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REFLECTIVE NETWORK THERAPY IN THE PRESCHOOL CLASSROOM                                                                               by Gilbert Kliman, MD                                                              

Click here to get your copy from Amazon 

Dr. Kliman’s long anticipated, definitive new book about the Reflective Network Therapy method is already getting significant attention. This book is expected to become a watershed for further replication of the method. More information about the book is posted here: Books/Papers 

Reviewers' comments: 

 

Dr. Kliman has creatively taken the application of classical child analysis a giant leap forward.    David Dean Brockman, MD Editor, The American College of Psychoanalysts Newsletter

 

The techniques are far more economical to use than we have found with the Lovaas method (ABA). We have seen the techniques transmitted to special education teachers as well as inexperienced therapists Jay S. Parnes, EdD, Senior Administrator, Special Education

 

I wept when I saw videos of actual changes in children and understood how much good this method was doing. Paul Jay Fink, MD, Child and Adolescent Psychiatrist, Clinical Professor of Psychiatry at Temple University School of Medicine

 

2012 SEATTLE OPPORTUNITY FOR IN-CLASSROOM THERAPISTS: RNT TRAINING

Wellspring Family Services has been using Reflective Network Therapy at its Morningsong Preschool in Seattle since late 2007, when demonstration sessions were held in its Early Learning Center, followed by intensive training of in house therapists and teachers. Very favorable clinical results keep happening, not only with traumatized and homeless children but also with pervasively developmentally delayed children. Training of psychology externs in the technique of Reflective Network Therapy is the next step. Applicants for in-classroom therapists are being considered. For information, send an email to jburrchellin@wellspring.org

PSYCHOLOGICAL RESOURCE for TRAUMATIZED CHILD SURVIVORS of EARTHQUAKES in HAITI 

To read about our agency's collaboration with the Massachusetts School of Professional Psychology and Ekòl Akasya to provide psychological first aid for children suffering the aftermaths of the 2010 earthquakes in Haiti, click on this link: Haiti Workbook. Free downloads of this new resource are posted on this website for individuals and families. The workbook is available in a bilingual editionHaitian Creole & French (Istwa Pa M Sou Tranblemanntè Ayiti a Mon Histoire Sur Le Tremblement De Terre En Haiti) and in English. Our agency continues to offer Free License Agreements to helping agencies and Disaster Relief organizations in Haiti to print and distribute an unlimited number of My Own Story About the Earthquake in Haiti workbooks. -Gilbert Kliman, MD

Our Medical Director receives the American College of Psychoanalysts                                                                          Award for Lifelong Contributions and Leadership In Psychoanalysis

SPECIAL HONOR for GILBERT KLIMAN, MD at Historic Meeting

Washington DC

 

The first joint scientific meeting of the American College of Psychoanalysts and the American Academy of Psychoanalysis and Psychodynamic Psychiatry was held May 3, 2008 at the JW Marriot in Washington DC. The first speaker selected to address this historic meeting was our own agency's Medical Director, Gilbert Kliman, MD.Kliman's lecture to over 200 colleagues was entitled "A Unifying Theory of PTSD – Videotaped Phenomenologic and Intervention Evidence" The enthusiastic response of Dr. Kliman's peers regarding the clinical and theoretical value of his original insights was very gratifying to the Children’s Psychological Health Center. CPHC is particularly pleased because CPHC has worked so hard to support Reflective Network Therapy services to children and to accumulate outcome data regarding childhood trauma which was included in Dr. Kliman's preentation.


Comments by Attendees

Discussant Clarice Kestenbaum, MD, Professor of Psychiatry, Columbia University College of Physicians and Surgeons, Department of Child Psychiatry, a highly published child psychiatrist and psychoanalyst with several decades practice and teaching experience:

“This is a remarkable, original, important as well as immense body of work on psychological trauma. In preparing to lead this discussion, I had the privilege and advantage of reading Kliman’s theory in essay form, and read it over three times. I did so because of ihe extraordinary exercise Kliman conducted in comprising a field of great complexity, ranging through evolutionary, neuroscience, and even chaos theory, as well as his review of a huge relevant psychological and psychoanalytic literature. The essay contains an enormous amount of thinking which time did not permit Dr. Kliman to cover today, such as his very important original research observations on memory changes with trauma and the hundreds of other scientific projects which he has considered and summarized. I especially appreciated the exquisite detail in his video interviews, further examples of which I had the privilege of seeing in greater fullness than he could present today. He further showed you a very carefully conducted treatment work based on his theory. His emphasis on the detailed use of reflective networks and narrative therapy, as in his guided activity workbooks, in overcoming behavioral traumatic memory is very important. I have known his work in such narrative therapies since he sent me his 9/11 workbook, “My Personal Story about the Attack on America”. There is so much of value in this essay that I hope he will now turn it into a book.”

