Interview with Natasha Collins, Marriage and Family Therapist in San Francisco, CA

4.) KP: What are the strategies you have used to help young people and their families?

Given the lack of basic needs being met, my initial strategies are to help the youth and families access resources, which can help address meeting basic needs. It’s very hard to address symptoms of depression and anxiety if you’re worried about where your next meal is going to come from. So, initially I spend time linking clients to things like financial resources in the community, or support with housing programs.

Early on, I provide a lot of psycho-education. There’s a lot of misinformation or no information at all about mental health in some of the communities that I serve, and oftentimes, youth and families don’t really have a clear understanding of how impactful a trauma or a death can be in their lives. For instance, they may notice that they’re having unpleasant symptoms, but they don’t really understand what they mean or why they’re there.  Providing psycho-education about what they may be experiencing, naming that, normalizing it, and coming up with some strategies for ways to help them cope with those symptoms is something I work to do right away.

Developing new and more effective coping strategies and skills to manage difficult feelings and stressors is a goal I work to address with almost all my clients. I work collaboratively with my clients to help them identify healthy and safe outlets through which they can express and process feelings.  I strategize how my clients can build and strengthen their support network, as they often experience feelings of isolation.

Sometimes it can be important to make referrals to other medical professionals like psychiatrists.  Some of my clients are experiencing depression or anxiety that is debilitating and impacting their ability to function daily.  A medication evaluation can be a helpful and crucial link.

KP: After you’ve done the stabilizing pieces with the case management, I’m curious to know about some of the things you’ve done to help the parents in particular?

Natasha: A lot of time the parents that I encounter feel very helpless and powerless. They don’t quite know what to do or how to best support their child; taking care of themselves alone is a struggle, in light of the poverty and trauma they face in their communities. So, one thing I do with families here at Seneca Center is look at building up and developing a support network for them. Sometimes it’s a formal support like a parenting group.  Sometimes it’s helping them identify who in their family they can go to when they’re feeling overwhelmed.  It’s so important for parents to have somebody to talk to, so they don’t feel completely alone and isolated. That tends to be a common feeling that parents often express, the feeling of isolation, the feeling of being alone in their struggle. Linking to supports both informal and formal is very important and works to ensure that a parent will feel strong and supported and better able to learn and implement new parenting techniques.

The parents I work with are often looking for guidance and support with learning how to more effectively respond to their child’s behavior.  I spend time teaching parents about the importance of establishing structure and creating an environment in which their child knows what to expect when they engage in various behaviors.   I help parents identify the behaviors they most want to see from their children and identify ways they can work to encourage and reinforce those behaviors.  In addition it is important for youth to know what the consequences of inappropriate behaviors are and be consistent enforcing them. Generally, parents are most frustrated and overwhelmed by negative behaviors of the youth that may or may not be related to their mental health problems. So, working with families to help them come up with plans for how they want to respond to certain behaviors can be quite effective and help parents feel like they have some power and more control over what’s happening in their home.

Another intervention I use with parents is to encourage them to focus on rebuilding their relationship with their child.  For example, I will ask that they plan to spend time engaging in a positive or fun activity together.  So much time and energy can become focused on problems and what’s wrong, so shifting focus on some of the things that are positive, like their child’s strengths and how much they love each other can be very effective and reparative.

KP: That’s great, I would imagine that by working with not only the youth, but their families, you’re able to provide a more comprehensive level of service than if you were just working with the youth in isolation. I imagine that this experience also has been really informative to you as a clinician, as working with the entire family system gives you a broader perspective than you get from just one on one work.

Next Section: 5.) You have had the unique experience of working as a psychological consultant to military members and their families.  What did you do in that role?

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