“Childhood is tricky to navigate. Emotions are big. Self-regulation is little” Today we chat all about infant and early childhood development with licensed professional counselor, Ashley Lingerfelt. Parenthood has a way of stretching us mentally, physically, and emotionally, and sometimes we need support. In this episode, we dive into:
What is playtime therapy as it pertains to the 0-12 year age range?
What techniques Ashley uses?
What are some of her favorite resources for parents?
What does a playtime therapy session look like?
What are the developmental issues and outcomes she sees in the office?
What is perinatal mental health and how does she work with moms?Support the show
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Editing: Godfrey Sound
Music: "Freedom” by Roa
Disclaimer: The information shared, obtained, and discussed in this podcast is not intended as medical advice and should not be relied upon as a substitute for professional consultation with a qualified healthcare provider familiar with your individual medical needs. By listening to this podcast you agree not to use this podcast as medical advice to treat any medical condition in either yourself or others. Consult your own physician for any medical issues that you may be having. This disclaimer includes all guests or contributors to the podcast.
Hello friends, you're listening to the Allied birth podcast. You've got Dr. Shannon here today. I'm one of the hosts of the show. And it's an interview day. So you know how excited I get about these interviews because there's just so many amazing and wonderful birth workers in the world. And our birth worker today is a fun she's in the perinatal mental health field. And so perinatal mental health that's meaning like everything encompassing it's the prenatal health, it's pregnancy, it's labor, it's birth, it's postpartum. It's motherhood is parenting, like it's that whole encompassing time period that can be in a woman's life. So today, we've got Ashley Linga, fell on today and she's a local therapist in the metro Atlanta area. I'm like big fan girl. I freaking love everything that she she's so fun. She's so good. She's so knowledgeable. She cares so much about the birthing community. And it's a wealth of knowledge. And so she and she's so busy, she's so busy, but in a good beautiful way because she really wants to help moms helps families and it's that mental health aspect. It's really like growing that tribe and that helping women grow that tribe takes some effort and some time and some energy and so she puts her all into it. So that's my own bio. For her. I love her to death, but I'm actually gone today we're talking playtime therapy, because she focuses on that as far as that infant early childhood, but also we're going to touch on some of the maternal mental health aspects of things, what she works with how she works with children, parents, families, and some of the outcomes that she sees and how people can benefit from Play time therapy. So again, Ashley Lagerfeld is on today. She's a licensed professional counselor specializing in infant early childhood perinatal mental health, clinical director and founder of playtime therapy of Georgia. So that is her office located here in metro Atlanta. And she serves on the board of directors for the Georgia first network and the Georgia chapter of postpartum support international racial night love those organizations. And she's the perinatal mental health subject expert subject matter expert for the state in the Postpartum Support International Group. She's been featured in articles for New York Times parenting The Washington Post romper Good Housekeeping, Oh amazing, and is published in Nature based play and expressive therapies, interventions for working children, teens and families. So she's a mother of two young children. Lots of happy pets and I am so excited to have you on the show today,
Ashley? Oh my gosh, thank you for that really, really warm welcome.
Of course now I yeah, I love I just love speaking with you and your energy is always so high and so good and you have so much good information to share. So I kind of want to jump in. This wasn't even actually one of the questions I tried. To send outlines to people so don't like blindside them with like questions where they're like, Wait, what are we going with this but I want to go a little bit into why perinatal mental health therapy and how you got into this field.
That is a good question. Yeah, that wasn't on the list. You cheat.
I know. I'm sorry. But a lot of birth workers you know, you you've ever reason why and when you share that reason that
passion comes through and
communicate well, so
yeah, okay, sure. I don't mind sharing and thank you again for the introduction because like that was really really warm and kind and fun and it makes me feel so special like to be wanted, like almost. I feel so special. Thank you. They want to know how much I appreciate you and your work and our relationship even though we haven't like gotten to be like super in touch over the past few years. It's been like awesome to still maintain this just relationships. So thank you. So how did I get into it? So I was okay. I was already a counselor whenever I had got pregnant for the first time with my daughter who is five now and I was already working with children. But after I had my daughter, I had a hard time with anxiety and depression. And so anxiety was a little bit anxiety was my main concern. That was the presenting issue for me. But I remember just feeling so kind of like helpless and kind of like stuck. And I thought this cannot be the end all be all for like parenting magazines. So how do people have children if this is what they feel like, like this is like it was it was really, really hard. And that's what kind of I started kind of just doing some Googling, right? For okay, what are the resources out there? And then I came across Postpartum Support international psi is what they go by and I took their training and which was really, really interesting and so informative, just for me personally. It was it was just very healing that experience to like, be like, Oh, this is a thing. People you know, have perinatal anxiety. I didn't even know this was a term you know, all this stuff and then I signed up to be like, I started volunteering with them basically. Right? And it started from there. And then I took an exam, passed it and got my certification, and then I kind of grew from there. But that's how I got into it was my own experience. I just had a really
need. I know and that's my love with with some of our birth workers too. And that's why I was like, I want her to go down this this rabbit hole because you were searching for resources for yourself. And then it's like, I know, I know. I'm not the only one that could benefit from these
resources and knowledge how it started.
