pregnancy. Perhaps she is starting to have worries or fears about how she is going to connect with the baby effectively. That connection begins in utero, so we can begin to build the relationship even before birth.

We are regularly addressing the caregiver’s mental health. Perhaps they weren’t attached to their parents in a healthy way, so they don’t know how to connect in a healthy parental role. We can help the caregiver identify what is healthy, what isn’t healthy, and in what ways they want to make things better with their own relationship.

Caregivers sometimes have their own issues of trauma. A parent who was abused or neglected as a child might be a candidate for the program if they never learned to process their own trauma history. We also can work in therapy with someone who is using or has a history of substance use as it relates to their ability to care for their child.

There also are some child-specific circumstances where the IMH program can be recommended, such as for an infant/toddler who suffers multiple separations, such as those in the foster care system, or a child identified with Failure to Thrive (for non-physiological reasons).

IMH clinicians have a master’s degree in social work or counseling. They must also secure an Infant Mental Health Endorsement, which requires additional training that typically takes two years to complete. There are three clinicians at ICCMH who provide direct services. All have been trained in assessment tools that look at the relationships between the caregiver and the infant or toddler and rate attachment, initiative and the child’s ability to regulate their own emotions. The clinician evaluates specific activities (such as an infant or toddler seeking a caregiver for reassurance) to see if those things improve over time.

Success is different for every family. Some define it as “knowing how to respond when baby cries.” For another caregiver it might be making sense of their own childhood trauma so as not to allow it to negatively interfere with their own parenting practices. Lots of times it’s as simple as “I enjoy being a parent now.” While that’s a simple statement, it’s invaluable for the life of that family.

For me, it’s rewarding to educate individuals. It’s a joy to know that families are being strengthened even before birth. Babies are sponges and they are impacted by everything (positive and negative) that happens in their presence. Sometimes people think that, when children are that small, they won’t remember, but that’s not true. How they experience the world comes out in their body, their behavior, and their cries. I love that we bring awareness to those pieces!

To learn more, visit the Michigan Association for Infant Mental Health at or call Ionia County Community Mental Health at 616-527-1790.