Supporting Young Students through Pregnancy and Parenthood

Helena Mackenzie, PhD, LP, Mental Health Specialist

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

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

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

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 parenthoodSource: Gottman, J., Schwartz Gottman, J. (2007) And Baby Makes Three. Crown; New York, NY.

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

Daily Tasks

WorkSleepEat/cookHouseholdHobbiesPartnerFamilyOther

From: Bringing Baby Home Workshop, John Gottman, PhD

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 pregnancySource: 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.

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

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…

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…

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)

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

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

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

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

5 Key Elements of Adolescent and Young Adult Parenting Programs

2. 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

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.

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

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

5 Key Elements of Adolescent and Young Adult Parenting Programs

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

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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!

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

5 Elements of ALL Parenting Programs

3. 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

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

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

Group Activity

• Discuss challenges on Job Corps centers related to pregnant or parenting students

• Share current strategies Job Corps centers are using to assist young parents

• Explore future directions for supporting young parents at Job Corps

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