Okay. I love it. Now, that has grown and developed. So you said you mainly started off with that Postpartum Support international psi. Like I said, Rachel and I love that organization. So that's more of that I guess like mental health aspects of things. But then how did the shift happen with play time therapy? And were you doing that beforehand, like the infant early childhood education or how did that ebb and flow and
tell us what that looks like? Yeah, so that so I came across that as well. Okay, because I was trying to meet basically, like, there's a, like a lack of resources. For families and there's like, what do they say like a gap in the literature, right? And that's what they say in the research world. So basically, I was already very interested. So before the perinatal mental health thing came along, I was very interested in working with children I was studying and preparing to be a play therapist. Well, what I learned through that journey is that like play therapy, mainly focuses on older kids, like many of the interventions work on like, they don't work with the Uber young, infant mental health, right? They don't work with toddlers. There's not a lot of training there and a lot of providers that focus on early parenting and also early child development. And so I was already very interested in that, but I wasn't exactly sure like what I needed to do for it, right? Well then come you know, I learned about perinatal mental health and then I learned through that I learned that I realized actually that everything is very divided. And this is my own personal opinion. But things are very divided. It's like we're either for the mothers or for the infants, but there's not a lot that bridges the middle where we say okay, you know, infant mental health, it says we're very dyadic you cannot have like there is no mother and baby there's only mother baby, right? But perinatal mental health and for good reason. It really it largely focuses just on mother, right. And it says no matter what we need to really make sure that the mother is okay. And that is true, but I felt like yes, but this is also important over here, right? The mother's health and mental and emotional well being it directly impacts the child's development and the childhood outcomes, right. And so that's the long story short, I started Googling and I found my infant parent mental health program through the University of Massachusetts, Boston. And this was I had my first cohort meeting like our welcome meeting. Literally, like four days before COVID
I remember talking to
you about that, but yeah, the world like shut down. I was in Boston though. I was supposed to go up there every other month for like four days and we were gonna go and like, do it right. I still got to complete the whole program, but we shifted to an online format every month it was all it was very intensive. So it was really hard. But I did that for two years and I completed my fellowship with like leaders in the field. It was amazing. And so many Anyway, like I come back, right. I'm here in Georgia. And that's how I kind of honed in on my my niche, right my niche. So I focus primarily on like pregnancy through the first six years of life. I do work and I have qualifications, right like general, like my education and training base covers children up to 12 and even adolescents but so I'm passionate. Young children zero to six in their families. So that's what I kind of hone in on.
Yeah, I love what you were talking about bridging the gap there and that there can be that disconnect and what you've received as far as the difference of like, okay, you can have parent and infant children but the two they have they exist because they are together.
