How is Reflective Network Therapy different from other therapies?
In most psychoanalytic therapies for preschoolers, children are pulled out of their classrooms into a private office with one adult and typically see a therapist once a week. In contrast, a child treated with RNT is never pulled out of the classroom; each child patient receives a short individual psychotherapy session within the play, social, and educational activity of the classroom, usually every school day. High frequency individual treatment in the classroom environment is a significant factor in the rapidity with which children achieve robust clinical gains. Uniquely, research demonstrates that ninety-five percent of tested children treated with this method regularly demonstrate their achievement of statistically significant IQ gains and mental health improvements when retested after about 8 months of starting treatment. The interactive synergy between individual psychotherapy and preschool curriculum is deliberately magnified in structured ways by the small social network of the child, her or his child peers in the classroom, a teacher-therapist team, and parents when they are in the classroom. The method takes advantage of classroom interactions, events, behaviors, and verbal or behavioral expressions. On-the-spot observations and conversations in this real-life-space are often the material for individual therapy sessions. Every child in the RNT classroom is always in a peer-inclusive process, which is therapeutically valuable for all the children.
• For a full understanding of the social, cognitive, mental health, relational, behavioral and other improvements typically derived from Reflective Network Therapy, see RNT Benefits.
• For a fuller description of our method’s techniques and practices, and how RNT differs from other treatments, see Our Method and Method Comparisons.
What childhood disorders and conditions improve with Reflective Network Therapy?
RNT is tailored to fit each child. It is remarkably effective for most preschool children with serious emotional disorders, autism spectrum disorders, social communication disorders, cognitive disorders or disturbances, reactive attachment disorders, posttraumatic disorders and behavioral problems. Children with trauma or post traumatic stress disorders, anxiety disorders, reactive attachment disorders, oppositional defiant disorders, or attention deficit hyperactivity disorders are commonly very responsive to this method. Readily individualized, RNT benefits children with some psychiatric diagnoses that do not really fit into broad categories; it also works with preschoolers who have co-ocurring psychiatric diagnoses (multiple diagnoses).
Challenges and stressors for parents
From decades of experience with more than 25 teacher-therapist teams treating more than 1700 children, CPHC senior staff is highly conscious of many additional challenges that parents of special needs children navigate. Knowing that it is not easy for the most courageous, conscientious and competent parents to manage the variable, persistent demands on their time and energy, we are alert to ways to actively support and involve parents efficiently without compromising the child’s treatment.
Parents give the teacher a short briefing when dropping their child off at school
All Reflective Network Therapy briefings among helping adults are done in the child’s presence and the child is encouraged to participate. This is a moment when the parent is part of the small social network functions that underpin the success of RNT. Parents brief the teacher in simple language the child may understand about such things as: how the child is feeling this morning; what the child expressed (behaviorally or verbally) that the teacher or therapist might want to know; or mention an important family event. The teacher will later conduct another briefing to share this information with the therapist in the child’s presence. Parents able to spend time in the classroom are strongly welcomed to do so, as parental involvement with their child in the classroom advances both therapeutic progress and the educational process.
Parent–teacher conferences are weekly. Conferences with the therapist occur monthly.
Conferences with the teacher support parents with updates on how their child is doing cognitively with the curriculum and conferences with the therapist update parents on the child’s progress in therapy.
In both cases, parental input is wanted; changes in behavior or symptoms are discussed; the adults share insights; and parents receive guidance and support. Sometimes, though not always, parents may arrange to participate in conferences by phone or via Skype.
Many parents ask about medications and supplemental therapies, such as behavioral aides.
Gilbert Kliman, MD responds:
We are likely to recommend reducing or removing medications as children improve. Children should continue any prescribed medication(s) when they first enter treatment. We prefer that children do not start new medications soon after starting RNT. We urge at least a trial of RNT before medication is changed. It takes two or three months in the Reflective Network Therapy classroom to establish a baseline of observations which might support a recommendation to the child’s pediatrician for the reduction or elimination of medication(s).
• No child who started RNT treatment with a one-on-one behavioral aide (ABA therapist) has ever needed the aide to always be in the Reflective Network Therapy classroom after a week or two.
• We encourage continuing any dietary, speech therapy, occupational therapy or other appropriate treatments already in progress when children enter our program. We prefer that speech therapy, occupational therapy and ABA interventions for autistic and other children take place right in our classroom.
Excerpted from: Chapter 3, Reflective Network Therapy: How-To-Do-It Manual For Therapists, Teachers IN: Reflective Network Therapy In The Preschool Classroom, Kliman, G. (2011).Landham, MI, University Press of America