Getting to Know Ourselves

After completing this module participants will be able to:

• Recognize their own behavior as influencing the mental health of co-workers and Head Start families;
• Assess the program's mental health services plan to determine how well it supports the mental health of staff and the relationships between adults in the program; and
• Recognize their own mental health strengths, needs, and areas for growth.

The relationships between adults in the program, that is, between parents and staff, between co-workers, and between supervisors and staff, will be reflected intheir relationships with children.

Supporting children and families, particularly children and families who are experiencing stress, is very hard, emotional work. To support the mental health of staff, supportive and safe supervision and mental health consultations are essential. This will enable workers to bring their skills and energy back to the children and families.

Caring for the emotional needs of others can trigger strong feelings. This happens to all of us. managing these feelings in ways that don't get in the way of our work is much easier with the support of our fellow workers.

The challenges that face Head Start families are often the same ones that face Head Start staff. Families ask us to help them with threats to mental health posed by economic hardship, violence, depression, and other issues. It is not uncommon for staff to be struggling with the very same stressors.

Background Information

"The most critical factor in quality child care is the human factor. Productive, confident, motivated staff are far more important to children than the blocks the children play with or the buildings in which they play. Ensuring that staff work at an optimum psychic level is rightly a central concern of every program administrator."

The work of promoting the mental health of and building resiliency in young children can sound deceptively simple-the heart of the work is in building warm, responsive, and respectful relationships. But how do we learn to be warm, responsive, and respectful partners in relationships? How are those skills nurtured and developed over time? Just as the children learn to give affection by having the experience of receiving affection, we learn to create nurturing relationships by having the opportunity to experience them.

We support the ability to be respectful, warm, and responsive in relationship to children by creating a climate where relationships among adults express these same qualities. Creating an environment for families where they are treated with respect, where power is shared, where strengths are celebrated, and where needs are addressed begins with creating a workplace environment in which these things are true for staff. Programs can take many actions that demonstrate that promoting the mental health of all members of the Head Start community is a priority.

A. Policies and Working Conditions That Promote Mental Health

Working conditions for staff make a significant contribution to their own mental health, and to that of the children.

• Caregivers with optimal adult-to-child ratios and fewer competing responsibilities (i.e., not also responsible for cooking, cleaning, etc.) touch, play, and laugh with children more.
• Caregivers in supportive environments are more likely than caregivers who feel isolated and stressed to have positive interactions with children.
• Working with families to achieve economic self-sufficiency is difficult if the family advocates themselves do not make enough money to support their full range of basic needs, including adequate housing, health care, childcare, and so on.
• It is important to model self-care for children and families through the ability and willingness to set reasonable limits, and by taking time for personal days off when necessary, using stress management techniques, and asking for consultation and help when overwhelmed, for example. This is enabled by supportive and health promoting policy.
• Conflict between and among adults in any workplace is inevitable. A valuable step toward violence prevention and mental health promotion is to model methods of peaceful conflict resolution that respect individuals and protect and value relationships.

B. The Mental Health Consultant: A Resource for Establishing a Mentally Healthy Workplace

All too often, limited mental health consultation resources are devoted exclusively to emergencies. However, when a mental health consultant only comes in to observe and handle referrals and/or treatment for a crisis, opportunities for ongoing relationships with the consultant, which can promote the morale and mental health of workers, parents, and children, are lost.

The mental health consultant can support a mentally healthy workplace through roles that may not be traditionally considered. In an environment where resources are scarce, it may feel like a luxury to use the mental health consultant to care for the needs of the staff and workplace rather than those of families. Creating a climate where staff can feel good about their work and grow as professionals, however, is no luxury: it is a basic ingredient that enables quality care for families.

Things that mental health consultants can do to promote a mentally healthy workplace for adults include:

• Help management institute regular supportive supervision;
• Attend staff meetings;
• Help mediate intra-staff conflict if requested;
• Facilitate staff support groups;
• Co-lead parenting classes or parent support groups;
• Provide ongoing in-service training; and
• Maintain a resource pool available to staff for their own and their families' mental health needs.