You know, you can't have one without the other. You can't have one without the other. So
I think that is a really nice way for you to try to bridge that gap and say like, counseling, therapy services can I offer so I know to a lot of people might be more familiar with like therapy, playtime therapy, like those type of therapies, like you were saying in that older aspect of children's so what is what is play time therapy and then you know the specifics of like that infant early childhood development, what that looks like differently than the
adolescent. Right? Yeah. So the big, so let me just provide a little bit of education because I don't know like what the audience knows, not many people like know much about the counseling world and the different credentials, but essentially, so like, you have people who are called RPTS registered play therapists. And that is a specialty that many people many counselors choose to pursue whenever they work with children. I was on that path. I was receiving all the supervision all the kings, Cross Station groups, all the trainings, but what I learned is that none of those interventions work with the early populate, like the early years, right? Literally, like none of them. They're there, they're far and few in between. And so I stopped pursuing that credential to pursue the higher and more specialized credential of infant and early childhood mental health specialists, which Georgia is just now coming around to recognize because the infant Minister, the World Association of infant mental health, and we have like our infant mental health coalition, they like it state dependent, right. So like not every state recognizes this yet. But Georgia is like literally just now adopting this so that way I can receive the endorsement in this state. Does that makes sense? Yes. So it's still very new even though the research has been there for a long time. We're just now being like, Oh, our state should recognize this right. So anyway, all that being said, so. Where was I going with that? Oh, so the the way that this differs though, with when we work with young young children and early parenting and really childhood, from the rest of the play therapy world is that it inherently involves parent has parental involvement. And you might think, well, like, Oh, I'll play therapy shouldn't have parental involvement. But that's not necessarily true. And I've worked at many practices, you know, before I opened up on my own when I was doing my internships, my practicums. And my, like, my directed experience are fully licensed. I worked in several practices, and they don't speak to parents. They don't inherently have parental involvement. It's more of like, we'll give you an update, right? Yes, but there's really a lack of knowledge on how to support parents. And so anyway, that's like a general issue in the field, but then we hone it down into like the young kids. What it looks like is basically i i support parents with a few things discerning whether or not their child needs clinical support, like are the presenting concerns and symptoms, excuse me, developmentally typical or appropriate? Are they a symptom of anxiety? Is it a neurodevelopmental difference? Is the child having a hard time with an injury pinion adjustment or an environmental stressor like a baby or is something going on in the daycare setting or preschool setting or you know, something going on within the home that's just causing them a little bit of stress? So some of it is just kind of practical like that. So very powerful because parents do they do want to know that like, Oh, my, does my child have ADHD? Are they a three year old and we can discern those things. At a very young age where the training die. Anyway, so is that that is also attachment related meetings, relational. I have parents come in and say I don't feel connected, or I don't know how to play in a way that fosters engagement. I feel frustrated a lot. And it's not really a child thing. It's a parent thing. And but
the child is affected impact
his house. It's relational, right? It's dyadic meaning it's two goes back and forth, right? So that's why I have my space. So right we bring into some little ones bring in their parents. We watch them play we have play based assessments, we have all kinds of things that kind of, we're able to establish a baseline for the health of our relationships and what what is safety within that relationship. So
yeah, yeah. Well, and it's I think that's really important to that feedback to the parent get because
I think sometimes in birth and pregnancy, it's supposed to
be this like, innate thing that we give birth. And this is you know, what that is supposed to look like, and now we transition into this new parental role and that adjustment is in cars. Because I feel like sometimes, yes, there's an innate aspect of meeting the needs, you know, parent child, but also brought another life role and it's, it's a different human being, they're gonna have a different personality, they're not going to be like you and so it's maybe looking at how you were parented. You probably hear or see that a lot with the parents and then transferring that into how they can interact with their child in that meaningful way, but to give them you know,
concrete, I tried to make it tangible. You know, it's because so much of mental health is not tangible, even so much for relational health doesn't seem tangible. But I tried to make it as tangible as possible for families. And I want them to walk away being like, Oh, I had my questions answered, and I now have a plan of action. Like I know what I can do at home. I know what I should be, how I how I can be responding. very tangible, and very specific. But yeah, yeah.
What are some of the techniques that you use because I know again, too, I'm not well versed in the counseling world, but as far as you know, I know cognitive based therapy, so different. There's different type of, I guess, counseling techniques. Is there anything specific that you use or that is primarily dominant in that infant and early childhood development? Group?
Yes, absolutely. So yeah, you're talking about CBT right, cognitive behavioral therapy. That's, that's right. Behavioral Yeah. Yeah, you're right. Yeah, you're right. That's, that's huge. Because it's what we call evidence based, right? Like we it's very measurable. We can understand treatment outcomes, things like that with them very easily. With the idea and obviously, I can't like represent all of infant mental health when I say this, but we don't lean into that very much because the idea is that like, young children, their behavior is not something that we should manipulate or try to change in any way. If there are behavioral problems. They're going to be stemming from the relationship, not just because the child woke up and chose to be, you know, malicious that day, or they chose they're having art. Yeah, they're like just being mean, that's not the belief, because children developmentally at a young age not have the ability to manipulate, you know, yeah, can they test limits? Sure. And sure, we respond to those, like tests appropriately. Yes. But we don't really lean in too heavily on like, punitive punishment trying like but not a lot of like,
because that frontal lobe is not fully developed. And that is
constant. Yeah. And the ECB. Yeah, and cognitive behavioral therapy just by its nature is very cognitive. It's in the name. You can't use cognitive work with young children. Parents, sure at times, right, but like no, so anyway, all that to say what we actually my specialty in terms of my modality and my treatment, focus and my, my, basically my theory, right, because every counselor has its theory that they're like, merrington Some people like to call themselves like, eclectic, which means like, they pull from different things. And that's, that's good and true and bind. That's, that's great.
