They may come from criminal court, where they have been
placed on probation for crimes as small as petty theft and as large as
attempted murder. They may come from the
child welfare system because their mothers have abused, neglected or abandoned
them or because they have abused, abandoned or neglected their babies. They
are as young as 12 and as old as 19. Despite the many differences among them, they
all hold one thing in common: All are mothers
In addition, most have failed at school, experienced
physical or sexual abuse, and/or suffer from depression, anxiety or other
mental health problems. And all are fortunate to participate in the Young Parents
Project.
This magnificent program, based on Yale University’s Minding
the Baby model, which integrates nursing, mental health and social work support
for teen mothers and their children, aims to break the cycle of poverty, delinquency
and teen parenthood. It began when Miami Circuit Court Judge Lester Langer
launched a program to heal the mothers, help them raise well-nurtured babies,
and change the destiny of young families in trouble.
It’s a tall order. The girls, who enter the program either
pregnant or already parenting, rarely have had strong, positive role modeling. They
don’t know how to make a business call on the telephone. They don’t know how to deal with the person on
the other end ifs he is at all negative or obstructionistic, so they have
trouble making appointments and obtaining information. Even accessing transportation is a challenge.
Worse, for many, trauma has tied one generation to the
next. Violence is often prevalent, and
their communities often lack the resources to help. One participant, a
15-year-old with a two-year-old and eight months pregnant, lives in a
three-bedroom home where mattresses on the floor sleep 10 – four adults and six
children, four of whom are teen parents themselves. This 15-year-old needs
prenatal care and an education. Her baby needs quality daycare, healthcare and
immunizations. Mom needs to learn and follow good health practices for herself
and her child. She needs to connect with the health and social service
resources in her community. And she must
learn to understand her child’s needs and nurture him. Then there are her mental health needs. Like almost every other teen parent, she has
a history of sexual abuse, which she must address before it affects her ability
to parent and protect her child.
“We have a chance right now, at this age, to work through
many things with them,” said Barbara White, who directs the Miami program. “This is a group of young women with
possibilities and hope, and if we can work with them over time, we can make a
difference.”
However, If the girls’ problems are allowed to become more
deeply seated, they will likely wind up in prison.
And so a nurse, a social worker, and an infant mental health
specialist take on the young family, visiting them at home once a week for two
years. The intervention aims to give mom the skills to organize her life and
access needed services, new strategies for managing problems and stress, an
understanding of her child’s needs, the skills to meet those needs, and a head
start on processing her trauma.
Task number one is school for mom and baby. One in every two girls in the program is not
in school at entry, and bad past behavior often makes schools reluctant to
readmit her. So the social worker advocates
to get her into school, ideally one that has high quality childcare onsite or nearby. The nurse makes sure mom and baby have a
medical home – an office or clinic that quarterbacks the family’s medical care
– that mom is getting routine adolescent and/or prenatal healthcare, that baby
is getting regular checkups and timely immunizations, and that mom understands
her medical instructions and the information on medication labels. Mom also
receives help obtaining needed documentation (e.g., birth certificate) and
applying for Medicaid and other needed social services.
For the first three weeks, the entire team visits together
so that the teen can see the three professionals work as a team. At
the outset, she is likely to be resistant and distrusting. Typically, the girls served by the project
move frequently. Phone servicer gets cut
off and phone numbers change. In
addition, they don’t know how to act on mail they receive. For all these reasons, the teens have
commonly had bad experience with other agencies. But Young Parents is
different.
Whereas other agencies give up, “we are consistent and
persistent,” Barbara said in unison with Juanita Armbrister, care coordinator
and team leader. They do outreach. They
give the families their cell phone numbers and make themselves available
24/7.
Gradually, the team gains trust. As the team visits, adults living in the
household watch the interaction. They
see that the teen is relating to another adult and so perhaps there is hope for
them as well.
“Definitely there is carryover,” said Barbara. “The family
is watching.”
One of the most essential components of the program is
dyadic intervention. With mom and baby on the floor together, the
therapist focuses on the development of the mom, development of the baby and
development of the relationship between them.
