National Center for Effective Mental Halth Consultation
   

Activity: What Should Happen Next?

Considering the role of the consultant and consultation in addressing trauma in the early care and education setting, use this "stop action" scenario to identify what should happen next after each brief segment. Write down your answers and check them with the Possible Answers listed at the end of the activity.

Stop Action Scene 1:
Justin Santos was an energetic and verbal child who enjoyed being in his Early Head Start classroom. After having turned three over the summer, Justin moved into Mrs. Huggins Head Start classroom. Unlike last year, Justin seemed less settled and focused. His behavior was sometimes aggressive. He had difficulty sustaining play and a hard time finishing any activity. With other children, he was bossy and irritable, sometimes acting abruptly and pushing whoever was in his way. When approached by his teacher to interrupt this type of behavior, he would shrug and duck his head, appearing startled or afraid.

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What should happen next?

View Possible Answers »

  • Mrs. Huggins should discuss her concerns with the mental health consultant
  • The consultant should make a classroom/child observation focused on the environment, behavior, and interaction
  • Together, Mrs. Huggins and the consultant should arrange an appointment with Justin's mother to inquire about Justin's behavior, home life, any changes, etc.
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Stop Action Scene 2:
Mrs. Huggins and the mental health consultant met with Justin's mother, Maria Santos, and shared their concerns with her. Ms. Santos said she hadn't noticed any change in Justin's behavior at home. The consultant invited Ms. Santos to share information about herself and their family life. Ms. Santos described herself as a single mother who worked two part-time jobs to make ends meet. She also admitted a history of alcohol use, but had quit drinking after going through rehabilitation and attending AA meetings. Ms. Santos claimed to be proud of her accomplishments and her continuing sobriety, but admitted having few supports in the community, often feeling alone with her struggle to raise Justin on her own. They agreed to continue to observe Justin's behavior in the classroom, implement some strategies to reduce his aggressive behavior, and stay in touch about how Justin was doing. A week later, Justin came to school with a dark bruise on his wrist. When Mrs. Huggins asked Justin about the bruise, he hid his hand behind his back and said he was" just wrestling with Roger". Mrs. Huggins learned from the Family Advocate that Ms. Santos had recently started seeing a new boyfriend that she had met at an AA meeting.

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What should happen next?

View Possible Answers »

  • Mrs. Huggins should document the bruise on Justin's arm, with support from her supervisor and the consultant and should inform Ms. Santos about her observation of the bruise on Justin's arm and concerns for his safety.
  • The consultant, Mrs. Huggins and other involved staff should try to determine the safety of Justin in his family situation, consider if a suspected child abuse report should be filed, and review the Head Start program's Suspected Child Abuse reporting procedure. Together, they should decide about reporting suspected child abuse and neglect and discuss how to inform and maintain a relationship with Ms. Santos after any filing.
  • Mrs. Huggins and/or the consultant should contact Ms. Santos and gather more information about changes at home and Roger's role and relationship.
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Stop Action Scene 3:
In her next communication with Ms. Santos, Mrs. Huggins described the bruise on Justin's arm and asked Ms. Santos what happened. She responded by saying that Justin had been wrestling with a family friend and that it was an accident. Mrs. Huggins asked if anything had changed at home. At first Ms. Santos said no, but then when Mrs. Huggins asked about Roger, she admitted that she has been seeing him and he sometimes spends the night. Ms. Santos described Roger as caring about her and Justin, and acknowledged that they sometimes disagree on how to discipline Justin. Roger had a tough childhood and was stricter than Ms. Santos, but she said Roger would never hurt Justin. Mrs. Huggins was concerned about Justin's family situation and now his safety. She was also becoming increasingly frustrated with his behavior. She wondered if some of his fearful behavior when an adult would approach to stop and redirect his behavior was linked to possible strict discipline from Roger. However, she could not understand his continuing aggressive behavior and his insistence on pretending to be a powerful, villain superhero. She began to wonder what else might be going on and if Justin was becoming a bully.

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What should happen next?

View Possible Answers »

  • Mrs. Huggins should be clear with Ms. Santos of her responsibility to assure Justin's safety and role as a mandated reporter as well as her wish to be a support to Justin and Ms. Santos.
  • The consultant should discuss Mrs. Huggins' understanding of Justin's behavior and share basic information about trauma, child abuse, and the impact of trauma on young children and their behavior; specifically exploring the mix of his fearful and "victim" like behavior, his possible "identification with the aggressor" in his aggressive behavior, and possible wish to be more "powerful" and control what's happening at home.
  • The consultant can help Mrs. Huggins to focus on Justin's strengths and understand that his current behavior is not his "destiny" to become a bully.
  • The consultant can encourage Mrs. Huggins and the Family Advocate to work together to have Ms. Santos, and possibly Roger, meet with them to continue to support intervention around Justin's behavior at school and the issue of discipline at home.
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Stop Action Scene 4:
Mrs. Huggins remained vigilant for any signs of physical punishment or harsh treatment from Roger. Justin had no further bruises or marks that she could see. Ms. Santos continued to deny any difficulties at home. One day, Justin says, "I'm not supposed to tell, but my mommy keeps a special secret bottle in the closet by her bed. She says it's medicine and not for kids. Sometimes she shares it with Roger, but not me." Mrs. Huggins supports Justin having shared this information and asks if he is worried about his mom. Justin nods silently. From this revelation, Mrs. Huggins, the Family Advocate, and the consultant suspect that Ms. Santos is drinking again. When they invite her to meet to discuss Justin's progress in the classroom, she says she is too busy or too tired from her jobs to come in. The consultant and the staff work together to explore other strategies to reach out to Ms. Santos, help her connect back to her AA supports, and seek additional assistance for herself and Justin.

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What should happen next?

View Possible Answers »

  • The consultant can help Mrs. Huggins and the Family Advocate deal with the stress and frustration they feel in this situation
  • The consultant can emphasize their important role in continuing to support Justin in his Head Start program and reframe Ms. Santos's reluctance to set up times to meet with them (denial, shame, fear, etc.)
  • Together, they can consider strategies to continue to reach out to Ms. Santos and monitor Justin's safety as much as possible
  • Together, they can discuss what community resources might be of additional support to Ms. Santos (e.g. her AA sponsor, her church, etc.) that might be agreeable to her and for Justin (e.g. therapy or intervention resources) should his behavior warrant referral for more intensive services.
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