Becky Bernstein, MSSA, LISW-S Holli Ritzenthaler, MSSA, LISW-S OhioGuidestone

1. Intervention with Adoptees and Their Families: Part 2/Interventia cu cei adoptati si cu familiile lor: Partea a doua Becky Bernstein, MSSA, LISW-S Holli Ritzenthaler, MSSA, LISW-S OhioGuidestone

2. Agenda • Review of the Intervention Goals/ Revederea obiectivelor interventiei • Relational Paradigm of Intervention/ Paradigma relationala in interventie • Intervention Techniques /Tehnici de interventie

3. Main Goals of Intervention with Adoptive Families/ Scopurile principale ale interventiei cu familiile adoptive • Attachment/ Atasamentul • Stabilize child in the family and build relationships/ Stabilizareacopilului in familiesiconstruirearelatiilor • Family Identity Development/ Dezvoltareaidentitatiifamiliei • Normalize/reframe feelings of ambivalence/ Normalizareasiredefinireasentimentelor de ambivalenta • Help family system re-stabilize & find new equilibrium/ Sprijinireasistemuluifamilieisa se restabileascasisa-sigaseasca un nouechilibru • Validate parent’s decision to adopt/ Validareadecizieiparintelui de a adopta • Grief & Loss/ Suferintasipierdere • Both child and family/ Atat copilul cat sifamilia • Communication/ Comunicarea • Open and honest about history, risks & strengths/ Deschisasionesta cu privire la istoric, riscurisiaspectepozitive • Empathy & Understanding/ Empatiesiintelegere • Child’s emotional & behavioral challenges/ Provocariemotionalesicomportamentale ale copilului • Core Issues & all adoption constellation members/ Temeprincipale la totimembriiconstelatieiadoptiei

4. Foundational Principles of Intervention/ Principii fundamentale ale interventiei • The parent is the primary agent of change/ Parinteleesteagentulprimar al schimbarii • The role of the therapist is to serve as a bridge between the child and parent’s experiences/ Rolulterapeutuluiesteacela de punteintreexperientacopiluluisiaceea a parintelui • Interventions are flexible, responsive and meet all family members where they are/ Interventiiletrebuiesa fie flexibile, responsive sisavina in intampinareatuturormembrilorfamiliei, in punctul in care se aflaei • Relationships are the key to success/ Relatiilesuntcheiasuccesului

5. Relational Paradigm of Intervention/ Paradigmarelationala in interventie • Every session SHOULD address 3 critical relationships/ Fiecaresedinta TREBUIE saabordeze 3 relatiicritice • Therapist – Child/ Terapeut- copil • Parent – Child/ Parinte - copil • Therapist – Parent/ Terapeut- parinte *Sessions may also include siblings, extended family and other caregivers/ Sedintele pot include sifratriile, familiaextinsasaualtepersoane cu responsabilitati in ingrijireacopilului

6. Effective, well-rounded intervention:/ Interventie eficienta • Empowers- encouragement of independent problem solving/ Capaciteaza- incurajarea solutionarii independente a problemelor • Builds on strengths- starting where the client is and building on things they already possess/do well/Construieste bazat pe punctele forte- incepe in punctul in care se afla clientul si construieste mai departe mergand pe lucrurile pe care acesta le face bine • Focuses on the family- children learn what they live!/ Se centreaza pe familie- copiii invata ceea ce traiesc! (din experienta) • Improves parent-child relationship-this relationship is the foundation for all social-emotional development/ Amelioreaza relatia parinte-copil- aceasta relatie este fundamentul oricarei dezvoltari socio-emotionale • Uses reflection-assists in developing understanding and insight into problems/issues/ Foloseste reflectia- asista dezvoltarea intelegerii si a revelatiilor asupra unor probleme sau teme

7. Effective, well-rounded intervention:/ Interventia eficienta • Provides empathy-promotesrespect for the client and builds rapport/ Asigura empatie- promoveaza respectul fata de client si construieste raportari • Promotes social play- play is the foundation for learning and relationship skills/ Promoveaza jocul social- jocul este fundamental pentru deprinderile de invatare si relationare • Uses creative techniques- therapeutic story-telling, art and play therapy/ Foloseste tehnici creative – povestiri terapeutice, artterapie si terapie prin joc • Educates- interpreting behavior and development, parenting techniques/ Educa- interpretarea comportamentului si a dezvoltarii, tehnici parentale • Provides modeling and coaching- allows for teaching and practicing of techniques/ Asigura modelarea si coachingul (antrenarea)- ingaduie invatarea si practicarea tehnicilor