Because we are all human, the challenges that face Head Start families are often the same ones that face Head Start staff. Families ask staff to help them with threats to their mental health posed by economic hardship, violence, depression, and other difficulties. It is not uncommon for staff to be struggling with the very same stressors. Sorting out emotional reactions to the work from professional roles and responses is critical. This can only be accomplished with access to supportive relationships within which to think about the feelings that the work can stir up. Programs can help staff manage these feelings by:

• acknowledging that work in Head Start, like all work with young children and their families, is emotionally demanding and can touch us very close to home;
• providing a regular structure for supervision/consultation.

The essential features of supervision that acknowledge the emotional nature of Head Start work and support the ability of staff to promote the mental health of the children and families with whom they work are:

Reflection: The relationship with the supervisor provides a safe place to slow down, step back, and think about the work. It is a place where it is okay to process and learn from emotional reactions to situations, think together about responses, and clarify one's roles and goals.

Collaboration: Supervisory relationships share power and are collaborative in nature. Supervisors encourage the supervisee's growth as a professional. Communication is mutual and mirrors the kind of communication staff should strive for with families.

Regularity: All relationships take time to build, and if supervision is to be useful, a reliable allocation of time must be devoted to it. This will only occur when management supports this allocation of resources and protects it as a valuable contribution to quality services.

Questions for Discussion/Reflection

• Think about whether or not you have ever had a mentor. This may have been a teacher or supervisor in a work role, or it may be the older brother who taught you how to throw a ball the right way.
• What was it about that relationship that helped you go beyond your previous level of capability?
• Do you have any relationships like that in your current work life?
• For directors: What are the barriers to making sure that regular, high-quality supervision occurs in your program? Who could you meet with regularly to think about how to overcome those barriers and who could support you?

 For this activity you will need:

· flip chart and markers

Step 1: Explain to participants that people tend to understand concepts in terms of stories, their own experiences, or in metaphors. One of the most common metaphors in our culture is the metaphor of war. We talk about the "Battle of the Sexes," the "War on Drugs," the "War on Poverty." Metaphors structure the way we view reality and therefore can limit or expand our behavior and how we feel. Let's look at the war metaphor and see how it affects the way we think about and experience conflict.

Step 2: Ask the group to use war as a metaphor and brainstorm some ways people might describe an argument. What are some common expressions? List the suggestions on the flip chart. Some examples might be:

· He attacked every point in my argument.
· She shot down all of my suggestions.
· My points were right on target.
· If you use that strategy, you'll be wiped out.
· I blew her out of the water.

Step 3: Now ask the group to think of how we would describe the process of arguing if our metaphor were a dance. Some examples might be:

· We waltzed around.
· She tripped over every point I made.
· He couldn't get the rhythm of my suggestions.
· I can't find the music to go with her choreography.
· If you try that step, you'll fall down.

Step 4:Ask the group what feelings they get when they consider the first list. What feelings do they get when they look at the second list?

Step 5: Ask the group to brainstorm a common situation of conflict among adults within a Head Start work setting: an angry parent, a difficult health care or social services provider, a dispute with
a co-worker. Choose one situation which the majority of the group seems to find realistic.

Step 6: Now have the group consider that situation from the warrior or dancer position. Ask for volunteer "warriors" and "dancers" or assign groups. Give each group approximately ten minutes to develop the situation and to describe it in their metaphor.

Step 7: Ask each group to present the situation from its different perspectives. Discuss the different feelings about the conflict.

· In each model, what is the power relationship between parties?
· How does the metaphor affect the style and effectiveness of communication between parties?
· How does it feel to be an individual on a battlefield?
· How does it feel to be an individual on a dance floor?

Step 8: Ask participants to stay in their warrior and dancer groups and imagine the following situation:

The adult conflict portrayed above haslust occurred, and now it is time for you to return to the classroom or go out on a home visit. As you resume your work, a fight erupts between two children and adult intervention and guidance are required.

