Open Communication

Previous posts have stressed the benefits of open communication in families for coping with trauma and other stressful events.

When school social workers meet with students who say that they "don't want to talk to their parents about their problems," do we collude with family separation and secrecy or do we explore the ambivalence in an effort to promote parent-child communication?  This is why I tend to meet with parents first.  I don't want to get caught in a position where I am being asked to "swear to secrecy" (suspected child abuse, suicidal and homicidal ideation notwithstanding) and feel pressured to triangulate with a student against a parent.

The dance of attachment security (also addressed in previous posts) involves a caregivers attuned responses to a child.  That is, providing proximity, soothing and support to a child in distress.  Support that is well-matched to the child's needs.  This is no easy dance.

What we know is that attachment security (fluid and elegant dancing) mediates and moderates the development of PTSD and other psychopathology.  Studies have examined the relationship between attachment security and PTSD symptom development among war veterans, holocaust survivors, targets of domestic violence, and victims of child abuse.  It significantly mediates and/or moderates every time.

If a child (or adult) does not have a partner in this dance, then what soothes the distress?  Substance abuse, self-mutilation, isolation?  There are studies about this too.

If attachment security is so powerful, then when students say, "I don't want my parents to know," do we leave it at that?  Or do we explore and engage in an effort to bring the child back into a dance with a willing caregiver that protects and soothes in times of distress? 

The Substance Abuse and Mental Health Services Administration (SAMHSA) conducted a national survey of school mental health services in 2002-03.  The most common types of services, reported by more than 80% of schools, included assessment, behavior management consultation, crisis intervention and referrals.  More than 70% of schools also reported individual counseling, case management and group counseling as common services provided.  Schools reported that among the most difficult services to deliver were family support services (Sopko, 2006).

What is the disconnect between school mental health services and families?  How do we bridge the gap system-wide?