Tender Press Books
Location
International
Year
2018-Present
A coalition of social workers and psychologists whose goal is to create free and accessible crisis intervention resources for situations when traditional forms of mental health care are unavailable.
All books and resources are free to download at https://tenderpressbooks.com/
There are many circumstances when access to mental healthcare is unavailable, and this is often when it is needed the most.
This is epecially true when it comes to vulnerable populations, such as children, who cannot advocate for themselves.
An example of such a time was when the Family Separation Policy was implemented and children were being taken from their caregivers with no plan regarding reunification or how to address the trauma of separation.
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I found out that some of these children were being housed in the Michigan foster care system, but that there was a lot of secrecy around what was happening and no clear avenue about how to support these kids.
As a social worker and child development researcher I felt like a responsibility to try and do something, and so I spoke with some colleagues and we decided to create resources for these children, their foster caregivers and the social workers working with them.
Research Question
How can we create a mental health intervention to support children in crisis situations with limited knowledge of their circumstances and a lack of access to find out more?
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Usually mental health interventions go through a rigorous trial process with a comparison group and standardized assessments of efficacy. In this situation our time was limited and we would not even be able to interview the children involved.
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We utilized the concept of an "evidence-informed" intervention and relied on previous studies of children in similar crisis situations, as well as expert analysis by interviewing immigration professionals at the Washtenaw Interfaith Coalition of Immigrant Rights (WICIR). Additionally, all of us had previous experience working with children without legal status to reside in the United States whose experiences, although not the same, provided some knowledge of the fear and uncertainty that comes with the immigration process.
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Ultimately, our belief in the power of storytelling made us feel that we could make an impact even from a distance.
The Science of Storytelling
Humans are neurologically wired to try and make sense of the world by telling themselves stories about what is happening. Children are the same way, except they have less knowledge about the world to incorporate into their narratives.
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Internal narratives are the emotional component that underlie these stories and create expectations of the world as either safe or scary. These narratives are created in childhood and can endure throughout the lifespan without intervention.
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Stories can be a much-needed healing mechanism when they are able to provide a comforting narrative that makes sense to the child, and can provide a different emotional experience for a child who has experienced trauma and loss. ​
C. M. Newberger in her testimony to the United States Congress in 1991 regarding the impact of childhood maltreatment, “It is not the acts alone that are traumatizing but their meaning to the child."
We created Cecilia y la Caminata (Cecilia and the Long Walk) a children’s story and coloring book written to help children separated from their parents at the border understand what happened to them and providing language to help organize internal confusion and terror.
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The core message of this book was, “This is not your fault, you did nothing wrong. Your caregivers love you, are thinking about you, and wish they were here with you.”
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We wanted to use storytelling to change the child’s narrative of their experience and remind them that they are loved.
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We involved colleagues in Mexico and Central America to aid us in making sure the nuances of the language were correct.
We also created resources to assist foster parents, alternative caregivers, and social workers supporting these children in the absence of their parents.
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We developed the concept of S.A.F.E communication to offer concrete suggestions and strategies for increasing a child's sense of safety:
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Safety: Emphasize your role in keeping the child safe
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Acceptance: Accept negative emotions
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Feelings: Put into words their feelings of anger, sadness, and confusion
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Expression: Help your child express their emotions
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Communication: Be with your child in a calm and present way
We included a worksheet with translations of common Spanish words and comforting phrases for those children staying in households with language barriers.
We partnered with the organization the Alliance for the Advancement of Infant Mental Health which distributed our materials to mental health professionals nationally.
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The feedback we received from clinicians and foster parents was incredibly positive, and it was amazing to hear how are resources were being used to support children during this terrible time in their lives. Our materials were also used by immigration attorneys and in workshops by the National Child Traumatic Stress Network.
The COVID-19 pandemic presented another clear need for mental health resources for young children and their families.
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At the beginning of the pandemic, we released Georgie and the Giant Germ, a coloring book that aims to address children's fears, worries, anger, and other big feelings related to COVID-19.
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Focused on the transition from school to quarantine, and the larger themes of sanitization and keeping each other safe.
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Even though Georgie might not understand what is happening on the same level as an adult, he is attuned to his mother's moods and knows something is wrong.
Our coloring book was translated into many different languages and distributed internationally. It was also chosen for inclusion in the National Institutes of Health (NIH) National Library of Medicine.
In 2021 we released a sequel, Georgie and the Giant Germ: A Very Different Birthday.
This story focused on pandemic fatigue and the ongoing changes in our lives due to COVID-19.
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This coloring book was also translated into multiple languages and distributed internationally.
Media Coverage & Public Dissemination of Research
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Ribaudo, J. M., Safyer, P., Stein, S. F. & Rosenblum, K. (2020). Georgie and the Giant Germ. Chosen for inclusion in the U.S. National Library of Medicine, National Institutes ofHealth, Department of Health & Human Services, Bethesda, MD.
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Good Morning Arizona (Local Television News Station in Phoenix, Arizona). “Georgie and the Giant Germ – Helping children cope with their feelings about COVID-19”. Segmentaired on May 20, 2020.
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KTAR News 92.3FM (Local Radio News Station in Phoenix, AZ). “Coloring book helps parents explain COVID-19 to their kids”. Segment aired on May 26, 2020. Retrieved from https://omny.fm/shows/ktar-reporter-audio/coloring-book-helps-parents-explain-covid-19-to-th/.
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Raising Arizona Kids (May 14, 2020). Georgie and the Giant Germ helps kids (and parents) process COVID-19 anxiety. Retrieved from https://www.raisingarizonakids.com/2020/05/georgie-and-the-giant-germ-help-kids-process-covid-19-anxiety/.
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USA Today (April 21, 2020). Staying apart, together: A cop show, bread and self-care to help you cope with the pandemic. Retrieved from https://www.usatoday.com/story/life/2020/04/21/staying-apart-together-newsletter-elementary-bread-self-care-coping-coronavirus/2999090001/.
Challenges & Lessons
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Creating resources that would be helpful in these circumstances was extremely difficult with such little information and a lack of access to the impacted population. However, this is often when support is needed the most.
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During this process I learned that "traditional" process can be a limiting factor when it comes to practical application, and a better balance between these two approaches is often needed. Learning about expert and heuristic analysis made me realize the user experience research field can offer valuable insight into intervention practices.
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These projects also made me realize how much I enjoy working with a team to generate a product. I also really loved using research to create something for a non-academic audience.
We will continue creating stories and resources for caregivers and finding unique ways to support children and families in crisis.
