Supporting Early Childhood Mental Health: Supporting Parent’s Nervous System Regulation
Welcome back!
Today we’re talking about parenting- supporting caregivers to parent in a way that aligns with their values. The focus of this post is supporting caregiver regulation - keep reading for some background and make it to the end for some strategies I use!
This post is a bit of a different take than the, sort of typical, ‘key parenting strategies’ or ‘how to be a better parent’ vibes. One of the central ideals I hold in my work is that caregivers of every gender, race, sexual orientation, national origin, religion, ability status, and identity want to do the best they can by their children. I approach working with caregivers as though they have the innate knowledge and wisdom they need about how to parent their children. There are certainly times when some additional skills, insight or support is needed in order for children to truly thrive. I see my job as an early childhood mental health provider as one in which I partner with parents to support them in meeting their own parenting goals NOT on in which I am there to teach them the right way to parent.
One of my favorite principles from Brazelton’s Touchpoints model (linked below) is the idea that every parent wants to do well by their child. And…every provider wants to do well by their client.
You might be thinking- she must just be working with parents who are all “pretty good parents” or “she’s not working with the families I work with who have hurt their kids.” Welp…yes I do! When I say all caregivers, I really mean all caregivers! In my almost 2 decades of working with kids and families, I have yet to meet anyone who truly did not want the best for their child. I have worked closely with parents whose difficulties regulating themselves and supporting their children turned into abuse. I’ve worked with families in which the ghosts of caregiver’s own childhood reared their heads and caused harmful parenting patterns to emerge. I’ve worked with caregivers who truly believed that even though they were [hit, whooped, yelled at, etc.] they turned out fine so it’s what they’re choosing to pass along to their children. I’ve also worked with parents who have had lives of abundance- supportive family and friend relationships, access to education, food, housing, transportation, leisure activities and, as a result, are able to approach parenting from a regulated, supported place.
Parenting as a Co-Occupation
As an OT, I think about caregiving partially in terms of occupation. The most recent OT Practice framework says “caregiving is a co-occupation that requires active participation by both the caregiver and the recipient of care. For the co-occupations required during parenting, the socially interactive routines of eating, feeding, and comforting may involves the parent, a partner, the child, and significant others (Olson, 2004).” (OTPF 4th ed, 2020 p 9).
There are a few important things to keep in mind when supporting caregivers
Caregiving involves both the adult and the child- what the child brings to the caregiving situation matters
We are looking for “goodness of fit” between caregiver and child, not a perfect caregiver
We can model what we hope caregiving looks like through our work with caregivers
As is now a common theme in this blog, caregiving is an extraordinarily complex endeavor that requires a near impossible amount of work and resources from the people who do it. It requires
Regulation
Connection & relationships
Critical thinking & reflection
Supporting parents at each of these three levels allows us to attune to the individual caregiver we are working with and build a parenting style alongside them that they feel aligns with their values. When we support the process of parenting in a values-driven, we are more likely to form deeper connections and avoid giving lots of information that a person doesn’t want and won’t use.
Supporting Nervous System Regulation for Parents
Just as with children, adults require self and co-regulation skills in order to participate in all the activities they need to do throughout the day. As the Neurosequential Model and many others teach, when the nervous system is regulated, the brain is able to devote more capacity to higher level functions. When the nervous system is dysregulated, the brain focuses on survival.
Parenting from a survival state might look like
Giving in to all demands of the child to avoid conflict or meltdowns
Missing the child’s subtle cues or bids for connection & attention
Feeling burned out and unable to get ahead of a child’s needs, always catching up
Feeling as though the child is out to get them, manipulating them or doing things on purpose
Parenting from a regulated state is more likely to look like
Holding boundaries that serve long term goals in the relationship
Being more attuned to the child enabling them to notice small changes or cues from their child
Holding longer-term plans in mind when making minute-to-minute or day-to-day choices
Having a broader or more neutral view of child behavior- very young children aren’t planning to frustrate their caregivers!
We can support regulation of caregivers in a number of ways
Use adult versions regulatory strategies we use with kids!
In person:
Let caregivers choose a scent for an aroma therapy diffuser (natural essential oils only!)
Check in with caregivers about lighting & room temperature
Encourage caregivers to bring snacks/beverages to meetings if they want
Sit at a 90 degree angle instead of face-to-face during meetings
Provide fidgets during meetings
Virtual
Encourage caregivers to be in a place that’s comfortable and private
Refrain from using a virtual or blurred background so it’s easy to see that you too are in a private, confidential setting and no one can see or hear them
Watch their cues closely and offer breaks as needed- maybe a break to get up but often shorter breaks where conversation lightens a bit can be very helpful
Refrain from judgement- be curious! Feeling judged is highly dysregulating and will prevent honest and vulnerable work from happening
Focus on your own regulation so you can co-regulate as needed. When you are regulated, you are able to help them regulate, if you’re dysregulated, you’ll both stay dysregulated
Model Skills We Want Caregivers to Use
There are always parallels in therapeutic work between how we are with clients and how they are with their communities. When working with parents, our goal should be to engage with them in the same way we hope they engage with their child. Using the regulation strategies above is one example- if I’m explicit with a caregiver - “I’m just checking to see if you’re comfortable because I know it will be easier to talk about these difficult topics if you’re not too cold or too hot in here” it signals to them that it makes sense and is often even helpful to take care of someone’s regulatory needs prior to expecting cognitive engagement. When they get home to their child maybe this will translate to “I’m going to turn the TV off so it’s quieter to make sure you can concentrate on what we’re doing.”
By showing up in a regulated, present, attuned, interested way, we allow caregivers to feel what it’s like. It gives them an implicit clue into what it will be like for their child when they show up that way. This isn’t a one and done strategy, it’s a part of the work that is often unnoticed but over time will build!
There are so many considerations in working with caregivers! Many of us are taught that the child is our client but it’s just not true in early childhood work! Dedicating real time to thinking about how to work best and best support caregivers of your clients is worth so much more than proceeding as though they are there to simply agree and execute your plan. These are the people who will be in our client’s life forever, long after we leave. It’s absolutely essential that we treat them as the core part of the intervention team and focus our efforts on making them into the strongest, most resilient and capable caregivers we can!
I hope this post was useful! In the coming weeks we’ll continue with this theme and get into supporting connection & relationships with caregivers and providing psychoeducation in a way that aligns with caregivers needs and preferences. Let me know what else would be helpful to read about here! Open to all of your suggestions and ideas!
Resources & References
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi. org/10.5014/ajot.2020.74S2001