We have one in the chiropractic world, too. Yeah. You know, like your mixers are straight. Yeah,
there's a need for that. But I pulled very heavily from what we call attachment theory. And Interpersonal Neurobiology is very scientific. Because it is measurable to a degree right how, how does stress affect our nervous system? How does that cause us to show up or pull up and pull away in relationships? But attachment is about safety. And what is the child experiencing and one of my like, mentors in my infant parent mental health program is Dr. Ed Tronic. And he was the creator of the still face experiment. A long time ago. But he is constantly saying how does the child making meaning of this experience even in just like basically play with their parent, but also in some of those bigger moments in life, but how is the child making meaning of their parents responsiveness or their parents tone of oh, you know, all these things that are measurable, but how are they making meaning? And that's really, I think, one of the jurists of attachment. And then also this idea that and this is one of those powerful things I share with families is that the idea of rupture and repair, every relationship has moments where we have ruptures like in marriages or just partnerships, romantic or not friendships, but especially in the parent child relationship, we have rupture. But what's really important is that the parent is going back and doing repair work. And that doesn't have to be intense, but how are we repairing any ruptures? Any disagreements? It can be as simple as like, oh, you know? I shouldn't have spoken to you that way. I didn't like the way that I spoke to, you know. Because I think so many of us we've grown up in families where lots of ruptures have taken place, but virtually no repair. That's an issue, right, like, that's a big issue. And so it's not about being perfect, but it's about repairing any ruptures that take place and just some parents want help with that. And that's what I'm here for.
Yeah. I love that. You mentioned that rupture and repair and it. I guess, part of my thought process too with is yes. So maybe we do get that adolescent space and there is play therapy, but it's almost like you're going upstream a little bit more with the infant and early childhood with those families that maybe have an awareness or like something going on. I need help in this aspect of things. You know, not to say that I mean, adolescent bringing something I'm trying to research right now.
A lot of the concepts actually apply though, to adolescents. It's just, it just looks a little different, right? But it's a thing. How can I how attuned am I? Sorry, how attuned Am I to my adolescent? How am I responding to their needs? How are they communicating to me, you know, but intervention just looks a little different. I just did that. But yeah, the concept though, that's what's amazing about attachment theory, it's applied to it. Age does not factor it's just we can be very preventative with care. Whenever we focus on young children, right, like, you know what I mean, so anyway,
now, so what are you mentioned briefly to as far as the playtime therapy and some of what you're hearing your parents what they're looking for, you know, just a little bit behavior or just my child. He so let's go into some of the some of
the things that you see in the office and the people that you work with.
Yeah, so one of the biggest things is usually like the probably like, three to five year old range, where parents just aren't not sure how to respond to their child's behavior. Which I mean, I understand I'm five year old I don't understand, you know, I don't know a lot to what they're wanting to do,
though. I think people know you hear that from therapists, like, Hey,
I mean, I do as I say, not as I've no, no, but um, you know, just really though they're like, I just don't I don't know how to respond. Because what I'm seeing is we have a generation of parents who are much more aware that the way that they the way they were raised, right, so they're attempting to change their parenting style. And their intentions are really, really good. Like, it's a really good change. But they're stuck in it. And they're like, Oh, well, you know, like my parents would have just done X, Y or Z. I don't know. Because like, and they feel dysregulated all the time, like activated by their child's responses. Oh, my God. I really want to hack you, I'm not going to, but then they're like, Well, what I do instead, and so it's like, I'm like a little bit of a guiding hand. These are some options, right? This isn't a failsafe, but these are some options, even just knowing that they have options. Sometimes they're like, that's really great. So all that to say I get a lot of that. They'll just say like how do I respond? What am I supposed to be doing? Is this a child issue? Is this a me issue? What? So we started off by doing a lot of screening for things we thought assessments will do different things, right? There's a certain like, okay, where who needs the most support? Right? But so I get a lot of that. I do
I do get quite a bit of referrals just from parents who, you know, they're not sure if their child has a neuro developmental difference with a meaning, you know, neurodevelopmental difference like ADHD or autism. Those are the two biggest things that I see. And they again, though it relates to the relationship because oftentimes parents will say, I feel like there are barriers to me feeling connected with my child or connected to my child engagement feels a little off or you know, and they they want to know, does my child is my is my child autistic? Does my child have ADHD? And so I do because as a licensed professional counselor, I do diagnosis that's you know, within my that is one of the goals Yes, my scope, my practice, right or scope of practice for counselors. And so I guide them through. So sometimes it's more clinical like that, right. And sometimes it's just it's, it's so clinical, but it's more relation, right where we're right in relationship versus just working on it like a like a diagnostic.