Ask the following questions:

· Considering your state of mind after the adult conflict, how do you respond to the children?
· Does the "warrior" group respond differently to the children than the "dancer" group?
· How might you apply these metaphors to relationships in the next few days?
· Are there ways to encourage the children to be "dancers" rather than "warriors?"

Points to Consider:

• In looking at the list with the war metaphor, what goals are there?To win, destroy opponent, kill... What about the dance metaphor? To make something beautiful together, to create, to enjoy...
• Conflict is inevitable. It can be troublesome and it can also be a chance for growth and creative problem solving.
• People in tense situations often become harsh and unyielding. If there is a way to defuse the tension-by looking at the situation in a "gentler" way-it opens the possibilities for a solution which is based more in consensus than win-lose.
• You have to have it to sell it. Nurturing children and families is hard when the relationships among adults in the workplace fail to nurture.
• What contributes to a workplace that is a dance floor rather than a battlefield? What can you do to turn a battlefield into a dance floor? What other metaphors help you think about the kind of workplace that promotes mental health?

· For this activity you will need to keep a brief journal for a week.

Step 1: Keep a brief journal of feelings about your work for a week. Every day after work, make note of any incidents during the day that were particularly stressful for you. Also make note of events or incidents that you found particularly satisfying or rewarding.

Step 2: At the end of the week, review your journal. Are there any patterns or types of events that are typically difficult for you to handle? Are there types of experiences that are always particularly satisfying for you? Take for instance:

Carolina is a teacher at Bueno Migrant Head Start, a site caring for children six weeks to four years old. During the week Carolina kept a journal. She had a lot of difficulty with Alejandro (a two-year-old). He snatched toys away and pushed the younger infants. Carolina knew that this was developmentally predictable for Alejandro, but she noticed that it always left her feeling very angry. Carolina asked herself why she had such a strong reaction to Alejandro. Gradually she began to think about her own childhood and remembered that no one stopped her two older brothers from picking on her. Carolina wonders if this is influencing the way she feels about Alejandro.

Maya, a family services worker, was surprised to see in her journal that she always felt very good about herself on days that she went on home visits to Winona 's house. This surprised Maya, because lots of the other staff at the Head Start center didn 't like to work with Winona. Winona has had problems with drugs and alcohol and her behavior can befrustratingfor staff Maya realizes that she draws on the things she has learned attending support groups for children of alcoholics. It helps her know how to be clear and set limits with Winona. She gets frustrated too-but also feels good about herself for knowing how to handle it.

Step 3: If the reflections in your journal have made you think about any events or situations that are stressful for you, spend some time thinking about any sources of support that you can draw on to help you deal with your responses. Is there a colleague you can talk with? Could a coordinator help provide resources or suggestions? For instance:

· Carolina realized that protecting the younger children from aggressive behavior triggers strong emotions for her. She was not sure that her reactions in those situations were too intense, but thought she could use some support. Carolina asked Jorge, another teacher in the classroom, to stay close to Alejandro and intervene when he was aggressive with the babies. Carolina paid close attention to her reactions and watched Jorge work with Alejandro. She feels better seeing that Jorge responds in a similar way, and reminds herself to stop and separate her intense reactions from her response when these types of events happen.

· Maya realized that she has a special affinity for working with parents struggling with substance use issues. She knows that she may have to work particularly hard at keeping limits and making sure that she is not falling into her family patterns of trying to rescue people with these problems, but she also knows that she has the special understanding and experience to be helpful. Maya arranges to talk with her health coordinator to locate drug and alcohol counselor certification programs in her area and also to look into the possibility of getting some extra supervision when working with families with substance abuse issues.

Points to Consider:

• Being aware of situations that trigger "hot spots" can help you deal better with the situation the next time around.
• Not all workplaces allow for exploration of hot spots and emotional responses to the work at hand. There are limits to how much personal "processing" is appropriate to share with co-workers.

For this activity each participant will need the following handouts:

• E-1: Kingpin County Head Start
• E-2: Headache Visualization
• E-3 Keeping Well-Hydrated
• E-4 Simple Massage

Step 2: Ask participants to read the story of Handout E- 1: Kingpin County Head Start.