David Mintz, MD: “Learning about Kliman’s truly profound New Theory of PTSD, I felt a sudden change in myself and my thinking about psychiatry. It was a Copernican moment, comparable to hearing Copernicus say the earth revolves around the sun rather than conversely. Kliman’s view that this set of danger reactions is evolutionarily produced and has value to the gene pool turned my thinking around with a flash of clinically relevant insight. Here the species is benefiting from the burdens of an individual. It makes me think of applications to other disorders, and wonder whether he is considering other disorders in an evolutionary light as well.

Reflective Network Therapy PRESENTATION BY Gilbert Kliman, MD to GROUP PSYCHOTHERAPY SOCIETY at annual Clinical Conference June 6, 2010. Asilomar              

 
Gilbert Kliman, MD, our agency's Medical Director and the originator of Reflective Network Therapy has been invited to present the method at a 3-hour seminar during the 44th Clinical Conference of the Northern California Group Psychotherapy Society at the Asilomar Conference Center in Pacific Grove, California (June 4-6, 2010).  We hope to have Dr. Kliman’s presentation videotaped in order in order to add this lecture and discussion to CPHC’s archives of training videos for therapists and teachers. This will give Dr. Kliman another opportunity to update old friends in the scientific community with our outcome studies, new service sites and new projects providing psychological first aid for child victims of natural disasters. Many professional peers new to Reflective Network Therapy will have the opportunity to discover the method’s proven efficacy and broad applicability for the first time.

ALLIANCE FOR CHILDREN AND FAMILIES FEATURES REFLECTIVE NETWORK THERAPY SERVICE March 30, 2010

The Alliance for Children & Families e-news features our Seattle affiliate, Wellspring Family Services in their member focus article. Judy Burr-Chelin, Director of Parent/Child Services at Wellspring, describes a key benefit of Reflective Network Therapy services for children:  “When children’s feelings and thoughts are understood they can be communicated through words instead of behavior, and then behavior can be changed.” Wellspring’s preschool program using Reflective Network Therapy supports children’s educational and emotional development.

 
REFLECTIVE NETWORK THERAPY IN ST. LOUIS, MO

Affliiated Service Site at the University City Children's Center                                            

The University City Children's Center of St. Louis, MO received funding from The Lutheran Foundation to train staff in Reflective Network Therapy. Wellspring Family Services of Seattle received Kresge Foundation funds for similar purposes as well as other funding.  Gilbert Kliman, MD, Medical Director of The Children's Psychological Health Center and Steven Zwolak, M.Ed. of the University Child Care Center will be leading their respective teams in the St. Louis collaboration. It is hoped that The University Child Care Center will become a regional base for training more therapists and teachers in Reflective Network Therapy.

Wellspring Family Services Clinical Director, Keith Myers, LICSW and Gilbert Kliman, MD led the collaboration between Wellspring and CPHC to deliver Reflective Network Therapy services in Seattle. In addition to providing RNT services locally, it is hoped that Wellspring will provide a Northwest demonstration laboratory for in-classroom training for staff of similar agencies. The Ann Martin Center will continue modeling mental health agency based Reflective Network Therapy services in Callifornia. On the east coast, Alexandra Harrison continues her innovative use of Reflective Network Therapy in Cambridge, MA. Alicia Mallo, MD continues training of RNT therapists in Buenos Aires. We think our agency is at the leading edge of developing replicable, manualized and efficient means for helping autistic preschoolers and preschoolers who have been psychologically traumatized. 
 