When mom was small, she likely experienced little playtime and too
little nurturing communication with her own adult caregivers. In dyadic therapy
she learns about play as a way of joyfully interacting with her child. Working to “hold the baby in mind,” i.e., to think
about what every life experience means to the baby, the therapy asks how things
are going. She asks, “What do you think this
experience means to your baby,” and “what was that moment like for your child?”
The therapist also talks to the mom about how she was
parented and the differences between what she experienced and what she is
learning. If mom mentions an unhappy
experience, the therapist asks, “What was that like for you? What do you think
it would be like for your child?” Through this process, mom develops empathy
and concern for the baby. She comes to
realize that almost every decision she makes will affect her baby, and so she
makes good life choices: going back to
school, dealing with court issues, and getting good healthcare, to name a few.
“We believe the approach will keep the young families safer
in the community because the teen begins to take on the role of the parent,
identify herself as a parent, and think that her decisions make a difference
for the baby,” said Barbara.
The program is equally intensive as it helps the moms
navigate their court experience. As they
transport each mom to court, they talk about the hearing, what mom can expect,
how to speak respectfully to the judge, what questions she might have for the
judge. Once before the judge, the Young
Parents team member stands with the teen, offering her valuable support. When
the mom has trouble expressing herself, she will look to her Young Parents
supporter for help. After the hearing,
the supporter helps the girl process what transpired and make sure she
understands it. This support helps mom gain confidence in the court process,
and as a result she is more likely to express her needs and wishes to the
judge.
The Young Parents Project, under the auspices of the Florida
State University Center for the Prevention and Early Intervention Policy, has
been operating in Miami-Dade County since 2007.
By June 2013, the program has served approximately 200 young
families. Compared to a comparable
population, pregnant teens coming through the program have had fewer babies
born at low birth weight and fewer closely spaced subsequent pregnancies. While
the girls who entered the program from the juvenile justice system (as opposed
to the child welfare system) had as many as seven arrests prior to entering the
Young Parents Project, 99% had zero arrests during their two years in the
program; the University is currently tracking the status of girls who
graduated. As for those in the child
welfare system, the number of teen mothers who retain or regain custody of their
children has risen.
Barbara attributes success to the intervention itself. The girls learn they can begin to trust
others and they come to learn about and trust the enormous web of community
services available to them. They also learn that as they become more
appropriate in their behavior, they win the support of others. And they learn
that with a baby and keeping the baby in mind, they can change their future.
LJ (who requested anonymity for herself and her son) is the personification
of this success. In foster care from the
age of 10, she became pregnant at 14 and gave birth to her son, DJ, at 15.
She was predictably resistant to Young Parents’ intervention at first,
believing she knew everything and didn’t need any help. But gradually she yielded, and although she
has graduated from the program still calls Juanita when she needs help. Just recently, Juanita accompanied her to look
at a new daycare for DJ, and, LJ reported, asked questions LJ herself hadn’t
even thought about.
Equally important, LJ and DJ are on a solid path toward a
successful future. With Young Parents
urging, they moved into Casa Valentina, supportive housing for girls aging out
of foster care( See "Casa Valentina: Living, Learning, Growing," Programs That Work, February 2012). LJ graduated from high school in June 2014,
is working in a medical office, and will begin college classes in
September. At three, DJ is an articulate
and engaging boy who grins broadly, hugs hard, and likes having his matchbox
cars in the bathtub.
The Miami Young Parents Project is one of two sites for the
Florida State program, the other being in Tallahassee. The Miami project
employs two treatment teams (six professionals) who, as of June 2014, were
serving 32 families throughout the vast Miami-Dade County. The Miami office operates on a budget of
approximately $500,000 a year with funding principally from the Children’s
Trust, FSU, the Department of Juvenile Justice, and matching funds from the Agency
for Health Care Administration.
Young Parents Project
Juvenile Justice Center
3300 NW 27 Avenue, Room 1162
Miami, FL 33142
305-638-6774 ext. 262