8. 1. Therapist-Child Intervention/ Interventia terapeut-copil • The Power of Play/ puterea jocului • “You can discover more about a person in an hour of play than in a year of conversation.”/ “Poti descoperi mai multe despre o persoana intr-o ora de joc decat poti descoperi intr-un an de conversatie” ~Plato • Play is how children explore, learn, problem solve and socialize/ Jocul arata modul in care copilul exploreaza, invata, solutioneaza probleme si socializeaza • Fosters warm and responsive relationships/ Promoveaza caldura si responsivitate in relatii • Increases communication/ Sporeste comunicarea • Promotes insight/ Promoveaza intelegerea de tipul revelatiilor • Provides opportunity for repeating OR correcting past experiences/ Asigura oportunitati pentru repetarea sau corectarea experientelor trecute

9. 1. Therapist – Child Intervention/ Interventia terapeut-copil • Child-Directed Play / Jocul directionat spre copil • The goal is to follow the child’s lead to strengthen their ability to solve problems and make positive choices/ Scopul este de a urmari sporirea capacitatii copilului de a rezolva probleme si de a face alegeri pozitive • The child leads the play interaction/ Copilul conduce interactiunile in joc • Freedom to explore and express/ Libertatea de a explora si exprima • Openly communicate their thoughts, feelings and ideas/ Comunicare deschisa a gandurilor, sentimentelor si ideilor • The therapist allows the child to lead without criticism or interpretation/Terapeutul ingaduie copilului sa preia conducerea fara criticism sau interpretari • Focuses on strengths/ Se centreaza pe punctele forte • Reflects feelings to promote insight/ Reflecta trairi care promoveaza revelatiile; • Recognizes the power of total acceptance of the child/ Recunoaste puterea acceptarii totale a copilului; • Stays in the moment/ Se centreaza pe moment;

10. Child-Directed Interventions/ Interventii directionate spre copil • Follow the child’s lead/ Urmeaza conducerea facuta de copil • View the world as the child does/ Vede lumea cu ochii copilului • Get on the child’s level/ Ajunge la nivelul copilului • Interact and communicate like the child/ Interactioneaza si comunica la fel ca si copilul • Make a conscious effort to understand the world as the child does/ Face eforturi constiente pt a intelege lumea in felul copilului • Respond to the child in a way that is compatible with their activity and intention/ Raspunde copilului intr-un mod compatibil cu intentiile si activitatile acestuia • Animation/ Animatie (insufleteste) • Be more Interesting than distractions/ Mai mult sa starneasca interesul decat sa distraga • When in doubt IMITATE/ Cand ai dubii, IMITA

11. Therapist-Directed Interventions/ Interventii directionate de terapeut • Safety and Security/ Siguranta si securitatea • Practice/Role-Play use of personal safety skills/ Practicarea/ jocul de rol valorizand deprinderile personale de siguranta • Coping and Social Skill Building/ Coping si construirea deprinderilor sociale • Deep Breathing - smell the cookie and blow out the candles or Bubbles for small children/ Respira adanc – miroase prajiturile si sufla lumanarile sau balonasele pentru copiii mici; • Visualization and Imagery – guide child through imagining a “Happy or Safe Place”/ Vizualizare si imaginare- ghideaza copilul sa-si imagineze “un loc fericit si sigur” • Progressive Relaxation/ Relaxare progresiva • Mandalas/ Mandale • Feeling Identification and Expression/ Trairea identificarii si a exprimarii • Tell or draw a time when you felt (insert feeling)/ Spune sau deseneaza momentul cand ai simtit (insereaza trairile) • Drawings for power/ Desene care sa sporeasca puterea

12. 1. Therapist-Child Intervention / Interventia terapeut-copil • Group Practice:/ Practica de grup • Create a picture of something scary/ Creaza o imagine infricosatoare • Crumple and Destroy/ Aduna-o si distruge-o • Create a picture of something Happy or Peaceful/ Creaza imaginea a ceva fericit si calm;

