Social-emotional Support and Therapy Help Family Move Forward

Names and details in this story have been changed to ensure confidentiality.

Daniel was four years old when Tina first met him at his preschool — as a mental health consultant who visited his preschool to provide social-emotional support to students and training for teachers, directors and parents.

Daniel was a child who seemed interested in connecting with Tina, but seemed to struggle with getting close or asking for too much help. He was often at the outskirts of Conscious Discipline I Love You Rituals — one-on-one interactions that help teachers connect with students. He would often join in for a bit, but then it seemed hard for him to tolerate connection so he would distance.

Over the course of the two years, while Tina periodically visited his classroom, Daniel demonstrated rage in various ways (outbursts, refusing to follow directions, yelling and screaming in class). Though these behaviors did not happen often, at times teachers were overwhelmed and in his final year of preschool, Daniel was sent home several times due to teachers feeling overwhelmed by his rage and not knowing how to help him calm. Tina provided instruction and support to teachers about co-regulation, and supported Daniel through the rage rather than sending him home, which further triggered his separation anxiety. The use of dolls that help children identify what they are feeling so they can separate themselves from the feeling and regulate it were helpful.

With Tina’s help, Daniel’s teachers were able to connect with him differently and make specific plans to help Daniel work through his intense emotions. Daniel’s rage and anxiety seemed specifically triggered by one absence of a primary teacher that he connected with a great deal, as well as the back-and-forth visits he made between caregivers weekly. On the very last day of preschool, amidst lots of feelings of sadness and grief, he was sent home early due to having a rage outburst.

Due to Daniel’s mother and teacher’s growing concerns, especially after his final day of school ending in being sent home and wanting him to do better in Kindergarten, Tina was asked to help the family find counseling. As Tina is also an outpatient mental health therapist at The Family Conservancy (working part-time as an ECMH and part-time as a therapist), and he was leaving the preschool setting, Tina decided to accept Daniel as a client.

Tina had recently been the fortunate recipient of grant funds to participate in a Child Parent Psychotherapy training cohort. That is the modality she decided to use with Daniel and his mother, knowing that there was a divorce history and intense emotional triggers around separation. In June 2021, Tina started working with Daniel and his mother every other week. They spent time using Conscious Discipline I Love You Rituals, breathing techniques, building a feeling vocabulary, using art, working on increasing his awareness of sensory needs, and developing ways to cope. Tina has spent time in each session building attachment, safety, and to process trauma from the past that is still impacting him in the form of intense sadness, anxiety and rage.

To date, Tina has had contact with three out of four main caregivers in Daniel’s life, providing psychoeducation around trauma, attachment, and ways to support Daniel through intense emotions. There have been no academic instances of rage reported since starting Kindergarten. Though Daniel continues to struggle with outbursts of anger at home at times, his mother has reported that she has a better understanding of what is happening and says that things are getting better. She is learning to invite Daniel to talk about his feelings, anticipate his feelings, and help him walk through managing big feelings with her instead of alone. She has grown in her confidence as a parent and has healed some of her own emotional wounds in the process.

Daniels’ mom said because of therapy he talks about his feelings and they talk about feelings in general more often. She has also noticed how he points out the feelings of his caregivers, and engages with her more about what he is afraid of as it is happening. Though Daniel has a hard time talking about and acknowledging his parents’ divorce, he has started processing that trauma with the use of dolls and other props. All of this work has taken place over telehealth with his mother doing the legwork of getting art supplies, dolls, and other materials. She has met with Tina consistently to work through her own grief work around the divorce, and how that has impacted her as a mother so that when we address it in session with Daniel she is prepared to support him.
Overall, Daniel has shown impressive improvement in his ability to seek support when upset, self-soothe at home, express his needs for connection, and to receive love from his parents differently. Tina has seen Daniel and his mother grow so much, and the investment in the entire family’s healing improve significantly.

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