Over the past two years, the San Francisco Psychoanalytic Institute (SFPI) and Society have developed a challenging pilot program: preventive mental health services for high-risk young children. SFPI&S collaborates with the Burnett Children's Center, a large preschool run by the San Francisco United School District, located in Hunter's Point, a socioeconomically disadvantaged area of the city. The program, a unique experiment in community outreach and education, is part of a larger child development program sponsored by the society.
About three years ago, in the face of insufficient funding for the society's many educational programs, the San Francisco Foundation for Psychoanalysis was formed. The foundation, an independent non-profit corporation established by the society's board of trustees, initiates outreach services to the community at large and raises funds as contributions to these public service efforts. The foundation holds these funds, together with an endowment that affords greater asset protection to these assets than if they were held by the society. The outreach programs become part of the work of the society. The child development program, although only one of many such projects, is an effort to make available to the public a psychoanalytic understanding of children's problems and development.
The child development program was an outgrowth of the Child Analysis Committee of the institute which has for ten years offered educational services to nursery schools, parent's groups, educators, and child psychotherapists in the larger Bay Area community. Phyllis Cath initiated the program with yearly classes for preschool directors and teachers on child development. For the past three years Zenobia Grusky has been in charge of a program offering on-site consultation to preschools. This combination of didactic courses and clinical consultation has been a powerful tool, allowing teachers to conceptualize problems and communicate effectively with parents. Additionally, Jan Baeuerlin and Graeme Hanson have been teaching postgraduate child psychotherapy seminars to interested therapists. These efforts have been very well received in the educational community.
Two years ago the child development program became part of the society and expanded its activities to include a project at the Burnett Children's Center. Mark Levy, president of the foundation, was able to obtain a large two-year grant from the Mimi and Peter Haas Family Foundation to fund the Burnett Center project. One and a half years into the project, the Haas Foundation extended the grant another two years, a total amount in excess of $600,000. This gives those involved with the Burnett Center three and a half years of collaborative work in which to see if they can create an
Barbara Almond, M.D., is a member of the San Francisco Psychoanalytic Institute and serves on its faculty. She is a clinical assistant professor in the Stanford University Department of Psychiatry and Behavioral Sciences.
autonomously functioning therapeutic nursery school and program for psychologically troubled and socially disadvantaged children aged two to five years, along lines influenced by psychoanalytic understanding and expertise.
Shahla Chehrazi, a child psychoanalyst, is the director of the program and a consultant to the Burnett Children's Center. On site at the center six hours a week, she works with a team that includes a psychologist, a social worker, an educational consultant, an administrator, and several interns from local psychology programs. Chehrazi describes the mission of this collaboration as follows. “Our vision is to create a therapeutic environment that supports resilient and socially competent children. Teaching staff receive intensive training and families receive mental health services, which strengthens and improves the quality of care-giving at home and in the classroom.”
Chehrazi's team targets three populations: the 75 preschool children who attend the center, their families, and the teachers and paraprofessionals who work with both. Their overall goal is to create a therapeutic classroom that can sustain itself once the period of funding is over, a classroom that can serve as a model to other preschool programs. The team teaches both educators and families how to identify troubled children and how to work with them within the school setting. Evaluation, therapeutic play groups, some individual play therapy, and therapeutic interventions in the classroom are the services they are working to develop for these children. Family services include parent support groups, family therapy, and family enrichment activities. The teachers, mental health workers, and paraprofessionals participate in classroom study teams, consultations, case conferences, professional development workshops, and seminars at the San Francisco Institute. The goal is to increase their skills in identifying troubled children and working therapeutically with them in a number of different venues.
The challenges of such an ambitious program are many. To build a collaborative relationship between the highly trained professionals of the San Francisco Institute and the staff and families of an underprivileged and socially disadvantaged neighborhood facility involves time and the continual testing of motivation and trust. A shared language and effective forms of communication are needed. Teachers and paraprofessionals, already burdened with the difficulties of working with a population of children at risk, must become actively involved in learning many new skills and concepts which they will ultimately implement on their own. Further, all participants' time and resources are limited, even with the generous Haas Foundation grant.
Despite these difficulties, the program is operating well. Community service and preventive mental health efforts are well served by the dedicated professionals involved in all aspects of the San Francisco Psychoanalytic Society's child development program.