13. 2. Parent-Child Intervention/ Interventia parinte-copil • Modeling/ Modelare • Coaching and Guidance/Coaching (antrenare) si ghidare • Maintenance and Support/ Mentinere si sprijin • Building Attachment/ Construirea atasamentului • Build trust, security and warmth between adoptive family members/ Construieste incredere, siguranta si caldura intre membrii familiei adoptive • Repair maladaptive attachment patterns, behavior and history/ Repara tiparele maladaptative de atasament, comportament si istoric

14. Promoting Attachment/ Promovarea atasamentului How/ Cum When/ Cand When the Child is calm & open/ Cand copilul e calm si deschis Fear/ Teama Fatigue/Oboseala Illness/ Boala • Positive interaction cycle/ Ciclul intercatiunilor pozitive • Claiming behaviors/ Comportamentele reclamate • Eye contact/ Contact cu ochii • Appropriate touch/ Atingeri adecvate • Open Communication/Comunicare deschisa

15. Theraplay (Jernberg & Booth)/Joc terapeutic • Theraplay looks to the healthy parent-child interactions as a guide./ Jocul terapeutic vede interactiunile sanatoase dintre parinte-copil ca pe un ghid • Use of intimate, physical, personal, focused fun!/ Foloseste amuzamentul in intimitate, in intercatiuni fizice, personale • Adult directed, structured but responsive./ Directionat spre adult, structurat dar responsiv • Goals: / Scopuri 1.Enhance attachment/ Sporeste atasamentul 4. Improve regulation/ Amelioreaza reglarile 2. Build trust / Construieste increderea 5. Improve Self-esteem/ Sporeste stima de sine 3. Replacement of negative behavioral cycles/ Inlocuieste ciclurile comportamentale negative

16. Theraplay/ Jocul terapeutic • Through Theraplay, parent and child become eager to please, protect, and cherish one another./ Prin joc terapeutic parintele si copilul devin dornici sa-si faca placere, sa se protejeze si sa se valorizeze unul pe celalalt • Theraplay breaks apart the negative interactional cycle and replaces it with a new cycle composed of enjoyment, optimism and acceptance./ Jocul terapeutic rupe ciclul interactional negativ si-l inlocuieste cu un nou ciclu compus din bucurie, optimism, acceptare • Theraplay fortifies children with a sturdy sense of self./ Jocul terapeutic fortifica copilul dandu-i un puternic sens al sinelui • Theraplay provides the building blocks for attunement in the parent-child relationship/ Jocul terapeutic asigura caramizile care construiesc sincronizarea in relatia parinte-copil.

17. Theraplay/ Jocul terapeutic • Sample Theraplay Activities/ Activitati simple de joc terapeutic • Take turns applying lotion to each other/ Pe rand isi aplica diferite lotiuni unul altuia • Build something together with blocks/ Construiesc impreuna ceva din cuburi • Blow up a balloon, create a game and play together/ Umfla baloane, creaza jocuri si se joaca impreuna • Check ups/ Verifica • Take turns doing something silly to make each other laugh/ Pe rand fac lucruri caraghioase menite sa-l faca pe celalalt sa rada

18. 3. Parent-Therapist Intervention/ Interventia parinte-terapeut • Active Listening/ Ascultare activa • Normalizing/ Normalizare • Psychoeducation/ Psihoeducatie • Examining Family of Origin/Examinarea familiei de origine • Explore Grief and Loss/ Explorarea suferintei si a pierderilor • Identify Current Level of Openness and process anxiety/fears/ Identificarea nivelului curent de deschidere si procesele de anxietate/frica

19. 3. Parent-Therapist Intervention/ Interventiile parinte- terapeut • Addressing parental self care/ Abordarea grijii de sine a parintelui • How do you know when you need to take a break?/ Cum stii cand ai nevoie de o pauza? • Do you have supports to help when you need a break?/ Ai la indemana un sprijin atunci cand ai nevoie de o pauza? • What do you do to take care of yourself daily?/ Ce faci pt a avea grija de tine insuti zi de zi? • Scheduling self care time with parents/ Construirea unui orar al momentelor in care parintii sa se ingrijeasca de ei insisi

