All parents need support. When times are good, it’s great. When times are tough, your network can be your lifeline as a parent. Helping families develop the skills to navigate challenges and thrive in difficult times is the work of the Exchange Family Center, which since its founding in 1992, has offered Durham County families a broad menu of services, free of charge to all clients. The Exchange Family Center’s team of therapists are crucial to this mission; they bring decades of experience, talent, training and compassion to their work with Durham County families.
Each EFC clinician is unique, in terms of education and life experience, but all share a core-deep dedication to improving the lives of children and families with evidence-based tools, techniques and resources that make a positive difference every day.
The commitment to healthy families is universal – but that doesn’t mean the work is routine or boring, therapists say. Rebecca Worley, MSW, especially appreciates the diversity of the families she encounters. “It’s really good to be working with parents of children from all kinds of backgrounds, because we [at the EFC] are open to any parent in Durham County. Across the board, most parents love their children and want to have the best relationships they can. Many court-mandated parents [who are required to participate in therapy] may not have a lot of resources or support – all the way up to those with the highest-end of support in the community who are finding they need extra help.”
“It’s really good to be working with parents of children from all kinds of backgrounds, because we [at the EFC] are open to any parent in Durham County. ”
Therapists at the EFC are assigned to one of three specific programs when they are hired, although the goal is mastery of all three, in order to provide the broadest support possible. One program, ECHO, focuses on strengthening the early attachment of parents and babies/toddlers; another, the Family Support Program, helps parents learn to constructively discipline and set boundaries for their youngsters; POA, the third, is dedicated to working with parents and adolescents.
Unique to the EFC, all three programs bring clinicians into family homes, unlike the impersonal offices that are often routine settings for therapy. Home visits give clinicians important insights into each family’s dynamics – and give parents regular, real-time opportunities to practice the techniques EFC suggests. Home visits have been temporarily suspended, given Coronavirus precautions, but therapists continue to serve families via digital tools like Zoom and FaceTime. This commitment means that observations and coaching have been sustained throughout the pandemic, with no interruption in services.
Home visiting – or home visiting via Zoom, in the current model – streamlines the learning process for kids and parents, and gives everyone the chance to practice together, at home, rather than “export” ideas from an off-site therapy setting and “translate” those ideas into new routines. (Home visiting programs for young families are not new – two well-regarded models are the Nurse Family Partnership and Healthy Foundations America – but rare for families with school-age and older children.) Therapists can see where challenges grow into potential obstacles and offer strategies that support cooperation and healthy discipline, not conflict. Parents appreciate the ease with which therapy arrives in their lives; no one has to buckle three kids into car seats and navigate traffic to get the help their family needs and deserves. “Getting to see the kids in their home environment is delightful,” Rebecca notes, “but the real clients are the parents. It’s not like taking a five-year-old for play therapy, when the parent sits outside in the waiting room. All of the work we do is coaching, supporting the parent-child relationship in real time.”
Cynia Black, MSW, works with parents and adolescents in the Parents of Adolescents (POA) program, which most often supports families who have been mandated to receive services by the courts. She appreciates the “holistic perspective” the program encourages. “We want youth to receive mental health services,” Cynia says, “but often, a lot has transpired at home that led to court. We want to address those factors, and help our families thrive better.” She offers teenagers and their families practical strategies like meditation and relaxation techniques to counter moments of intensity – and helps them develop behavior plans that outline clear expectations. This gives parents a supportive structure and helps adolescents become successful in settings that have been stressful before, or in new settings, like custody arrangements, that require accommodation and adjustment. Families and therapists meet up to three times a week over the course of a year, on average. “It’s a lot of work!” says Black, but the satisfaction vastly outweighs the effort, as families find more love, affection and pleasure in each other’s company.
Many parents come to the EFC at the end of their emotional rope. They’ve tried everything they can think of, and nothing’s helping. Coaching in real time “often works well,” says Worley. “It’s great to see the change from start to finish. It’s not a fairy tale -- parents will still make mistakes! But there is a real reward to see parents try something and see it work.”
Consider the rambunctious family of three kids, headed by a single mom. Overwhelmed and frustrated, the mother told Rebecca that “the only thing that works is when I spank them — nothing else gets through to them.” To give the family another approach to solving conflict, Rebecca suggested a simple experiment: She proposed a system for recognizing cooperation, rather than punishing disobedience, that involved a simple glass jar and a few dozen small, colored balls. Every time the mother was pleased with a child’s actions, she would “tell them with descriptive praise” – naming the positive behavior and recognizing the child’s contribution – and “put a little ball in the jar.” Every week, the children were rewarded for their good behavior with “prizes” like choosing the family weekend movie or going to the park. Astonished, the mother reported “They love it! It works! It’s set up by the TV – now they’re looking for it, when they do something good, they’re asking, where’s the little ball?” Most gratifying to the therapist – and likely, the most significant gain for the family as a whole – was the realization by the once-overwhelmed parent that her children wanted to please her; they sought and needed her praise and approval. “Just getting the praise and the ball felt GREAT to the kids,” Rebecca said. The special rewards were icing on the cake, and over time, the family found a new way to interact that replaced corporal punishment with praise, recognition, and pleasure.
Worley misses visiting with ‘her’ families in this season of social distance and universal precautions. She and Cynia Black both acknowledge the uncertainty that the novel Coronavirus has wrought, as well as the negative effects of the pandemic on struggling families. “Corona definitely shows me how vital what we do is” to the clients and children, Black said. “Meeting in person, you’re able to see faces, see expressions, coach quietly on the spot. Corona makes it harder, but we have to be a little more creative!”
Even with the challenges of an uncertain time, “I love my job all the more,” Black says simply. “I respect my job all the more. Corona has helped me improve my creativity – offering relaxation techniques on line, for example, and finding new, digital ways to engage with the adolescents,” like a pixel-art drawing contest between Black and her teen clients or sharing favorite YouTube clips. “The adolescents felt great – they loved it! And at the end, it made the therapeutic alliance even stronger.”