How are you collaborating to address the needs with multicultural perspective and language barriers?

We are constantly collaborating with colleagues who can guide us in the areas of multicultural needs. We have many who function as translators and we also offer most of our programs in both English and Spanish. We also call on our many community partners to help us when there is a need. We have many cultures and languages in our district and are always seeking out how to best serve. 
— Monya Crow, Lewisville ISD CHOICES Program

In addition to basic responses like coordinating with faith institutions, employers and schools, we are aggressively recruiting interns that speak Spanish (not only for the work we’re doing in Mental Health, but for our Financial Stability programs and Education programs). Ultimately, we must build and strengthen relationships within cultures we are striving to reach.  You are seeing more UWDC program website content provided in English and Spanish, as well as all printed outreach materials.  Our desire is to raise advocates within each culture. 
                         — Gary Henderson, United Way of Denton County

We are still working on providing more services to the Spanish speaking population. Our goal is to offer parenting classes in Spanish by the end of the year.  Our counselors and staff receive training to be sensitive to multicultural needs as we recognize the diverse needs of our community.
— Dr. Jennifer Livings, Cumberland Presbyterian Children’s Home

How can churches become more involved? How  is HIPPA/confidentiality issues/etc. maintained or coordinated?

 The LISD CHOICES program has two mentor programs that are supported by churches and their members as the mentors. With regard to HIPPA/Confidentiality, all mentors are trained in what they must report (I.e. Abuse,  intent to harm self or others). Each mentor also receives training on how to maintain appropriate boundaries while building rapport with students. In one of our mentor programs, we have had long term mentors that have worked with a particular student for many years. Each mentor is also paired with a “contact person” at the campus                                      level in order to consult and collaborate when a question arises. 
                         — Monya Crow, Lewisville ISD CHOICES Program

Faith organizations have much to offer from free access to facilities for programming to safe, caring adults to serve as volunteers in programs. HIPPA and confidentiality issues must be met, which may, at times, hinder the flow of information between organizations, not only faith organizations, but just as with FERPA in the schools, we must adhere to these requirements of confidentiality.
— Gary Henderson, United Way of Denton County

 

We have a blossoming volunteer program that can help the church community become more involved with us. In addition, we have a full time Chaplain on staff that can be a great resource for churches as well. We embrace all denominations and would be eager to have the churches in our community learn more about what we do at Cumberland and our mission.  
— Dr. Jennifer Livings, Cumberland Presbyterian Children’s Home

Could Dr. Livings speak to collaboration between Cumberland and DISD?

Cumberland collaborates with Denton ISD regularly. Our residents have biweekly meetings with Mrs. Martha Puga, a wonderful DentonISD social worker who listens to our kids needs and provides essential support for school related concerns and advocates for our resident’s best interest. In addition, our staff communicates with teachers, attends ARD meetings, and follows up with school support staff and social workers to communicate about our resident’s educational needs.                                        Denton ISD is very receptive to our needs and continually works to provide services to help                                    address our resident’s special circumstances.
                       — Dr. Jennifer Livings, Cumberland Presbyterian Children’s Home

What are your opinions on reducing the stigma of mental health issues and getting our children and families counseling services and medications?

We are huge proponents of a family accessing outside community resources. While we do not make formal recommendations to one entity or another, as a response to the many many parents who call on us for guidance, we recommend a family looking into a combination of a discussion with their family doctor, accessing qualified persons to do assessments as well as our many providers in the community who offer counseling. We also work collectively to keep the dialogue open with families, teachers and other staff about mental health in efforts to reduce stigma. Much                          of our on-going professional development for next year is centered on bringing in professionals                              to talk to counselors/staff about having conversations with parents whose child may be                                          experiencing mental health issues. 
                         — Monya Crow, Lewisville ISD CHOICES Program

Education for parents about the variety of services available and the importance of engaging in both counseling and medication management (only if necessary) is essential. When medication is necessary, the combination of services is most effective in treating these issues. Therapists must also provide a welcoming environment and directly address potential stigmas that can impact the likelihood of a successful counseling experience. When clients can address their concerns about                            counseling, because it is not a natural process for many, the possibility to achieve change                                      becomes more likely.
                       — Dr. Jennifer Livings, Cumberland Presbyterian Children’s Home

How will United Way Impact Funds be allocated to increasing funding for mental health services given current discussions? 