Yeah, do you get like the assessment aspect, but then after that, it can be like, Okay, these are the action steps.
Yeah, this is where
we're going with that. And I'll go for
generally speaking, you know, I have a lot of parents just like they're like, I don't know, but I know you work with young children. And so I do something what I call like a developmental care consultation. So like we go through the process and we use we do general screening between anxiety, depression, and look at each challenge overall things we look at the health, parent child relationship, and then at the end of the day, it's a minor way she's doing the woman, it would be, they might not need that type of support. They might need something like maybe the child needs occupational or she'll do this maybe the child needs maybe like psychological assessment to look at all kinds of things, you know, executive functioning and, like, just more intense, right psychological assessment. Anyway, so I ever speech therapy, I make appropriate referrals, right. But parents at least walk away being like, Oh, now we know, right? Because I do have the knowledge base to let them know what their child might need support with developmentally so
right and pointing them to those referrals that you have. Yeah, yeah, definitely. What does it look like in the early infant stage?
Yeah. You mean just like,
well, but then also, when parents are coming to you, what are some of the things that you're working with in that, you know, earlier stage before maybe two years of age, you know?
Yeah. So a lot of times, so I would say there's two primary things on the parent, and it's usually because in my experience so far, right, it's usually because we have a parent, typically a mother, who she, like, has self she, like self reports is struggling with anxiety or depression, and she doesn't feel as connected to her. And so I do have parents of quite a bit who seek out support for me for that. So they just want to make sure that basically they're like, Are we okay? Right. It's like, Am I okay with my child? Right. So, there's that and it's reassurance. So in also setting up the parent with the appropriate resources to, you know, okay. If she thinks she might have anxiety, we can screen for that, and then help her feel better. Right, which will directly impact her relationship with their child or her perception of her relationship with our child. But then the other one is, I do get referrals for families who have very, very like in the infant stage, right? And they're worried about the legs. And so they just want to see like, is this a delay? Is this within the realm of normal? What can we be doing relationally to support development? So those are kind of the two camps right? I don't usually. That's only if the parents are following their gut though. And they're like, pediatrician says everything is fine, but we feel like something's off and they're seeking a second opinion. Because pediatricians do have their great what you know, the medical world just doesn't always hone in on specific niches. Right. Thank you.
That's that's the nice yeah. Do you see that because I get that a lot in the office to theatres is is is is normal. But for whatever the reason, so I like that. You mentioned that it's kind of the parent is still like, Okay, I hear that. You're saying that but still, I just want another set of eyes that maybe looks at things with a different lens, you know, and that's that's a good support.
System for parents to have.
What is something that you I guess, kind of wish that new parents knew or were more aware of as they transition into this Parenthood because I think too, that yes, you work a lot with mothers and in that you know, am I having are these thoughts and feelings anxiety depression, what are these thoughts and feelings mentioned? It's the working with the two but then you also have the other spouse in involved as well too. So I'm sure you work with those that family unit as well. So what are you what are some of those things that you wish parents are more familiar with as it pertains to, like parenting and that childhood development?
I think the biggest thing is I wish parents would be given education because I don't necessarily feel like the burden is on them all the time to seek this out, but I wish providers all the important people who come into contact with these families while they're pregnant, which you know, is anfal. Usually it's chiropractors, right. Sometimes it's lactation consultants beforehand. Often doulas, often obese or midwives like these parents are given plenty of opportunities to be given information. But for some reason that none of them hardly are educated on biological norms for feeding, sleep, and like, like activity, right, like, like just development, like what are the norms? So, you know, it amazes me that I still have mothers who talk to me and they say, Well, my babies only they're waking up every hour and a half to eat. Because no one ever told her that was more. Right and then and then when I'm the first person who's like, Well, yeah, that's so that's very much so in the realm of normal, like the relief she feels right. It's like, well, that could have been prevented that stress that she's been feeling for three months, or eight weeks or however long it could have been prevented by one person explaining or just a little pamphlet being like, this is normal, right? So honestly, that's my biggest thing is I just wish that parents would be more educated on the norms for sleep and feeding. And then, like I said, like activity meaning like, like, smiles or eye contact or just some of those early markers for things. Just I wish that they were just given more information.
