Parent Infant Psychotherapy

Parent Infant Psychotherapy I
Assessment of the Problem
Reason for
Consultation
Motivation
Risk to Child
Factors in
the Child
Presenting
Complaint or
Symptoms
Other Findings
Factors in the
Relationship: This
Child and This Parent
Diagnosis of
Problem.
Zero to Three
Relationship
Factors in the
Parent
Factors in: Social Milieu. Extended Family. Cultural Factors
Parent Infant Psychotherapy II
Formulation of Treatment Needs
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What Needs to Change
What Should Ideally Change
Child’s Resources and Strengths
Parent’s Resources and Strengths
Therapeutic Contract
Formulation of Treatment Plan
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Motivational Factors
Realistic Limitations (Time, Distance, Work, Etc.)
Initial Phase—Middle Phase—Termination
Parent Infant Psychotherapy III
Techniques
Combination of therapeutic modalities-interventions
Family
Therapy
Influences
Developmental
Psychopathology
Psychodynamic
Influences
Play
Therapy
Cognitive
Behavioral
Psychiatry
Parent Infant Psychotherapy IV
Family Therapy Influences
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Joining
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Frequency
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Focus on Observable Behaviors
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Ethological Observation-Interaction
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Family Myths and Transgenerational Patterns
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Conceptualization of Systems. Mutual Influences
Parent Infant Psychotherapy V
Psychodynamic Influences
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Empathy vis-à-vis the Child
Promotion of Reflective Self in the Parent. Theory of Mind
About the Child
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Exploration of Ghosts. Fantasmatic Interactions.
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Parental Working Model of Parent
Parental Working Model of Child
Parental Working Model of Self
Projective Identification. Pressures Toward Child
Corrective Attachment Experience. Interpretation.
Transference and Countertransference Analysis.
Parent Infant Psychotherapy VI
Developmental Psychopathology Influences
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Normality Vs. Psychopathology
Assessment of Development of Child
Charting Course of Treatment According to Developmental Lines
 Circles
of Communication
 Relatedness
 Use of Language
 Development of Imagination. Symbolic Play
 Representational Play
 Expression of Range of Affects
 Moral Development
Parent Infant Psychotherapy VII
Behavioral Cognitive Therapy Influences
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Recording Behavior. Journals.
Use of Positive Reinforcements.
Changing Behavioral Interactions and Contingencies
Positive Parenting Approaches
Suggestion
 Cognitions and Attributions in the Parent.
 Assignation of Meaning to Infant’s Behaviors
 Teaching About Child Development and Normative Events
Parent Infant Psychotherapy VIII
Influence of Psychiatry. Child and General.
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Recognition and Treatment of Maternal Depression
Use of Medication and Other Techniques
Recognition and Treatment of Anxiety Disorder.
E.G. Panic, Agoraphobia, Generalized Anxiety
Recognition and Treatment of Posttraumatic Stress Disorder in
Parent. May Include Medication
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Recognition of Personality Disorder. Treatment Approaches
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Eating Disorder
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Other Psychopathologies
TERAPIA MULTIMODAL PADRES-BEBÉ
Variedad de dificultades
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Fallo del crecimiento. Retraso del crecimiento
Efectos del uso de sondas nasogástricas o
internamiento en UCIN
Rehusamiento de la comida.
Selectividad excesiva
Problema de conducta en las comidas
Rumiación o mericismo, pica.
Conflictos durante las comidas
Psicoterapia multimodal padres bebé
Evaluación del problema
Problema
que presenta
el bebé
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Historia del problema
Evaluación médica del niño
Evaluar estado nutricional . Peso real, peso
ideal, masa corporal
Diario de alimentación
Ingesta..Cantidad
Consistencia
Variedad. Sabores. Olores
Evaluación del bebé en otros respectos:
Cognoseitivo. Motriz. Capacidad para relacionarse.
Sensibilidades. Capacidad de autorregularse. Otras areas.
Psicoterapia multimodal padres bebé
Evaluación 2
Probl. En
el bebé
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Evaluación de los padres
Actitud hacia el problema. Su percepción y la realidad.
Concepto que los padres tienen del bebé.
Flexibilidad. Lo que han intentado antes para aliviar el probl.
Lo que el problema significa para los padres
Significado de la comida. Si hay antecedente de trast. de alim.
Si hay psicopatologia: depresión, problema de ansiedad o
carácter.
Psicoterapia multimodal padres- bebé.
Evaluación 3
Valoración de la relación padres- bebé
Evaluación
 De la rel. de alimentación
 Comer en esa familia
 La relación en forma global.
 Reciprocidad Atención
mutua.Placer o alegría en la
relación.
Expectativas y realidades.
