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Me gustaría comenzar este blog discutiendo una plataforma que está muy cerca de mi corazón: ¡los libros ilustrados para niños! El primer libro ilustrado que elegí analizar es Estoy contigo de Cori Doerrfeld (https://www.coridoerrfeld.com).
Es uno de mis libros de imágenes favoritos para niños y padres porque ayuda a las familias a identificar, de una manera simple, cómo abordan un problema (por ejemplo, disputas entre hermanos, divorcios, fallas en la comunicación, etc.). La historia comienza con un niño pequeño llamado Taylor (dato curioso: a Taylor nunca se le asigna un sexo, por lo que está abierto a todos los géneros). Taylor está jugando con algunos bloques de construcción y después de que Taylor completa la construcción, da un paso atrás para admirar el trabajo, pero luego, de la nada, una bandada de cuervos negros se precipita y destruye la obra maestra. Taylor se siente devastado. Luego, un desfile de animales entra en la historia y cada uno sugiere cómo Taylor puede superar el problema. Sin embargo, no es hasta que un pequeño conejo entra en escena y simplemente escucha, que Taylor se siente lo suficientemente cómodo como para abrirse y decidir construir de nuevo. ¿Cómo podemos nosotros, como profesionales de la salud mental, ayudar a nuestros pacientes a aprender a escuchar como un conejo? ¿Y qué significa escuchar como un conejo? Usando el silencio y una presencia reconfortante, podemos permitir que una persona se sienta lo suficientemente segura como para abrirse y dar los primeros pasos hacia su propia curación. Como usar este libro: He creado una lista de preguntas para ayudar a cualquier profesional de la salud mental a facilitar el uso de este libro en una sesión de asesoramiento tradicional y/o una visita BHC más corta. Desgloso el enfoque de cada animal para ayudar a Taylor y le explico cómo estos animales pueden ser símbolos de diferentes reacciones humanas a un problema. Usando EC en una sesión de terapia tradicional: Si el tiempo lo permite, lea la historia con el niño o la familia durante la sesión (hablaré sobre qué hacer si usted es un BHC y tiene solo 15-30 minutos con la familia). Después de leer el libro juntos, hágales las siguientes preguntas: Como utlizar EC en una cita de salud mental ¿Cómo puede un terapeuta usar biblioterapia en un corto espacio de tiempo? Respuesta simple: es la tarea, la entrevista motivacional, y EMAPI (https://prezi.com/j9qmy4jpfym0/metas-empai-smart-goals/), cómo hacer metas. He proporcionado la lista de las preguntas de EC en una hoja de trabajo descargable en mi página web que puede dar a la familia para que se la lleven. Responda a las tres primeras preguntas en la visita para ayudar a la familia a identificar sus bloqueos, cuervos, y animales. Después, deles una hoja de trabajo se llama “declaraciones ‘yo’” (la hoja tiene phrases como “Declaraciones sobre mí”) para practicar en casa. Usando una meta EMPAI para establecer un número concreto de veces al día, semana, etc. para que practiquen el ejercicio. (Realmente me gusta la hoja de trabajo "Declaración I" de Therapist Aid.) (Https://www.therapistaid.com/worksheets/i-statements.pdf) Ejemplos: Me siento como el oso cuando llego a casa y veo que la casa es un desastre. Realmente agradecería que pudieras lavar los platos antes de que llegue a casa. Me siento como el avestruz cuando te escucho a ti y a mamá peleando. Quiero esconderme y fingir que no pasa nada. En una visita de seguimiento, asigne una tarea adicional donde el paciente practique "escuchar como un conejo" a un amigo, hermano, padre, compañero de trabajo o miembro de la familia, etc. Y cuando el paciente venga a la visita de seguimiento, el BHC se comunicará con ellos y les preguntará cómo va la práctica; identificará las barreras y trabajará con el paciente para encontrar soluciones adicionales, generando la voluntad de seguir adelante con las preguntas de escala de MI. También sería beneficioso para los padres utilizar TRL y las preguntas del blog que lo acompañan para aumentar la conciencia emocional y enseñar a los padres cómo modelar la escucha de sus hijos. Cuando el padre modela el comportamiento, el niño está mucho más dispuesto a poner en práctica estos cambios de comportamiento. Ejemplo: En una escala del 1 al 10, ¿con qué frecuencia estás dispuesto a escuchar como un conejo con tu pareja cuando se están desahogando sobre su día? Barreras para cuidar: Acceso al libro- Entiendo que no todos los padres podrán pagar el libro o estarán dispuestos a salir y comprar una copia. Idealmente, su lugar de trabajo podría reunir algunos fondos para una biblioteca clínica o un negocio local podría patrocinar un programa de biblioterapia y proporcionar algunos libros. Esto requeriría algo de esfuerzo extra y trabajo social por parte del profesional de salud mental, pero creo que valdría