Yeah, I know. I know. I feel that but I think things I do think things are shifting now as far as how much because I in my office a lot to talk about, like, Hey, here's information overload. Sorry, but here, lots of things better. Yeah. And I'd rather and I'm sure you're the same way too. I'd rather someone leave and say okay, I know about that. But I don't want that. I don't need that right now. Like I'm aware of instead of having to worry like, Gosh, I wish I had, you know, known earlier or sooner. I don't at all. So I think that's an important, you know, I do agree to agree with what you preach to people. No, no, I agree with it. Um, what are some of your favorite resources for new parents? Yeah, so,
um, some really easy ones that like, I mean, I know that not a lot of parents have time to read there's really good ones. So anything written by Dan Siegel, Dan is like, you know, he's, he's amazing. And he he writes a lot of very accessible books regarding like parenting from a relational perspective, but also, you know, what is neuroscience and what is you know, like, what do we know physiologically about stress and the nervous system whenever we show up in a certain way in a relationship, so anywho he writes a lot of books about that, like parenting from the inside out. It's one of his books like these really good ones. And then but one of my favorites though, honestly, it's Dr. Sarah auquel. Smith, so well happening. And she has a lot of really wonderful, like, affordable, easy to read books on responsive parenting. I mean, in general on almost every topic like bringing a second baby, how can you prepare your child and like a very like a very attachment focused way or oriented way about bringing a second baby into the family? What does research say about bringing a second baby into the family? She has like a potty training when she has, you know preparing for your first day of school, asleep like a gentle baby sleep book. She has so many different things that are just really full of informative information. That it's not Shamy it's not like that you should be doing this. It's some it's really objective. It is in many ways, but it's it's like how does science support responding, you know, and and showing up in relationship. So anyway, Dr. Sarah Aqua Smith, and she's all over Amazon, Her books are really and then I think you know, other resources are more like topic dependent but like your sleep a good one is the possum approach to sleep. They call it a neuro protective model of sleep is really good. I encourage people to get that one to Google. Yeah. But for just general parenting and child development, Sarah Smith or Dan Siegel, and then also the Harvard So Harvard had, there's like a he's called the Harvard child Institute or something like that, but Harvard has a lot of free resources for early childhood. A lot like handouts, PDFs, little videos and stuff. Because what's happening is people are recognizing that this is a critical like, you know, this is a really critical intervention window. Like humanity, not to sound dramatic, but it really Yeah,
yeah. And it's you can make that lasting change. And you can start early, you know?
Yeah, yeah. So anywho those are just some resources but called the Harvard Institute for like the developing mind. Sorry, it's something like that. Maybe.
Agree. Yeah, I was gonna say I know I'm trying to like I'm also taking notes. So I keep if we're looking at this, because I always write lots of notes. But I learned I learned so much from these things. I know you and I have we've been able to work with you know, several patients together as well too. Because again, like I screen for those things in the office, or you're hearing certain words, or and that's why I always ask my mom's Do we have a history of anxiety or depression because everything that you were mentioning with the children and your work with it's like those big transitions in life you know, and it's, it's almost like, like that potty training is a really big time bringing home Sibley like those big changes when we had I always say like, lots of emotions and a little body, you know, and not fully understanding it. So is that something that you see quite a bit is those transition periods?