Step 3: Ask participants to decide if the headache-reducing activities described in Handout E-2: Headache Visualization, might be helpful in their program. If so, ask them to choose a buddy person on staff who can support them in their efforts to try out these remedies. If these activities don't seem useful, ask participants to suggest some other small, tension-reducing activity which they could do on a regular basis. Use Handout E-3: Keeping Well-Hydrated, and Handout E-4: Simple Massage, as resources for this and for stress reduction "homework:" Suggest that their buddy be someone they see on a regular basis throughout the day who can cover for a moment for them if they need to be out of the room to practice this technique.

Step 4: Over the course of the next week, ask the participants to share with their partners the variety of headache-reducing techniques and other stress busters. Suggest that participants check in with each other at least once a day to see that their buddy is taking a few moments to try out this technique.

Step 5: After the week is over, ask participants if they noticed any change in the way they felt at the end of the day. If so, encourage them to continue these simple strategies. If not, ask them to talk with you about what other tension-reducing activities they could do on a regular basis.

Points to Consider:

• Headaches very often represent tension in some part of the body. Simple relaxation can relieve some of that tension and reduce the headache. Some headaches, however, are signs of illness. Any headache that involves severe pain, lasts for several days, or does not respond to the usual remedies should be discussed with a health care provider.
• It is very difficult for any of us to take time for ourselves to relax, to stretch, to get that extra glass of water. A buddy can help in giving us the time and reminding us to take that moment for self-care.
• Within any workplace, there are stressors which are out of the individual's control. If the worker cannot change the situation, he needs to change his own response to it in order to reduce tension.

For this activity you will need:

· One copy of Handout F: Action Plan for a Mentally Healthy Workplace, for each participant
· Flip chart paper & markers

Step 1: This activity allows a staff team to identify what it would be like to have an "Action Plan" in place to make the work climate supportive of members' mental health, and to set priorities and make plans to make those things a reality. Share with the group that this is an activity about imagining change. It may not be possible to make everyone's wish a reality, but the first step is to know what everyone's vision for a better workplace is. Because this is a brainstorming session, no one is allowed to comment on or criticize anyone else's idea.

Ask participants to call out their wishes for a workplace that would support mental health. List their responses on a flip chart. Remind participants that wishes can involve the areas of policy and/or practice, for example:

· Policy: Flexible scheduling for personal days, etc.
· Practice: Regular peer support meetings, etc.

Step 2: After every person's wishes have been recorded, ask each member of the group to choose three items from the list that are their priority items. Each person should choose the things that she feels would be the most important to her in achieving a supportive workplace climate that promotes mental health.

Step 3: Go through the original list and ask for a show of hands on each item to see how many people selected that item as one of their top three. The number of participants that chose the item should be listed next to it.

Step 4: Look at the wishlist and eliminate all items but the five that the largest number of people chose as priorities. Now ask the group to consider just these five items. From those five, have each participant select their top three priorities.

Step 5: Go through the top five items and again list how many people have chosen each item as one of their top three. From each item's "score," choose the top three priority items.

Step 6: Insert the top three priority items on a flip chart with four columns:

· The Wish
· Anticipated Benefits
· Available Resources
· Action Steps

For each of the three priority items, the group should brainstorm available resources. Be sure to include resources from private and public community agencies including volunteers, resources that parents could help contribute, agency resources such as the mental health consultant or health coordinator, training money, and others.

After considering resources, list two or three action steps that could move the wish a step closer to reality.

Points to Consider:

· People in work groups have overlapping needs, and it is possible to come to some consensus on at least a few ways to improve the workplace.

· Sometimes it feels risky to suggest ways to change a workplace. What if the management team or your supervisor disagrees? New management philosophy recognizes that often the changes that result in improved quality are those that are suggested from the front lines.

· Sometimes, institutional change is impossible to effect. In caring for our own mental health, we need to build in strategies that we can control ourselves, for example, using lunch breaks for exercise or meditation.

