Presentation Overview

1. Supporting Young Students through Pregnancy and ParenthoodHelena Mackenzie, PhD, LP, Mental Health Specialist

2. Presentation Overview • Discuss transition to parenthood • Explore unique challenges of young parents and factors associated with better outcomes • Share key elements of parenting programs specific to young parents and review elements common to general parenting programs • Small group discussion regarding case scenarios and assisting young parents in the Job Corps community

3. http://www.youtube.com/watch?v=mx8S9AKb_oM

4. Transition to Parenthood • Standard to focus on physical needs during pregnancy (prenatal health, birth process, breastfeeding) • Less discussion of the emotional and relational challenges inherent in transitioning to parenthood • Little to no education about parenting

5. Challenges in Transitioning to Parenthood • Huge philosophical shift • From “me” to “we,” new identity as mother/father • Many physiological and physical changes • Sleep deprivation and exhaustion • Intimacy declines • Body image concerns for many women • Relationships change • Conflict intensifies (feeding, diapers, daycare, time to self, finances) • Divide between father and mother • Realistic expectations can soften blow of parenthood Source: Gottman, J., Schwartz Gottman, J. (2007) And Baby Makes Three. Crown; New York, NY.

6. Group Activity: Before Baby Arrives • Exercise to help develop realistic expectations about the transition to parenthood • Work/school • Sleep/personal care • Eat/cook • Household (laundry, cleaning) • Hobbies/social/friendship time • Intimacy/partner time • Family time • Other From: Bringing Baby Home Workshop, John Gottman, PhD

7. Does Young Motherhood = Negative Consequences? • Large number of pregnant and parenting teens • In US, 34% of young women pregnant prior age 20 • In US, 11% of all births are to adolescent mothers • Approximately a half million births to teen mothers annually • 95% of teen pregnancies are “unplanned.” Majority of teen mothers (80-90%) are unmarried, many are “single parents” living with their own parents • Early research: negative outcomes for young parents, but based largely on risk factors correlated with teen mothers • Recent research: many negative factors predate pregnancy Source: Savio Beers, LA., Hollo, R. (2009). Approaching the Adolescent-Headed Family: A Review of Teen Parenting. Current Problems Pediatric Adolescent Health Care. 39 (3), 21-233.

8. Risk Factors of Pregnant Teens Prior to Pregnancy • Living in poverty • Living in distressed communities • History of unprotected sex • Less supervision by family • Drug/alcohol use • Higher rates of childhood sexual victimization • Higher school drop out rates/lower educational attainment

9. Unique Characteristics of Adolescence That May Cause Parenting Difficulties • Yearning for autonomy and independence at a time when… • Tend to be egocentric and in search of “self” at a time when… • “Trying out” and learning about relationships (intimate and friendships) at a time when…

10. Continued: Unique Challenges of Adolescent Parents • Focusing on completing school/job training at time when… • Learning about one’s emotions and emotion regulation at a time when… • Becoming more cognitively mature and responsible in problem solving and reasoning at a time when…

11. Compared To Adult Parents, Young Parents Often Have: • Less understanding of normal child development • More difficulty reading infant cues • More problems empathizing with child • Less knowledge of parenting strategies; less monitoring of kids • Higher levels of parenting stress • More prone to physical discipline (possibly at higher risk of neglect and abuse of children)

12. Protective Factors Tied to Better Parenting Outcomes • Greater cognitive maturity • High self efficacy and self esteem • Strong social support network • Positive relationship with child’s grandmother and father • Participation in supportive parenting program • Stable mental health • Limited subsequent pregnancies • Early childcare assistance • Ability to pursue educational/career goals

13. Pregnancy and Birth of Child Fosters Motivation for Change • Motivated to make behavior changes to create healthy environment for child • Excellent time for intervention and education

14. Parenting Programs for Young Adults Versus “Regular” Parenting Programs • Young adults have unique needs • Effective teen and young adult parenting programs differ from “typical” parenting programs in at least five basic ways

15. 5 Key Elements of Adolescent and Young Adult Parenting Programs 1. Intensive, hands-on practical support • Begin support and education as early as possible, ideally during pregnancy • Build trust and nurturance • Identify resources (childcare, financial, legal, housing) and help coordinate care • Educate about family planning and impact of substance use on baby in utero and postnatal