Massachusetts School of Professional Psychology Continuing Education Workshop July 21, 2010 
THERAPEUTIC ACTIVITY WORKBOOKS FOR CHILDREN AND FAMILIES:
PREVENTING PTSD IN CHILDREN AFFECTED BY THE HAITI EARTHQUAKE AND OTHER DISASTERS

This workshop will introduce participants to the therapeutic, preventive, and educational uses of a guided activity workbook designed to help Haitian and Haitian-American children and teens cope with their direct or indirect experiences related to the earthquake in Haiti. The workbook will demonstrate the specific uses of My Own Story about the Earthquake in Haiti, which all four presenters developed for use directly in Haiti, and My North American Story about the Earthquake in Haiti, which the two Boston-area presenters developed for Haitian children who, although living outside of Haiti, are still deeply affected by their families’ and communities’ terrible losses during and after the earthquake. This workbook can be used by therapists, educators, youth workers, and church members working with Haitian children here in the Boston area or elsewhere outside of Haiti, and can be used by relief workers and mental health volunteers working directly in Haiti. Earlier versions of this workbook have been shown to be effective in reducing the symptoms of PTSD in children who have survived large-scale disasters and in reducing foster children’s “bouncing” between foster homes. Presenters will include the developer of the original workbook method and two Haitian coauthors, an educator and a therapist. Two authors, Jodie Kliman, Ph.D. and Dorothie Ferdinand, M.A., will lead the training in Boston. Caroline Hudicourt, M.Ed., a coauthor of the workbook who is using My Own Story about the Earthquake in Haiti both educationally and therapeutically with children in Haiti, and Gilbert Kliman, MD, the original developer of the workbook model, participating in portions of the workshop via SKYPE, from Haiti and California, respectively. Instructors: Jodie Kliman, PhD, Dorothie Ferdinand, MA, Caroline Hudicourt, M.Ed, Gilbert Kliman, MD. mspp.edu/community/events/haiti.asp

News on Children's Mental HealtH: Editorial, The Lancet, Volume 375, Issue 9731, Page 2052, 12 June 2010

Mental disorders often receive less attention than do other illnesses, and diagnosis of mental ill health in children can be especially challenging. In the USA, 21% of children are thought to meet criteria for diagnosis of a mental illness, with a further 16% showing some impairment; yet only about 20% of children who could benefit from mental health or drug use services receive them. Recognizing the seriousness of this situation, the American Academy of Pediatrics Task Force on Mental Health, led by pediatrician Jane Meschan Foy, has published a series of recommendations aimed at improving community mental health services.

In view of the obstacles to providing effective primary mental health care for children, a substantial part of the Task Force's report is devoted to preparative and organizational work at community and practice level. Educational programmes in child psychiatry are being designed for primary care clinicians. Emphasis is to be placed on building relationships with schools, mental health services, and social care providers, to enable consistent and appropriate care to be provided to families throughout childhood, from the early age when a pervasive developmental disorder might become manifest to adolescence when drug use services could be needed. The series includes algorithms for primary care focused on pediatric mental health, including routine screening for mental health problems.

Although the risk of leaving mentally well children with an inappropriate burden of medicalization and stigma must be kept to a minimum, the American Academy of Pediatrics' initiative is welcome and timely—evidence suggests that early intervention for children with behavioural problems is effective. The UK’s Healthy Child Programme emphasizes parental disadvantages, including low income and mental health problems, which place children at risk. In the USA, the system of reimbursement for health-care provision can make it difficult for primary care physicians to provide effective pediatric mental health care. As reform brings uninsured Americans into the domain of health insurance, evaluation of mental health treatment and outcomes in children will be key to the success of the Academy's initiative.

Psychological Trauma in Childhood – Gilbert Kliman, MD

More than a dozen advanced child psychotherapy students attended this course at the Child Development Program of the San Francisco Center for Psychoanalysis. They were Doctors of Psychology, Doctoral students, Marriage and Family Therapists and Social Workers. Attendees gave “outstanding” reviews of the course on childhood trauma taught by our Medical Director, Gilbert Kliman, MD at the San Francisco Center for Psychoanalysis in San Francisco on March 12 and March 19, 2008. Discussion was based on videotaped diagnostic interviews of highly traumatized children and videotaped treatment archives using Reflected Network Therapy. Videos illustrated the phenomenon of iconic memory, where traumatized children symbolically re-enact devastating trauma. A DVD of treatment sessions demonstrated not only well understood cognitive and emotional problems associated with Post-Traumatic Stress Syndrome, but also demonstrated Reflective Network Therapy techniques which reduce PTSD symptoms. DVDs used in this course  are available for qualified professionals who make request by submitting a binding Confidentiality Agreement: download  Please specify the course materials by name: Iconic Memory and Treatment by The Cornerstone Method. Fax the signed confidentiality agreement to 415 749-2802.

