Progress definitely came this week; slowly but surely. As hoped for a monthly schedule for the caregivers has been completed, marking each Friday as the day for our meetings together. This also meant that today marked our second meeting together. Attendance from the caregivers was excellent, but was subpar for the sisters (although frankly more than expected). Hopefully as time goes on the presence of the sisters will increase. After having them complete a caregiver knowledge survey I developed, I opened the session with a funny YouTube video to remind them why we all love children. Moving on to the lesson, I really pounded home the need for positive feedback and encouragement; especially specific, immediate praise for good behaviors. I had them write lists of positive/negative aspects about the children, as well as practice giving positive feedback to each other. The importance of not bringing up past poor behaviors or combining positive/negative feedback was also discussed. When children constantly hear reminders about negative behaviors these behaviors remain on their mind; when children constantly hear praise about positive behaviors the same holds true. I encouraged them to continue with the good work of designating chores for the children and getting all the children involved in participating.
The staff asked many good questions and scenarios regarding the material, demonstrating that they were both paying attention and seeking more knowledge. Several of their questions related to the material I prepared for next week (establishing rules and instruction-giving). A few admitted to not realizing when they yell or criticize because they are so used to acting in this manner. In my mind this reflection already marks a victory-- now we need to find a solution. Videotaping their interactions with the children will commence this week, as I obtained their consent to do so. This will definitely serve as a powerful teaching tool, as well as an evaluative component of the train-the-trainer program. I also posted several quotes regarding change to serve as reminders for the staff (and children) to continue working towards changing. Iulia and I are still learning how effectually execute the oral translation process, but we will undoubtedly have much practice. For me specifically, being more conscious of my terminology and phrasing will help Iulia immensly in this process. In this way she will not be translating from English-Romanian and then from complex Romanian-simple Romanian.
On Monday Iulia, Madalin, Catalin (the "OT"), and I met again to discuss the design of a potential program for parents and their children. Parents with children between the ages of 12-16 years old who experience behavioral problems comprise the target populations. Delivered one weekend a month, the program will provide instructional material and interactive activities for both the parent group and the adolescent group, with a combined activity at the conclusion of each session. Interviews with the parents and children will be conducted the first week to ensure client-centeredness. As of now evaluative components include a parent knowledge survey, an adolescent behavior self-report, and an observation session. The location, still to be determined, will optimally be a quiet, spacious cabin area in the mountains with easy access for the families. Clearly many more details and considerations must be resolved, but we established a fairly firm foundation. Weekly or bi-weekly meetings will continue to occur until the program is off the ground. If things go as planned the first session (or two?) will be implemented before I leave.
After the discussion (and throughout the week) I headed to the literature to see what evidence-based elements exist for similar programs. Luckily I found that our design is headed in the right direction. Some key components that primarily influence outcomes for parental-based programs include: active participation, practicing interactions with their own child, emotional communication skills, consistent responding techniques, and strategies for positive interactions. Similarly, child-based programs demonstrate positive results when integrating the following: positive reinforcement of good behaviors, coached role-play, regular social "dates" with friends, handling confrontation with adults, anger management/avoiding fights, and meeting friends/praising others. Barriers I anticipate consist of transportation, other siblings, gender differences, influence from the child's peer group, and other stressors at home, to name a few. While all of these will not be resolved we can work to diminish several of them.
Definitely excited for what the coming week brings!
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