Método o instrumento
 Observar la comida
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Visita domiciliaria o videogravación
de la comida. )
Observar interacción de juego
Otros métodos: Valoración del
desasrrollo del niño. Escala de
eval. De la relación.
Otros
Psicoterapia multimodal padres- bebé
Intervención
Diagnóstico del
bebé, los padres y
la relación
Programa específico
para resolver las areas
de problema, en todos
los dominios
Psicoterapia padres - bebé
Psicoterapia multimodal padres- bebé
Expectativas del
terapeuta
Preocupaciones de
los padres. Deseos
Fantasias
Distorsiones
Objetivos de la
terapia.
Bebé:
Rango
aceptable
de
cambio
Vulnerabilidades (físicas,
sensibilidades, )
Capacidad de
autorregulación.
Habilidad para la
relación interpersonal.
Interés en la comida
Psicoterapia multimodal padres- bebé
Hacer registros
Diario de
comida.
Episodios de vómito, regurgitación. Rehusamiento.
Tiempo que toma la
comida.
Tipo de comida
Consisencia
Cantidad
Ganancia de peso
o estatura.
Intervención
conductual
Retroalimentación a los
padres
respecto al progreso del niño
Evaluación del
progreso del niño
Aumento gradual de
cantidad
de comida. Consistencias
en aumento gradual.
Exponer a sabores nuevos.
Comidas nuevas.
Incremento de variedad de
comidas. Nuevos olores.
Ayuda en la autorregulaicón
y capacidad adaptativa.
Psicoterapia multimodal padresbebé.
Ideas de los padres
interacciones fantasmáticas
Exploration
Early History
Parent Relationship to Own Parents
Parent Relationship to Food
Body Image. Attractiveness
Psychodynamic
Interventions
Forging of New
Feeding Relationship
And Parent-Child
Relationship
Meaning of Feeding Projections
Projective Identification
in Child
Decrease Focus on Feeding
Increase Focus on Other Interactions
Play Time. Floor Time
Promote Social Exchanges
Pleasurable Interactions and Play Interactions
Psicoterapia multmodal padres bebe
Establecer alianza terapeutica con los padres y niño
Valorar la motivación para hacer cambios
Quién participará. Incluír a la famlia extendida si es necesario
Intervenciones de terapia
familiar
Punto de vista sistémico
Trabajar en las relaciones
Frecuencia de las sesiones
Explorar y trabajar
los mitos de la
familia. En cuanto a
comida, orden de
nacimiento, género,
características
físicas, etc
Intervenciones estratégicas. Prácticas, medibles, aceptables para
la familia. Enfoque en las conductas
Psicoterapia padres bebé.Feeding and Eating Disorder—10
Promover la reflexión en los
padres respecto a las
dificultades del niño y sus
luchas internas.
Desarrollo de patrones
de aceptación de
alimentos.
De las habilidades para
alimentarse
Punto de vista de
la psicologia del
desarrollo
Sensibilidades,
autorregulación
Autonomia,
Promover la empatía en los
padres.
Estilo de crianza. Respeto vs.
control
Terapia
ocupacional
Interacciones de juego simbólcio entre
padres y niño, Tiempo de jeugo
Transcultural Infant Mental Health. Latin-America
Indian Health Beliefs
European/Spanish Health Beliefs
Influence of Magic
Emphasis on Scientific
Role of Shaman or Curandero
Role of Physician, Health System
Environmental Threats
Air
Cold Vs. Hot
Spirits
Evil Eyesight
Eclipse
Fright, Strong Emotions
Infectious Agents
Toxic Agents
Metabolic Diseases
Mental Illness
Emotional Disturbance
Behavioral Disturbance
Transcultural Infant Mental Health. Latin-America
Indian
Belief
System
Syncretic
System
Health Beliefs
Nosology Therapies
European
Spanish
Belief
System
Transcultural Infant Mental Health. Latin-America
The Care of Infants
Color Red. Against Evil Eye
Precautions
Against Cold Air. Cold Foods
Avoidance Cold Foods Lactating
Mother
Avoid Strong Emotions. Fright
Emphasis on Contentedness
Cleansing of the Baby Against
Negative Influences
Transcultural Infant Mental Health. Latin-America
Cultural/Historical Roots of
Health Beliefs and Practices
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Marginalization of Indian Population
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Level of Education
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Poverty
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Traditional Society. Interdependence
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High Infant Mortality. High Birth Rate. Short Life Expectancy
Influence of Indian Religious Ideas. Predestination
Transcultural Infant Mental Health
Nosology–Culture-Bound
Mal De Ojo (Evil Eye)
Manifestations
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Difficulty to Settle to Sleep
Waking up in the Night
Excessive Fussing or Crying
Child Appears Sad
Eyes Reddened
May Have Digestive Problem
Caused by Heavy Eye Sight or
Envy Due to Child’s Beauty
Intervention
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Prevention. Avoid Long-standing
Looking or Admiration. Or Touch
Child or Child’s Hear
Choral Reef
Bracelet of Eritrina Americana
Ojo de Venado (Seed)
Infusion to Drink
Cleansing of Evil Eye (Epasote, etc.)