16. 5 Key Elements of Adolescent and Young Adult Parenting Programs • Use collaborative teaching methods, not “expert” model • Young parents more likely to “rebel” from direct advice • Building self confidence and self efficacy is key • Benefit of video demonstration/ role play • Explore parenting concepts in personal context • Group format ideal, build social support

17. 5 Key Elements of Adolescent and Young Adult Parenting Programs 3. Explore life goals and build social problem solving skills • Identify life dreams in core areas: education, personal relationships, parenting, career • List challenges standing between adolescent and dreams • Identify strengths/resources adolescent already has to assist with challenges • Line up dreams, challenges, and strengths and identify possible plans/strategies • Make a plan for action by identifying smaller tasks • Encourage action! Source: Harris, M.B., & Franklin, C. (2008). Taking Charge. Oxford University Press, New York, NY.

18. 5 Key Elements of Adolescent and Young Adult Parenting Programs 4. Model ways to connect with children, focus on strengths • Provide information about infant social interaction • Discuss importance of play (play is a child’s work) • Practice child-directed play • Child chooses activity; parent follows lead. Parent as “sportscaster,” describing events without asking questions or giving commands

20. 5 Key Elements of Adolescent and Young Adult Parenting Programs 5. Discuss depression, stress, and anger management • 10-15% of all women experience post partum depression within first year of birth of child • Adolescent moms twice as likely to become depressed as adult moms • Normalize stress of parenting • Need for preventative self care plan (healthy eating, exercise, relaxation, sharing feelings, etc.) and “emergency plan” for when “flooded” or highly stressed • Discuss impact of anger on parenting and coping • Many mothers feel ashamed and don’t ask for help Source: Deal, L.W. & Holt, V.L. (1998). Young maternal age and depressive symptoms: Results from the 1988 National Maternal and Infant Health Survey. American Journal of Public Health, 88, 266-270

22. 5 Elements of ALL Parenting Programs 1. Discuss timeline of infant/toddler development to foster realistic expectations • 0-5 months: babies communicate by crying, day/night can be confused, suck to self soothe, reach for objects • 6-12 months: social referencing begins, first words, crawling begins, walking may begin, specific attachments and stranger anxiety begins • 12-24 months: two word sentences, separation anxiety begins, control struggles, toddler has egocentric view of world. Often too early for toilet!

23. 5 Elements of ALL Parenting Programs 2. Discipline Starts with Praise • Praise and encouragement help kids master new skills and teaches desirable action • Effective praise: • Specific: “I like the way you said thank you” • Contingent: given immediately after behavior • Done with enthusiasm!!!!! • Avoid tagging on criticism to praise

24. 5 Elements of ALL Parenting Programs • Tangible reinforcement: motivate positive behavior with concrete rewards (“start behaviors”) • Use concrete rewards less often than social rewards • Be specific about behavior to be rewarded • Make a goal “doable” • Tackle only one or two behaviors at a time • Small frequent rewards work best • Show child you anticipate success

25. 5 Elements of ALL Parenting Programs 4. Importance of structure and limit setting • Teaches kids appropriate behavior and helps them feel safe (“stop behaviors”) • Kids will test limits, especially if limits set inconsistently • Pick battles carefully, many behaviors disappear through ignoring • Allow natural consequences • Teach effective use of time-out: no emotion, few words

26. 5 Elements of ALL Parenting Programs 5. Openly discuss pros/cons of spanking • Short term: very effective in stopping behavior • Long term: • Parents model aggression; children learn aggressive response when frustrated, unhappy • Spanking tends to leave child with no remorse for behavior. Behave with parents; misbehave elsewhere. Learn to hide/lie about misbehavior to avoid spanking • Loss of control while spanking increases risk of abuse; guilt following may lead to inappropriate overcompensating

27. Group Activity • Discuss challenges on Job Corps centers related to pregnant or parenting students • Share currentstrategiesJob Corps centers are using to assist young parents • Explore future directions for supporting young parents at Job Corps

28. Scenarios • 19 year old, motivated Job Corps student becomes pregnant early in Job Corps training • 22-year-old Job Corps student with two year old child appears overly harsh in parenting on center • 20-year-old male Job Corps student appears depressed and shares desire for contact with 2-year-old child, but mother of child refuses to allow him contact