la pena el esfuerzo. Acceso al Internet Si sus pacientes tienen acceso a Internet en sus teléfonos o en sus hogares, pueden ver el siguiente video de TRL que lee la bibliotecaria de servicios juveniles, Jennifer Smith, de la Biblioteca del Condado de Dorchester. El video solo dura unos 6 minutos, entonces, es totalmente factible verlo en una visita de seguimiento de BHC también: https://www.youtube.com/watch?v=-0N1ew6Hk2o Resumiendo: Estoy Contigo es una gran herramienta para agregar a la caja de herramientas de biblioterapia de cualquier terapeuta. No solo es un cuento bellamente escrito e ilustrado, sino que proporciona un lenguaje simple, claro y concreto para padres e hijos para navegar el conflicto. El libro también nos muestra que está bien sentir todas estas emociones y maravillosamente modela cómo mantener un espacio para alguien que se siente lo suficientemente vulnerable como para compartir.
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I’d like to start this blog off by discussing a medium that is very close to my heart: children’s picture books! The first picture book I’ve chosen to analyze is The Rabbit Listened (TRL) by Cori Doerrfeld (https://www.coridoerrfeld.com).
It’s one of my favorite picture books for both kids AND parents because it helps families identify, in a simple way, how they are approaching an issue (e.g., sibling squabbles, divorce, breakdowns in communication, etc.). The story begins with a young child named Taylor (fun fact: Taylor is never given a sex, so she/he/they is open to all genders.). Taylor is playing with some building blocks and after Taylor completes the construction, Taylor steps back to admire the work but then, out of nowhere, a flock of black crows swoops in and destroys the masterpiece. Taylor feels devastated. Next, a parade of animals enters the story and each suggests how Taylor can overcome the problem. However, it isn’t until a small Rabbit comes on the scene and simply listens does Taylor feel comfortable enough to open up and decide to build again. How can we as mental health professionals help our patients learn to listen like a Rabbit? And what does listening like a Rabbit entail? Using silence and a comforting presence, we can allow a person to feel safe enough to open up and take the first steps toward their own healing. How to use this book: I’ve created a list of questions to help any mental health practitioner facilitate the use of this book in either a traditional counseling session and/or a shorter BHC visit. I break down each animal's approach to helping Taylor and explain how these animals can stand as symbols for different human reactions to a problem. Using TRL in a traditional therapy session: If time allows, read the story with the child or family in session (I’ll talk about what to do if you are a BHC and have only 15-30 minutes with the family). After reading the book together, ask them the following questions:
Let’s take a closer look at these animals and the specifics of each of their communication styles: Chicken-The Chicken is first on the scene and notices the negatives of the situation and wants to talk out all the details. Is your impulse to focus on the negative when there is a problem? Do you feel compelled to immediately talk out an issue? Do apologize excessively even if what happened isn’t your fault? How would you like to be comforted if the roles were reversed? Bear-The Bear arrives second and is very angry about what has occurred. Is your impulse to lash out when there is a problem? Do you scream and hit? Kick and bite? In what other ways is anger affecting your life? What comments do your loved ones make about your anger? Elephant- The Elephant is third and immediately wants to remember how the blocks were arranged and fix the situation. Is your impulse to immediately want to jump to a solution and make things the way they were? Do you ruminate over the issue and are unable to let go and move forward? Hyena- The Hyena arrives fourth and tells Taylor to laugh about what happened. Is your impulse to make light of a situation and hide in humor and jokes? Are you aware of your inappropriate affect in situations that call for a more serious reaction? Ostrich-The Ostrich is fifth on the scene and immediately hides. Is your impulse to avoid and refrain from thinking or talking about a situation altogether? What is your avoidance doing for you? Kangaroo-The Kangaroo offers another avoidant suggestion, which is simply to throw all the blocks away. Is your impulse to give up completely when situations become uncomfortable and require commitment and follow through? (e.g. giving up on a diet) What would give you hope to rebuild again? Snake- The Snake is the last to arrive and suggests that Taylor go and knock someone else’s blocks down. Do you often punish others for the hurt you feel yourself? Finally, we meet the