The Children and Family Community Service Award of the American Psychoanalytic Association recognizes each year one program in our nation that achieves exceptional distinction in the quality and extent of its direct service to the children and families in its local community. The Lucy Daniels Center for Early Childhood has been honored as the 2005 award recipient. Cal Narcisi, chair of the Committee on Child and Adolescent Psychoanalysis that nominates award recipients, said in presenting the award, that the Lucy Daniels Center “provides a model for community service, involvement, and impact that we can all look to for inspiration.”
In what ways does the Lucy Daniels Center provide inspiration? As founder of the center and full-time director for its 14 years, I can say that from the outset we envisioned Lucy Daniels Center to be a psychoanalytic community agency. In order to be a true community agency, we believed that we needed to be a community partner and player that gave to the community in various ways. We also decided that although we were willing to do the work to achieve wide acceptance, we would never hide our lantern under the bushel. We are unabashedly a psychoanalytic and psychodynamic program. The community endorsement of Lucy Daniels Center is understood as an acceptance of the value of a psychoanalytic approach to helping children.
However, I have come to believe that, for psychoanalysis, real marketing comes from real work, real relationships, and, most of all, real giving.
This basic approach of reaching out through community partnership and service has taken various forms. One component has been the center's many adult and professional educational activities, including an extensive (and very low cost) program of workshops for teachers, parents, and others who are involved with children. Most of the programs have a psychoanalytic focus, such as presentations about supporting healthy separations. Others are not specifically within the psychoanalytic domain, such as programs on autism or learning disabilities. Invited nonpsychoanalytic or nonmental health colleagues with special expertise from the community have participated in many of these programs.
The center's willingness to participate in community boards and initiatives around children has been a second aspect of the reaching out. Through this work, the center has come to be seen as one of the key agencies in the broad community effort to assist children— which is how Lucy Daniels Center sees itself. I believe that psychoanalytic early childhood programs are at-risk for being perceived as, and for actually being, isolated, self-sufficient entities, which is not a desirable situation. We have been largely able to overcome this by not seeing ourselves that way, and acting as we see ourselves.
A third outreach approach has been to establish, from the outset, a board of directors overseeing Lucy Daniels Center that is numerically dominated by nonmental health, prominent members of the community. (The Lucy Daniels Center, although strongly affiliated with the University of North Carolina-Duke Psychoanalytic Education Program through informal arrangements, is a free-standing private non-profit corporation.) Although arranging the board of directors in such a way presents challenges to maintaining the clinical orientation and philosophy of a program, the Lucy Daniels Center believes that the act of creating and then handing over the program to the community has contributed substantially to the program's ability to be owned and supported by the community at large.
There are many other strategies that the center has used, such as the willingness to see that psychoanalytic assistance is only one aspect of the comprehensive help that many children need, and that the best care for children is provided by integrating other approaches into its work and collaborating with other professionals, such as early childhood educators, occupational therapists, speech therapists, early interventionists, and mental health professionals of different orientations.
What have been the fruits of this effort?
One measure of acceptance is the extent to which the community turns to the Lucy Daniels Center for assistance. In a typical week, the Lucy Daniels Center receives upwards of 15 requests from families for mental health assistance for their children, on the basis of referrals from an extremely broad constituency. The center serves as many of these children as it can, currently over 300 yearly and growing each year, with assessment and/or treatment. All families are served on a sliding scale or free, through three programs that offer a broad range of mental health treatments.
Donald L. Rosenblitt, M.D., is director of the Lucy Daniels Center for Early Childhood.
The center provides:
A school that includes a therapeutic nursery and kindergarten program for children age three through seven;
An outpatient treatment clinic for children birth through 11. This clinic offers comprehensive care that is psychodynamically based but which integrates psychopharmacological and other approaches;
A home-based treatment program for children from birth through five.
The center's community acceptance can be measured in many ways, such as from the grants it has received, the community leaders who sit on its board, the many hundreds of community members (completely outside the mental health community) who assist in the center's fund-raising, and its frequent press exposure. However, it is the home-based treatment program for children birth through five that demonstrates particularly well the blend of community involvement on the center's part and support for the center's work on the community's part.
This program, known as “SecurePath,” is funded by a statewide initiative in North Carolina known as SmartStart. On the basis of its work in the community, the relationships it had established, and a prior SmartStart funded activity, the center helped its local SmartStart affiliate develop SecurePath and was successful in being chosen as the lead agency to implement the program. Part of the center's contribution is to offer a portion of the program pro bono. The program involves in-home mental health assessments and treatment (such as parent counseling, mother-child work, and play therapy) for families who are without insurance or who have Medicaid. The Lucy Daniels Center is thus following in a worthy tradition of psychoanalytically-informed in-home mental health intervention for young children begun decades ago by Selma Fraiberg and her colleagues.
SecurePath has been a huge success. Long waiting lists developed within several months of launching clinical services. The provision of services to underserved, often highly burdened families is a wonderful and deeply rewarding activity in and of itself. Additionally, our agency's willingness to leave the comfort of our classrooms, playrooms, and consulting rooms, to go into the most disadvantaged neighborhoods, to offer bi-lingual therapists for our particularly underserved Hispanic population, to make psychoanalytic help something for the disadvantaged rather than just for the advantaged—all of this frames our agency and psychoanalysis in a way that leaves everyone proud that psychoanalysis exists and that children and families can benefit from it.
The lesson that can be generalized from their experience is that brochures, newsletters, and other activities have their place in getting the word out. However, I have come to believe that, for psychoanalysis, real marketing comes from real work, real relationships, and, most of all, real giving.