I see that a lot. And the thing is, like, I think it's important for people to understand that, you know, not everything within the world of infinite early childhood and even perinatal mental health is like pathological or clinical right, like, just because a child is having a hard time because they have a new sibling, or maybe they're going to a daycare pre K for the first time and having a regression with pottying or whatever it might be, right? Like, that doesn't necessarily mean we're going to slap a diagnosis on they're like, Oh, well, they have anxiety, no, but it can also be true that they're having, you know, they do have some anxiety we're having a stress response, something in the environment and support would be helpful. Have children gone like, you know, for like hundreds of years and these transitions and turned out fine. Yeah. But I mean, what I find is that for a little bit, right, family, the tension is high family struggle a little bit and we can alleviate a lot of that by having the proper support. And so I don't want parents to think that they are to not seek out care because it'll be like they're labeling their child or something's wrong with their child. Well, that's not really the case. Like, I don't I don't diagnose a lot like the majority of my patients. You know, I have a private pay practice that is part of it. But like, I'm not required to diagnose anyone, right? Like, it makes sense. So I was not going to be labeled up and say slapped on their medical record. It's just truly for general support. But anyway, the way that released and released to your question is yes, I get a lot of those things like all the time, literally all the time. And they'll be like, No, we had a baby three years ago, but my six year old can't adjust. They're still having a hard time and we feel like it started when the baby came home. Right. And so maybe we do sibling work and we work on the sibling relationship. And so, you know,
there's a lot there's a lot to it. I know that's where it's like I'm asking you these huge questions are like, How do I turn down everything?
Well, it's just all through we just all circle it back down to theory, right? Like, theory can be applied to a lot of different scenarios, but it all comes back to attachment theory, in my opinion,
in your opinion. Yeah. Now, but I mean, that's what all of these were in relationship all the time with ourselves, but also with everyone like that is just part of humanity. And so you have you know, certain attachments to thing. There's probably aspects of you working with you to the expectations of some relationships as well too. So there's lots to it. It's multilayer. I want to switch gears just a little bit into because you also are in that perinatal mental world we talked about at the beginning. With the it sounds like to when you're working with the children, you're also working with the parent and so it could be that you know, moms or parents are also seeking you out. So what are some of the mental health that I know we're just barely touching on this? We'll have to do a whole other episode. I have plans to have you on. But just touching a little bit on the ways that you support that maternal mental health as well.
Yeah, so um, you know, I have to be careful I can't have like, I can't have clients who are like seeing me for perinatal mental health and then me like start working with their kid for like another reasons that makes sense. Like I have to make sure there's just as you make sure my role is just really clear, right? But I just want to like put that out there. But yes, so the way that I support perinatal mental health. Okay, yeah. So some of the big referral reasons for referral from parents or their providers is because there's been a traumatic birth, whether the mother just perceived her experience as traumatic and nothing medical medically traumatic actually happened. Or there is medical trauma where baby was born very earlier, there's preeclampsia or like postpartum preeclampsia or, you know, like just big changes or sometimes. Well, hold on. So that's the birth trauma piece right? I get a lot of that because I do have like additional additional training in birth trauma specifically. And then anxiety and depression and OCD or the others. So whether that's a partner has noticed that they're the you know, the, the birth mother is having a hard time or seems a little off so the partner is reaching out to me or the mother, she's like, listen, I know this. I just feel like this is normal. So anyway, all that to say, I depending on why they're coming we start with screening screening is you're like in the mental health world screening is your friend. A lot of counselors do not screen I don't know why. I think it might be lack of I don't say lack of education, but it's lack of just lack of resources surrounding our continuing continuing education. Maybe that makes sense. There's not really a focus on assessment and screening for counselors, but it's within our scope. We're really going to be exercising that so any counselors listening to this, please do it. Yeah. So I always start with screening and appropriate screeners to you know, not just generic ones there. perinatal mental health specific, because we have all of those things for birth trauma, we have those things for anxiety. We haven't refreshed so I'm aiming to screening and then developing an appropriate plan of care which you know, sounds like very sometimes it's very practical. It's like what does support look like for you at home? How are you managing things do you need to be managing them because that's not even your job? You know, like
we talked about that. I want to have you on again, I know.
systemic issue, it's not your fault. But anyway, and then also like, you know, if for symptoms are significant enough, you know, holding your hand and helping her navigate like, do you feel comfortable with medicine? Medicinal support, like are you okay, with prescribing this? I can connect you with someone who can help you with prescribe medicine, right, like, let's talk about the providers that are appropriate for that and the avenues for seeking that out. So it's just different things. But yeah, there's always formal treatment and formal treatment plan that's created and it's not always intense, you know, it's like, we see that moms feel better break the play, whenever they understand that support is at least there, right? It makes a big deal.