Next Steps: Ideas to Extended Practice

Identify Sources of Support for "Hot Spots"

If it feels "safe" and if you choose to do so, share the results of your journal exercise from Activity 2: Hot Spots with a peer or supervisor. Together identify possible sources of support. Agree to pursue one source of support and set a date to check-in with each other about whether or not that was helpful.

Make a Presentation to the Policy Council

Take the results from Activity 4: Care for Caregivers: Creating a Mentally Healthy Workplace, and make a presentation to the Policy Council to get its input on concrete action steps to improve the workplace.

Review the Mental Health Component Plan

Review the mental health component plan and assess whether or not it considers the mental health of and relationships among staff. If not, how might it be modified? Real attention to the mental health of staff may mean reallocating mental health resources.

Build on Trainings with Activities from other Guides

Build on this training with activities from Communicating with Parents, another curriculum from the Training Guides for the Head Start Learning Community series. Although this training resource has been written to promote communication that builds partnerships with parents, the fundamentals of improving communication can apply to all adult relationships in Head Start.

Handout E-1: Kingpin County Head Start

The staff at Kingpin County Head Start has been working for some months on a work place-weilness program. Led by their health coordinator, they have held a number of staff meetings to look at the various challenges to health which they feel exist in their jobs. They have looked at the information their program has about lost work days and discussed the various issues over their lunch breaks. They have managed to make a few positive changes in their workplace: they now have a separate area where they are able to take brief breaks from the activity, and they contacted a local bottled water and juice distributor who is willing to donate beverages to their center for staff use. In this way they hope to cut back on the amount of soda and coffee they are drinking.

However, they have noticed that, despite their efforts, headaches are a still a major complaint within their work group. Some staff members are out of work occasionally because of migraines, but many staff members find their heads aching somewhat regularly at the end of the day. Although a few of the staff members remain unconvinced of the need to address the issue, they are certainly not opposed to addressing it. The staff has had discussions with the physician who is on their Health Services Advisory Committee, with a massage therapist who works at the local hospital, and with the curandera who is consulted by many of the Latino parents in the program.

Staff have learned a number of relaxation and headache-stopping techniques from these practitioners. They are:

• Keeping Well-Hydrated. Drink lots of water.
• The Headache Visualization
• Simple Partner Massage

Handout E-2: Keeping Well-Hydrated

Our bodies are made mostly of water. It stands to reason, then, that we need to drink lots of this precious fluid. It is sometimes recommended that each adult-when not exercising heavily should drink eight 8-ounce glasses of water each day. When active or hot, we need more. Some of this liquid need can be met through drinking other kinds of bever ages. However, coffee and sodas may have caffeine or other additives which do not help with our bodies' water needs. Many people find that dehydration leads to headaches. Others find that stopping for a moment to get a glass of water helps them to pace them selves. Those who are inclined to smoke cigarettes or nibble nervously on foods which are not nutritious find that substituting water for nibbling can appease the nervous appetite.

Consider the following strategies to increase your water consumption:

(1) Have a special cup which you enjoy. Keep it filled with water at your desk or other work-space.
(2) Remind yourself to drink a few sips of water at specific times of the day.
(3) Get a glass of water each time you are at the sink, washing your hands or helping a child.
(4) Flavor your water with a slice of lemon or orange.
(5) Consider the cost of purchasing beverages such as coffee or sodas. Try to encourage yourself to drink water instead by keeping a jar for coins that you save from not drinking the more expensive beverages. Buy yourself a reward!

Handout E-3 Headache Visualization

A peaceful way to make a headache go away:

Close your eyes. "Look" for the headache inside your head.

- See what color it is.
- What shape is it?
- Where is it?

Look for the headache again.

-Is it still there?
- Is it the same size?
- Is it the same color?

Look for it again. Repeat the same questions to yourself. See if the headache changes shape or color. Keep breathing slowly and deeply.

Why it works:

The theory behind the visualization is that, by stopping and slowing down, we break the pattern of tension that may be causing the headache. Deep breathing assures that there is airflow to all parts of the body. Focusing on the site of the headache encourages blood flow to that area and encourages the expansion of blood vessels and the reduction of pressure.