20. 3. Parent-Therapist Intervention/ Interventia parinte-terapeut • Increase parental insight into the child’s experiences (Being the bridge)/ Sporeste revelatiile parentale cu privire la experientele copilului (rolul de punte) • How does the environment impact the child’s mood and behavior/ Modul in care mediul influenteaza starea emotionala si comportamentul copilului • Explore the child’s experiences with stressful situations or trauma and how they understand these/ Exploreaza experientele stresante sau traumatice ale copilului si modul in care le intelege parintele • Gain understanding of how the child views their world/ Castiga mai multa intelegere cu privire la modul in care copilul vede lumea

21. 3. Parent-Therapist Intervention/ Interventia parinte-terapeut • Genograms and Ecomaps/ Genogramesiecomape • Rules, routine, discipline, praise, and rewards/ Reguli, rutini, desciplina, premierisi recompense • Help parents develop daily or nightly nurturing routines for client/ Ajutaparintiisadezvolterutine de ‘hranire’ zisinoapte a clientului • Develop charts or reward systems for client/ Dezvoltasisteme de inregistraresirecompensapt client • Documenting behaviors to identify triggers, cycles, or patterns/ Sprijinacomportamente de identificare a provocarilor, a ciclurilorsautiparelor • Creating family rules/ Creazareguli de familie

22. Family Interventions/ Interventie cu familia • Adoption is a restructuring process where a new person enters the family, alters the equilibrium and brings about change for every member of the system/ Adoptiaeste un proces de restructurare in care o nouapersoana intra in familie, altereazaechilibrulsiimpuneschimbaripentrufiecaremembru din sistem • Intervention to address family formation should work to promote:/ Interventiilemenitesaabordezeformareafamilieitrebuiesapromoveze: • Entitlement and claiming behaviors/ Comportamente de legitimare (de asumare a drepturilor) sireclamare • Acknowledgment of child and family history/ Recunoastereaistoriculuifamilieisi a copilului • Insight into intergenerational patterns/ Revelatii (intelegeri) ale tiparelorintergenerationale • Identification of strengths and positive characteristics/ Identificareasiintarireacaracteristicilorpozitive

23. Family Interventions/ Interventii cu familia • Family Portrait/ Portretul familiei • Therapist passes out paper and drawing supplies/ Terapeutul paseaza hartii si desene • Asks adoptee and family members to draw a picture of their family/ Cere adoptatului si membrilor familiei sa deseneze familia lor • Each person then describes their family portrait/ Fiecare membru descrie portretul familiei • Allows therapist, client & family to explore:/ Ingaduie terapeutului, clientului si familiei sa exploreze: • Family boundaries/ Limitele familiei • Subsystems/Subsistemele • Attachment relationships/ Relatiile de atasament • Interpersonal communication patterns/ Tipare de comunicare interpersonala • Each members perception of family/ Perceptia fiecarui membru al familiei cu privire la familie

24. Family Interventions/ Interventii cu familia • Life Map/ Harta vietii • Similar to a Life Book, but set up like a road on a board game/ Similar cu cartea vietii dar figureaza in joc ceva ca o cale • Therapist & adoptee make a chronological outline of child’s life including:/ Terapeutul si adoptatul structureaza o constructie cronologica a vietiui copilului incluzand: • All places the child lived/ Toate locurile unde a trait copilul • Dates of each transition/ Datele momentelor de tranzitie • Names of significant people/ Numele persoanelor semnificative • Child illustrates each event in symbolic way of their choosing/ Copilul ilustreaza simbolic, cum vrea el, fiecare eveniment • Adoptive family actively joins in when the map is at the point of placement in their home/ Familia adoptiva participa activ cand harta ajunge la momentul plasamentului in familie

25. Life Map/ Harta vietii • Example

26. Group Exercise/ Exercitiu de grup • Select a child or family you work with and complete a Family Portrait or Life Map/ Alege un copilsau o familie cu care lucrezisicompleteazaportretulfamilieisauhartavietii

27. Acknowledgements/ Recunoastere • Portions of the this presentation completed in collaboration with Zoë Breen Wood, Ph. D., Case Western Reserve University Mandel School of Applied Social Sciences and the Adoption PARTners Program./ Parti din aceastaprezentare au fostcompletate in colaborarecu Zoë Breen Wood, Ph. D., Case Western Reserve University Mandel School of Applied Social Sciences and the Adoption PARTnersProgram.