Now, I know I usually get asked a lot like, you know, finding out someone's starting under care how often do I need to come in what is the care plan look like? So I'm gonna be clutching after that. Cuz my answer is always it depends on everybody, because it really does. It really, really does. And I want to highlight that too. As far as like, plan of care with sometimes it's a longer term, sometimes it's shorter term. And so what does what does that what are the options or what does it look like in that input world and then that perinatal mental health
world? So I obviously as a clinician and a provider, I do provide like formal, like recommendations for care, right. And sometimes those recommendations really do need to be followed like it isn't. It's imperative that they come in you know, X amount of times or whatever. They usually like literally nine out of 10 times, as long as symptoms are not incredibly significant. I provide a recommendation, but I tell all my clients that they have autonomy over their care, because I believe in that and they can schedule as frequently or infrequently as they'd like. That I'm obligated to check in if I don't hear after a certain amount of time, but I believe is giving them control over that. And what I find is that that really motivates me. Right like and it's not like, you know, their treatment outcome is dependent upon their, you know, so many different things, right, but their availability, emotional availability of also physical availability, but also like finances, their bandwidth, so many different things and I don't want to put pressure on them be like what you need to come meet right. Now if they really, really do sure, because I have an obligation to make sure that they are safe, you know, emotionally healthy, right. But all that being said, I get four more recommendations, and we see that there's an alleviation of symptoms really quickly, like, if they're coming consistently, we'll see a huge change within a month. But it just depends on also what is support looking like outside of our town, but
there's a lot more you know, they're only with you for that hour or however long that appointment is there's I look at them the same way like there's a whole other world going on with you, you know, outside of that.
So I do try to take a more holistic systemic approach. I'm like, Oh, look, if you only can't afford or like, want to come once a month, that's fine. These are all these are things that need to be happening on the outside to to support your well being right. So yeah, that makes sense.
Yes. Now I just wanted to touch a little bit you know, yeah, you know,
some people it's different from counselor, the counselor to you know, some people really they're like, we're going to do weekly for the first eight weeks to establish rapport. Everyone has different methods, you know, and there's nothing wrong with them. We're just all different.
But that's what's also kind of the beauty of it is finding you know, the office in that space in that person where you do feel safe, you know, and able because you need that if you really want to see the results. You know, if you really want it to work, you have to feel that openness. What anything else you want to mention that maybe I didn't have on my list or things of that nature as it pertains to play time therapy. I know you've been doing you've been doing a lot of new things lately. We're not necessarily new things but you've been having a lot of like Mommy and Me groups and really helping, you know, build that tribe. So tell tell me a little bit about that and what your goals and thoughts are with that.
Yeah, so I'm having an extra room in my office that's not being used. And so I was like, You know what? had options. I was like, I could rent it out. I could hire someone. No, I just made it to a mommy baby room. And so basically, I have been hosting groups every other week, every other Saturday. And for moms and their babies zero to 12 months up, I will probably end up opening up the age range eventually. But like right now it's working. And we have little mommies and babies who come with their little ones and we do I call it precious tales. And it's a storytime like an infant storytime. So we always read a book but it's also honestly just like a peer support group. So like, it's a lot of chatting and, and just like relating and engaging, to be honest, which a lot of them a lot of mothers just don't get it naturally. It's really hard in today's society to get that. And so anyway, yeah, so I'm doing that. And I've been doing some groups also, I call them play time. So like practicing play time and things like that for the younger kids. So I've just been like kind of having fun with groups, just to kind of switch it up, you know. But yeah,
I love it though. I love seeing that. I love at the thing. It's important for to help, you know, winds create that tribe in that community as well. So yeah, anything else that you maybe want to mention that we haven't talked about or?
I don't know. I don't think so. Um, yeah, we
talked about a lot. Yeah, we
talked about a ton.
More talk about like, I know, you get to the end and it's like, wait a minute, I want to say this, this this. I loved having you on today. I hope this has been I know this has been, you know, important for new parents to hear and I think a little bit too of being like hey, you know, trust your gut. If something is kind of saying like, you know what, I just want another set of eyes on on my kid and how they're developing and how I'm interacting. I don't know I've always felt parenthood is so much. It's just a huge journey, not only for the new life that you brought in but you learn you become an and become so much with that parent that journey. So that is kind of what I wanted, you know, folks to really kind of get out of it or hear from an end to reach out and to be aware of the perinatal mental health resource but also the play time therapy resource because I think that's really important. So, again, thank you so much for being on the show today. Stay tuned every Wednesday where we have new episodes coming out alive.
Transcribed by https://otter.ai