CPHC Treatment Video Archives Developed Further for Training and Scientific Study

Supported by a grant from the Windholz Memorial Fund, Elissa Burian, an experienced Reflective Network Therapy supervisor, has begun annotating videotapes of RNT treatments from our agency’s extensive video archives. Detailed annotation will assist independent researchers and make the videos much more practical for training purposes by minimizing or eliminating the need for personal psychoanalytic explication by individual RNT therapist-supervisors.
 

Matching Grant 

 
New Book Offers New Hope

Reflective Network Therapy in the Preschool Classroom © 2010 by Gilbert Kliman, MD

Parents of severely disturbed preschoolers will be encouraged by this new book’s emphasis on valuing their input and feedback and providing regular guidance and support to families. It is good news that this method is also cost effective for early childhood intervention within public school systems. Dr. Kliman's new book offers practical hope to families and communities struggling to meet the special needs of children who have lost or damaged capacity to care about and learn from others. A dynamic psychological and psychosocial network method, Reflective Network Therapy enables most emotionally disturbed or cognitively impaired children to become healthier and receptive to learning. This method helps developmentally challenged young children develop empathy, relate to family and peers, and grow intellectually. Twice-tested child patients regularly show statistically highly significant IQ gains which are sustained over time. Children become emotionally healthier and smarter, gaining new interpersonal and cognitive skills.

Surprisingly positive outcomes have been measured in varied psychosocial contexts: inclusive public special education classes, day care centers, Head Start programs, public and private therapeutic preschools. It is good news that this method is also cost effective for early childhood intervention within public school systems. Reflective Network Therapy appears to be a major advance in the effort to meet the emotional and developmental special needs of young children. The book includes a replication Manual for the benefit of therapists, teachers, parents and researchers. The author strikes a balance between making complex material accessible to the general reader and keeping to the rigors of scientific presentation. Real life classroom narratives and discussion of more formal case studies enhance the reader’s understanding and help personalize theoretical explication.

New research --in collaboration with Harvard Medical School Assistant Professor, Alexandra Harrison, MD-- may ultimately help explain why this method works. The method is evidence-based and time-tested by clinical, comparative, and controlled psychometric studies. The author describes his own experience and that of many colleagues with 1500 children treated by over 20 teams of using Reflective Network Therapy. Case studies are enriched with the author’s psychoanalytic commentary which illuminates scientific studies and findings and points out aspects of the method which will benefit from future multi-site studies.

News from New Orleans -Help for Children with Post Traumatic Stress Disorders

Tulane Department of Medicine Researchers led by Jan Johnson, MD studied a derivative of  Reflective Network Therapy called “The Personal Life History Book Method,” which has resulted in a series of reflective network therapy applications for children who survive large scale disasters. Applied to children who were displaced by hurricanes Katrina and Rita, this derivative of Cornerstone is producing highly significant reductions of the children’s posttraumatic stress disorder scores. Together with Mercy Corps, The Children’s Psychological Health Center produced a guided activity workbook for New Orleans children, called “My Personal Story About Hurricanes Katrina and Rita.” Over 12,000 copies were used by school children and their families.The Tulane study is published on our website in the Research section.

News from Oklahoma --Another Long Term Ermergence from Apparently Deep Autism: Sustained IQ Rise and Achievement Reported in Long-Term Follow Up

Fran Morris, M.A., Clinical Professor of Psychiatry & Behavioral Sciences, University of Oklahoma Health Sciences Center, has been in touch with Dr. Kliman for many years. Morris conducted a therapeutic preschool equivalent to Reflective Network Therapy service in Oklahoma City, Oklahoma for several years. Morris recently contacted Dr. Kliman with follow-up notes on a child patient of hers who presented with severe autistic regression and whose initial WISC-R IQ test result was 47.