Handout E-4: Simple Partner Massage

• Coaches should make sure that only persons comfortable with this activity participate. Individuals should choose their own partners. Give participants permission not to do this activity if they would prefer not to.
• The recipient of the massage should sit down in a comfortable chair which allows the helper to reach her head, neck, and shoulders.
• The helper should stand behind the chair, and ask the recipient to relax and let her head fall backwards while the helper supports it.
• Ask the recipient to really relax, to let go of the weight of her head (our heads weigh up to 25 pounds!) and to feel like a baby; to let go of holding up her head.
• While supporting the recipient's head against the helper's chest, the helper should gently stroke the forehead and temples of the recipient. Feel the tension melt away.
• Next, ask the recipient to lean forward, placing her forearms on her knees, supporting the upper part of her body. Her head should fall forward comfortably. The helper should use her fingertips with whatever amount of pressure feels good, and massage the neck and shoulders. Press gently and firmly from the base of the neck out over the shoulders.
• After a few moments, ask the recipient to let her upper body fall forward so that her chest is almost resting on her knees. Her hands should be loosely falling toward her feet. Ask her to wiggle her shoulders, roll them about, and then gently roll back upwards to a sitting position, taking the time to roll from the base of the spine all the way up until she has her head upright again.
• Change places, so the helper gets a turn as the recipient.

Invite a speaker familiar with the topic and build on the discussion by asking key community agencies to come together to develop an action plan for a mentally healthy community.

2.Become a mental health promotion instigator for your community!

The National Mental Health Association (NMHA) offers manuals that provide a comprehensive framework for bringing proven prevention programs to your communities. Two recommended publications are, Getting Started.: The NMHA Guide to Establishing Community-Based Prevention Programs, and Getting Started: The NMHA Directory of Model Programs to Prevent Mental Disorders and Promote Mental Health. For ordering information, contact the NMIIA in Alexandria, Virginia, (703) 684-7722.

3. Create an action plan to make your program a welcoming place for the men in the lives of your children.

A good resource to get you started is Getting Men Involved: Strategies for Early Childhood Programs, available through the Fatherhood Project of Families and Work Institute. The same project also has developed a self-assessment tool called the Male Involvement Profile to help programs to assess how pro-active they are in engaging men. Get more information on both resources from The Fatherhood Project of the Families and Work Institute, (212) 465-2044.

4. Invest in skills that build resilient children and families.

Al's Pals: Kids Making Healthy Choices is a resiliency based substance abuse/violence prevention preschool curriculum, accompanied by training sessions and technical assistance for teachers. The curriculum provides short, fun lessons designed to foster specific resiliency characteristics in children. The curriculum kit, available to trained teachers, includes puppets, original songs on audiocassette, a songbook, parent letters, home-school messages, and color photographs.

5. Design trainings for parent education group leaders.

The resiliency based parent education series, Here, Now, and Down the Road.:: Tips for Loving Parents, is designed to enhance parent's skills in guiding their children toward healthy life-styles: Parents learn practical tips for daily interactions which help their children develop positive social skills and shape their children's attitudes to favor peaceful resolutions and health.
 

For further information on Al's Pals: Kids Making Healthy Choices and Here, Now, and Down the Road... Tips for Loving Parents, contact Resilient Children Making Healthy Choices, at Virginia Institute for Developmental Disabilities/VCU, P.O. Box 843020, Richmond, Virginia, 23284-3020, (804) 828-8586.

American Orthopsychiatric Association Task Force on Head Start and Mental Health. Strengthening Mental Health in Head Start: Pathways to Quality Improvement. Report of the Task Force on Head Start and Mental Health. New York: American Orthopsychiatric Association, 1994.

American Orthopsychiatric Association. Lessons From the Field: Head Start Mental Health Strategies to Meet Changing Needs. New York: American Orthopsychiatric Association, in press.

These reports highlight 12 Head Start programs and the range of strategies they use to promote emotional well-being among children, families and staff, and to provide specific interventions.