Transcultural Infant Mental Health
Care During Pregnancy
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Environmental Threats. Eclipse (Wear
Metal Object)
Hot State. Avoid Cold Foods
Lifting of Objects
Strong Emotions, Particularly Anger and
Fright Should Be Avoided
Sexual Intercourse
Transcultural Infant Mental Health
Care at the time of birth
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Aztec. Compared to Act of Heroism or Status of
Warriors
Positioning. Women Are Present
Burial of Placenta. Later on of Umbilical Cord (Roots)
Caution Against Cold Foods
Caution Against Drafts of Cold Air
Forty Days of Vulnerability
Foods to Promote Production of Milk
Transcultural Infant Mental Health. Latin-America
Conditions in Latin-America
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Degree of Control Over One’s Own Future Health,
Work, Education, Life Expectancy, etc.
Scarcity of Medical Care, Facilities
Self-Help Methods of Seeking Help
Herbs Market, Herbs Expert and Folk Remedies
Before Physician
External Damages vs. Internal Conflicts
No Psychological Explanations
Transcultural Infant Mental Health
Parent Child Interactions
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Constant Contact With Mother (or
Substitute Woman)
Very Few Separations During Early Years
Soothe Immediately When Crying, Pickup
More Playfulness With Siblings
Importance of Child’s Own Attributes,
Preferences, Uniqueness or Destiny
Transcultural Infant Mental Health
Precautions for Infant
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Concern About Standing up Too Soon (Back, Spine,
Legs, Fallen Fontanelle, Fall of Other Supports)
Concern About Cutting Hair, Cutting Nails
Promote Eruption of Teeth. Promotion of Walking
Through Folk Remedies
Aztec Concepts of Physiology
Bones
As Center of Soul
Umbilicus As Center of Body
Joints As Points of Penetration of Air, etc.
Transcultural Infant Mental Health
The Care of Infants
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Breastfeeding Day and Night
On demand
No schedule
Soothing of the baby
(Breast Feeding). Ablactation.
Carrying. Avoidance of Cry
Carrying and Lactation for Years
Importance of Meals. Social Event. Manifestation of Love
Co-sleeping.
Transcultural Infant Mental Health
Nosology–Culture-Bound
Caida de Mollera
Sunken Fontanelle
Caida de Varillas
Manifestations
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Depressed Fontanelle
Caused by Dehydration or sudden
impression or negative impression
Standing up baby too soon
Fussiness
Excessive crying
Appears sad or anxious
May have digestive problems
Intervention
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Stand Upside Down and Strike
the Plants of Feet
Correct Sunkeness by Raising
the Hard Palate
Massage to Neck to Correct
the Varillas
Infusions. Other Massage
Transcultural Infant Mental Health
Nosology–Culture-Bound
Susto
Fright
Manifestations
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Child Is Anxious, Frightened, or
Cries Excessively
Readily Cries, Readily Scared
Bruxism
Sadness, Listlessness
Spirit Leaves the Body. Other
Spirit May Penetrate?
Intervention
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Prevention. Stand Upside
Down
Feed Bread to Catch Up Bile
Avoid Some Foods
Massage With Lotion
Drink Mirto Infussin (Salvia
Microphila)
Other Calming Infusions
Transcultural Infant Mental Health
Nosology–Culture-Bound
Empacho
Manifestations
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Intense or Excessive Cry
Sensitivities
Irritability
Usually in Evening
(Like Colic)
Food Has Stuck to baby's Gut Or
Food Was Decomposed
Intervention
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Try to Dislodge Food
Break the Empacho
(Skin From Back to Cause a
Reflex)
Elicit Intestine Movement
Infusion With Medicinal Herbs
Transcultural Infant Mental Health
Nosology–Culture-Bound
Air
Doenza a Crianza
(Selective Neglect)
(Brazil)
Malformations
Attribution of Any
Disease or
Behavior Change
Transcultural Infant Mental Health
Some Implications
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Role of Physician or Mental Health Professional
Attributions for Emotional/Behavioral Problems in
Children
Prescriptions and Recommendations
Coexistence
of Several Belief Systems
Coexistence of Medical Cultures
Use of Folk Beliefs to Promote Changes
Respect for Traditional Beliefs
Advice Sensitive to Potential Contradictions
Take a Clear Position
Pragmatic Emphasis