The child began in-classroom treatment in 1978 at age 4 with a very dim prognosis. His treatment was an in-classroom combination of psychotherapy and education. His full scale IQ rose to 91. His most recent full scale IQ was documented as 125, quite respectably above average! Now nearly 30, his prospects have changed dramatically. Morris reports that this young man completed a University education, receiving his B.A. and that he is currently in graduate school earning an M.A. The findings she reports verify that in-classroom Reflective Network Therapy led to a marked and sustained rise of Wechsler Full Scale IQ, and a great deal of clinical improvement. Both IQ and clinical status continued to improve for many years.

Though not a full cure, this case resembles a 33 year follow-up of a fully cured patient similarly treated and reported by Kliman. This was of a severely autistic and seemingly retarded three year old. Miriam Siegel, Ph.D found that the child’s IQ was too low for testing. But over several years of in-classroom psychotherapy her IQ rose to a full scale WPPSI score of 80. Ultimately she had no symptoms of autism and her full scale IQ when re-tested at age eight was 120, then at age twelve was 149. (Further details and her autobiography are published in  Reflective Network Therapy in the Preschool Classroom, by Gilbert Kliman, MD )

Windholz Foundation Grant

CPHC was awarded a Windholz Foundation grant from the San Francisco Psychoanalytic Institute and Society of $11,300 (July 2007). The award will be used to purchase video conferencing equipment to further enhance ongoing supervision of the Ann Martin Center service site, and to support the services of an experienced Reflective Network Therapy supervisor (Elissa Burian, MA) who is annotating some of our treatment tapes from our archives. A major goal is to begin indexing and deepening the training value of our video archives. Detailed annotation will assist independent researchers as well as potential Reflective Network Therapy practitioners. Continued development of heightened training tools for training, supervision, replication and research study of Reflective Network Therapy’s value for existing and new child patients is the primary goal of this project. Funds are requested for basic video-conferencing regarding child patients Ann Martin Center, for equipment and supplies to continue video documentation of in-classroom treatments at this service site, and for indexing of 150 hours of Ann Martin Cornerstone DVD archives of treatment selections for collation into training videos by Elissa Burian, MA, a co-founder of the method in collaboration with Gilbert Kliman, MD, whose services are donated. Requested funds will also cover the costs of an independent videographer’s services to attach indexed treatment notes to training videos.

Verbatim transcription and scientific notation of 100 existing archived video records of actual treatment sessions selected for their value regarding children with Autism Spectrum Disorders, Attention Deficit Disorder and Posttraumatic Stress Disorder. Transcripts will be a contribution to the best didactic use and application range of existing DVD’s as an educational and training tool. It makes the details of this applied analytic treatment method more accessible (DVD menu findable) for further objective study of non-verbal aspects of psychotherapy and education. Psychoanalytically informed annotation of transcripts will augment written case reports and studies of Reflective Network Therapy for preschoolers and enhance the cost-effectiveness of video archives as a foundation for training new therapists. Such transcripts will be an important new tool to promote independent verification of clinical, cognitive and linguistic results and to support ongoing and future research. Study of the phenomena of statistically significant psychometric improvements will be facilitated. For example, videotapes of children with IQ and CGAS gains could be studied by a Q-Sort method to compare with non-responders or children treated by other methods. Transcripts will assist Reflective Network Therapy supervisors in the training of therapists, teachers and parents for future independent trials of the method in new sites for comparison studies. 

Donations 

In 2008, CPHC's Board of Directors designated $25,000 in donated funds to support expansion of services at Family Services of King County (Seattle service site) in 2009. In 2007, CPHC received $75,983 in private donations targeted for the continued support of the Ann Martin project and Cornerstone Argentina Children’s Psychological Health Center Board Members have given contributions to the Harvard Medical School Cornerstone Project totaling $35,250. The International Psychoanalytic Association’s Cornerstone Service and Research Fellowship recently received $27,850 from CPHC. The Ann Martin Center in Piedmont, California, received a CPHC $13,250 grant installment for Reflective Network Therapy service in Cornerstone Argentina. (See Affiliated Service Sites)

To support research, training, and therapeutic education scholarships for needy children, click here to make a tax deductible donation.

 


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