This book is a "map of behavioral and emotional development" for the infant and toddler years. The book is arranged chronologically by child age but also includes chapters on common areas of concern including discipline, loss and grief, toilet training, temperament, and many others.

This is a workbook for parents by the researchers who developed the concept of "goodness-of-fit between a child's temperament and environment."

This is a workbook that describes characteristics of healthy families and offers activities to build those skills and characteristics.

This practical parenting book is about acquiring skills in effective communication with children. Special attention is given to helping adults .listen to children's feelings in a supportive, understanding way without judging the feeling or offering to "fix" the situation. This can be used as a organizing curriculum for a parent education group.

Jorde-Bloorn, P. "Teachers Need TLC Too." Young Children 43, no. 6 (September 1988): 4-8.

A Great Place to Work: Improving Conditions for Staff in Young Children 's Programs. Washington, DC: National Association for the Education of Young Children, 1988.

These manuals offer strategies on how to improve the child care center environment (which also applies well to Head Start) for the benefit of staff, parents, and children. They identify the qualities of an organizational climate that support positive professional attitudes and shared decision making.

This is a practical guide for program directors on how to develop a sense of responsibility for quality improvements (including staff morale) that is shared collectively by staff. Includes tools to assess the needs of the center as a whole as well as needs of individual staff including a process for designing an individualized model of staff development.

This book for parents is about understanding their child's temperament and structuring daily routines and activities to "fit" so that everyone experiences less conflict. A particular strength of this book is encouraging parents to see the strengths and positive attributes in their "spirited" (often referred to as difficult) child.

This guide for infant and toddler caregivers offers practical guidelines and suggestions that focus on the caregiver becoming sensitive to the individual traits and needs of infants and toddlers, and creating emotionally nurturing relationships with them.

Overcoming the Odds: High Risk Children from Birth to Adulthood. Ithaca, NY: Cornell University Press, 1992.

Emmy Werner has done some of the best resiliency research in the literature. This book looks at outcomes for the cohort that she has followed from birth at age 30: She and Smith describe a common core of individual differences and sources of support that buffer responses to constitutional risk factors and/or stressful life events.

Mengel, Patrica N. "Mental Health in Migrant Head Start." Arlington, VA: East Coast Migrant Head Start Project.

An overview of mental health and family support issues for migrant Head Start families. Includes videotapes in both English and Spanish, training manual, and workshop outline.

This guide, written primarily for the mental health coordinator in a Head Start Program, assists in the development of a program's mental health plan.

As I Am is a resource book for early childhood education programs. The book describes experiences and activities for children that promote self esteem and mental health. Instructions for each experience include the benefits of participation, what the adult needs to do to prepare, and how to facilitate the experience. Many of the activities include guidelines for parents offering ideas to extend the learning from preschool to home.

A skill-based training program for staff in the education component. There are practical strategies for working with children in multi-stressed environments. The program has been organized into an eight session training program which ends with staff providing ongoing peer support for one another.

The American Orthopsychiatric Association
330 Seventh Avenue
New York, New York 10001
(212) 564-5930

Families and Work Institute
330 Seventh Avenue
New York, NY 10001
(212) 465-2044

National Center for Clinical Infant Programs/ZERO TO THREE
2000 14th Street #38C
Arlington, VA 22201
(703) 528-4300

National Mental Health Association
1021 Prince Street
Alexandria, VA 22314-2971
(703) 684-7722.

National Center for Children in Poverty
154 Haven Ave
New York, New York 10032
(212) 927-8793

Videos

Mental Health in Head Start: It's Everybody's Business. VHS videotape and discussion guide. Also available in Spanish. Available through the Head Start Publications Center, P.O. Box 26417, Alexandria, VA 22313-0417. Fax order request to: (703) 683-5769.

Mental Health in Head Start: A Partner for Families. VHS videotape and discussion guide. Available through the Head Start Publications Center, P.O. Box 26417, Alexandria, VA 223 13-0417. Fax order request to: (703) 683-5769.