Our ICSS service provides support for children and adolescents (0-17) with serious or complex mental health diagnoses who are referred by Child Youth and Family Services (CYFS) and our Child and Adolescent Mental Health Services (CAMHS).
We provide care based on the ‘Wraparound System of Care’. This is a strengths-based model that recognises and responds to the uniqueness of family / whānau through the use of 10 guiding principles:
- Family voice and choice
- Team based
- Natural supports
- Community based
- Culturally competent
- Strengths based
- Outcome based
What are we trying to achieve?
- For our client group, we identified that the major factors impacting on many were relational, particularly within the mother-daughter relationship
- The mother-child relationship is critical for the positive development of self-esteem for both genders, but especially for adolescent girls [Chadrow, 1980]
- Research suggests that adolescent differentiation and autonomy is developed most successfully in the context of a secure relationship [Nakash-Eisikovits… 2002]
The goals of our Connecting Mothers and Daughters programme were to:
- introduce an evidence-based programme to provide positive, structured mother-daughter interaction with a focus on:
- adolescent development / mother-daughter relationship
- therapeutic experiential activities towards relational healing and recovery
- develop an understanding of the roles and needs within a mother-daughter relationship
- empower mothers and daughters to manage environmental stressors, mental health difficulties and developmental challenges
What have we done?
We ran two pilots for our Connecting Mothers and Daughters programme which involved:
- Identifying participants from clients who needed to strengthen their relationships
- Carrying out face-to-face interviews with participants which included goal setting
- Final tailoring of the programme to suit the selected participants
- Pre-programme questionnaires completed by the participants:
- a behavioural screening tool to identify the strengths of clients and to provide insight into the mother’s perception of their daughter’s current presentation
- a Mother and Daughter (MAD) questionnaire to identify daughter’s perception of their relationship
Mothers and Daughters Programme
We developed the programme to include a mix of intrapersonal and interpersonal skills. The programme involved 8-10 structured sessions plus one follow-up session with the participants which involved:
- check-in and review of takeaway tasks
- identifying relationship goal for the session
- skills session – DBT or Calming the Storm
- a therapeutic experiential activity
- reflection, collaborative journal and strengths wall
- takeaway tasks
The types of experiential activities that we organised were:
- Making Connections
- Stretch and Grow (yoga and hand massage)
- Create and Paint (pottery)
- Final Challenge (bumper balls and low ropes course)
We completed 2 pilot programmes with 9 mother/caregiver-daughter groups and clients aged 13 to 16 years old. Our initial scope of mother-daughter groups was extended to include other family / whānau and caregivers to cater for the living situations of our client group. We also adapted the therapeutic activities to meet the identified needs of the individual participants.
- Dialectical behavior therapy (DBT) is a specific type of cognitive-behavioral psychotherapy developed in the late 1980s by psychologist Marsha M. Linehan to help better treat borderline personality disorder. Since its development, it has also been used for the treatment of other kinds of mental health disorders
Did we make a difference?
- We have developed a multi-disciplinary evidence-informed therapeutic intervention that has extended and enhanced the Wraparound principles and outcomes
- The passion and commitment from our facilitators has resulted in better engagement with clients and their families / whānau, and has provided opportunities for shared experience
- The programme has been tailored according to the participants’ needs and has resulted in improvements in the mother-daughter relationships
- We had great engagement with community partners to provide therapeutic activities
Our participants also completed the two questionnaires on completion of the programme. Comparison of the outcome data indicates that the programmes have achieved our goals of providing positive structured time together to connect and consolidate the quality of the mothers-daughters relationships.
The results from the Mother and Daughter (MAD) questionnaire pre and post the programme indicated an increase in all three dimensions of Connectedness, Interdependence and Trust.
Mother and Daughter Questionnaire - Daughters' average scores pre and post programme
Feedback from participants
Overall participants provided positive feedback regarding all activities and both mothers and daughters reported that the opportunity to increase communication and collaboration on activities was a positive outcome.
Mother and daughter reflections:
One of the highlights reported by participants was our session involving inspirational speakers. Although extremely emotive for both participants and the speakers due to the journeys shared, there was motivation and hope instilled in participants as a result of hearing about how extreme adversity can be overcome.
For the inspirational speakers, the opportunity to help others was also of great benefit in their healing process and journeys of recovery.
Where to from here?
- Continue with the formative and evaluative components of the programme to ensure continuous improvement
- Review the pre/post measures and research recently developed resources to trial
- Build on skills of participants / previous clients and utilise these within future programmes
- Review activity base to increase challenge
- Extend and adapt the programme contents to meet the needs of younger clients