Rabbit, who simply stays near Taylor and listens to the child go through the gamut of emotions presented by the parade of animals until Taylor comes back full circle and is ready to build again. So, what is our goal with this exercise? Our goal is to embrace all these animal parts of ourselves that get angry and want to hurt others, hide etc., but then move past them to be able to listen compassionately to ourselves and others. The goal: Listen like a rabbit. We’re all (myself included) working on “listening like the Rabbit” which means to listen to someone else’s pain and practice listening with empathy and understanding; offering no solution unless the patient is ready for it and ready to make change. I.e. Motivational Interviewing Using TRL in a BHC visit: How can a BHC use bibliotherapy in their short time frame? The simple answer: Homework, Motivational Interviewing, and SMART goal-setting. I’ve provided the list of TRL questions on a downloadable worksheet on my homepage that you can hand to the family to take home with them. Answer the first three questions together in the visit to help the family identify their blocks, crows, and animals. Then, give them an “I statement” exercise to practice at home, using a SMART goal to set up a concrete number of times a day, week, etc. that they will practice the exercise. (I really like the “I statement” worksheet from Therapist Aid.) (https://www.therapistaid.com/worksheets/i-statements.pdf) Examples: I feel like the Bear when I come home and see that the house is a mess. I would really appreciate it if you could do the dishes before I get home. I feel like the Ostrich when I hear you and mom fighting. I want to hide and pretend nothing is happening. In a follow-up visit, give an additional homework assignment where the patient practices “listening like a Rabbit” to a friend, sibling, parent, co-worker, or fellow family member, etc.. And when the patient comes in for a follow-up visit, the BHC checks in with them and ask how practice is going, identify barriers, and work with the patient to additional solutions, gauging willingness to follow through with MI scaling questions. It would also be beneficial for parents to utilize TRL and accompanying blog questions to raise emotional awareness and teach parents how to model listening to their child. When the parent models the behavior the child is much more willing to put these behavioral changes into practice. Example: On a scale of 1 to 10, how often are you willing to practice listening like a Rabbit with your partner when they are venting about their day? Barriers to care:
Summing up: The Rabbit Listened is a great tool to add to any therapist’s bibliotherapy toolbox. Not only is it a beautifully written and illustrated tale, but it provides a simple and clear, concrete language for parents and children to use to navigate conflict. The book also shows us that it is ok to feel all of these emotions and wonderfully models how to hold space for someone who is feeling vulnerable enough to share. Greetings! Welcome to Mind Body Brain, a blog dedicated to reviewing books and providing helpful tips on how to implement them into your behavioral health practice contained within primary care settings.
A little about me: My name is Norma, and I’m a recent graduate from the University of Texas at San Antonio’s Clinical Mental Health Counseling program. I am currently working towards completing my 3,000 hours for LPC licensure under the supervision of Connie Ann Tucker, LPC-S. Because there are limited resources designed to fit within the time constraints of primary care, I’ve designed this blog to help sift through and adapt several resources in order to strengthen, empower, and enhance your personal practice. In addition to looking at traditional psychology books, popular self-help guides, and specialty mental health articles, I will also be breaking down some popular children’s books and detailing how a mental health professional could use them with patients in their care. All of my reviews will suggest how to best adapt these resources to the fast-paced and time-restricted environment of primary care, which is where I was specially trained to work by Dr. Stacy Ogbeide at UTSA. I look forward to working as a behavioral health consultant once I am fully licensed. So enjoy the blog, and I look forward to sharing my reviews and insights while fostering this important conversation. See you out there! Norma |
AuthorNorma recently graduated with an M.S. in Clinical Mental Health Counseling from UTSA. She was part of the PITCH program's second cohort which was designed to train LPCs to work as BHCs in Primary Care. This blog is for LPCs and BHCs alike and hopes to add to the conversation about mid-levels joining the PCBH ranks and promoting IBH. ArchivesCategories |
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