That remains to be seen at this point.  As the United Way of Denton County Citizen’s Council on Mental Health inventories the existing services and identifies gaps, we will also be looking at other communities for best practices.  Our observations to date indicate inadequate levels of services to meet the need, inadequate levels of Medicaid providers, and gaps between service providers resulting in fragmented services.
— Gary Henderson, United Way of Denton County

How do you engage parents/family members who often place unrealistic expectations on the health professional?

In our counseling center and our truancy intervention program, parent involvement is mandatory. We also require parent involvement when a student expresses a threat to themselves or someone else. We come from the perspective that they are truly the expert on their child and we want to partner with them in order for the student to experience success. While there can be resistance up front, many parents will shift from resistance to engagement  when they discover that we value their expertise and that their participation is seen as valuable instead of                            met with a “this is your fault” approach.  

                         Part of the engagement is an education piece to decrease the stigma or lack of understanding                              about what a particular diagnosis may entail. Often a source of parental resistance can be due                              to frustration and/or not seeing progress. We work to help them see that participating is a vital                            step in seeing some success occur. 
                         — Monya Crow, Lewisville ISD CHOICES Program

 

As a therapist, talking directly about the roles of the parents in treatment often helps. Many clients do not understand their power to change and solve problems. When parents embrace their potential to be an agent of change, it can be very therapeutic for client’s to embrace the fact that they have a huge role in helping the family functional in healthy ways. Reframing and not blaming is the key. In addition, a therapist must set the expectation of continuous parental involvement in the therapy process. Solutions to family problems are not done while parents                                   are in the waiting room.
                          — Dr. Jennifer Livings, Cumberland Presbyterian Children’s Home

What can be done to get parents to get help versus removing child from home when there is no physical danger to child?

In our district we have a wealth of community resources that we refer to when a parent needs help. We offer a lot of parenting classes and have many opportunities to have conversations with parents when there is a struggle. We find that often a parent will feel resistant to getting help as a result of viewing needing or getting help as a sign that they are not a “good” parent. We address this up front in our unconditional positive regard approach where we share with a parent our belief that it takes courage and a true love for your child to seek out guidance. One on going                           effort that can pave the way is the continual open dialogue with parents and the previous efforts                          made to build a relationship with them. This is a great asset for when a difficult conversation                                  must happen.
                         — Monya Crow, Lewisville ISD CHOICES Program

 

This is a challenge because parents must take that first step. Resources about healthy self care and coping skills for parents so they can place themselves in a calm state to then take the first step to reach out for help to heal from trauma, behaviors, or other challenges is helpful. Information about basic coping skills is a simple and underutilized method of educating parents about the stressors of raising children and dealing with multiple, challenging family dynamics.
                        — Dr. Jennifer Livings, Cumberland Presbyterian Children’s Home

Advocating for children takes an incredible amount of energy and compassion. How do your organizations help your employees and volunteers fight compassion fatigue and burnout?

A portion of our professional development centers around “being good to yourself” as a counselor. We have had presenters on “compassion fatigue  signs, symptoms and what to do” and also promote an atmosphere of collaboration/openness among counselors so that when the load gets heavy we can share it. 
— Monya Crow, Lewisville ISD CHOICES Program

 

We frequently engage in team building activities (prayer walks, relaxation time, ice cream breaks). We also have a Chaplain on staff available to listen to staff concerns while providing a supportive work environment. Also, as a team, we openly discuss the dangers of burnout and ways to cope.
— Dr. Jennifer Livings, Cumberland Presbyterian Children’s Home

Comments:

–Pam with MHMR stated, “We need to believe these kids and their families can change and get better.” I would add, “We all need to help the children and families believe they can change and get better.”

–One way that Denton Community Health Clinic has done is to re-frame mental health as behavioral needs and learning new strategies & behaviors to deal with life. This has increased willingness to see our “teacher for learning new behaviors” for help.

–UNT does a tremendous amount of research in the area of play therapy in Denton ISD (every Title I campus)

Table discussion responses – a summary of all responses from participants’ Table Discussion Guides