=== Qnlu portal login - Search A National Louis University A Module 1: Risk and Resilience E X Case Study + + 1 of 4 https://d2l.nl.edu/content/enforced/193568-10859.202410/CaseStudyM01-TiffanyLetitia1.pdf Draw T Read aloud Ask Copilot { = 0 M1: Risk and Resilience Case Study: Tiffany and Letitia This case study focuses on the healing power and potential of relationships. In this scenario, the home visitor, Tiffany, is an infant mental health therapist. Letitia, a single mother, has an important realization that feels pivotal in her relationship with her infant daughter, Carmine. Although this scenario features a mental therapist, who is playing a different role than an early childhood educator would, there are still some important takeaways from the story. Tiffany, an infant mental health therapist who was working in an Early Head Start home- based program, met Letitia and her daughter, Carmine, when she was 4 months old. Letitia was usually ready for the weekly visits. The two adults played with Carmine and discussed Letitia's challenges in reading the infant's cues. Letitia, a single mother, also talked about the legal and other challenges she was facing in her relationship with Carmine's father and in juggling multiple responsibilities and a lack of money. Gradually, Letitia began to share about her life story and steps she was taking to heal. Two months into the visits, Carmine developed meningitis. Letitia worked hard to advocate for Carmine even though doctors missed early symptoms of the illness. In the course of staying with Carmine while she was ill, Letitia found that she was important to Carmine. Letitia realized that Carmine only stopped crying when she was there to hold her. Carmine got better, but medical staff worried about the illness' impact on the infant's skills. Letitia did not want to view a video made of Carmine. Tiffany asked her about her reluctance, and Letitia share that she had been high when the video was made. Since Tiffany was building a relationship based on trust and respect, she asked Letitia to sign a contract saying that she would not be high during the weekly visits and would reschedule if she needed to. Letitia had a childhood experience of loss that has led to relationship challenges and substance use. Tiffany thought that if she stopped working with Letitia, she would take that as a rejection of her instead of her substance use. Tiffany was concerned that additional feelings of rejection and abandonment could increase Letitia's substance use and potentially impact Carmine. Plus, Tiffany thought that Letitia was doing some important work when not in an altered state. Although Letitia's use was hurtful to her and emotionally damaging to Carmine, Tiffany did not think it was physically harming Carmine. Tiffany did express concern that Letitia's substance use was negatively impacting her interactions with Carmine. Letitia stressed + 32F Q Search Partly cloudy PRE a myhp 6:14 AM 1/15/2024 D === 2 of 4 D Qnlu portal login - Search A National Louis University A Module 1: Risk and Resilience E X Case Study https://d2l.nl.edu/content/enforced/193568-10859.202410/CaseStudyM01-TiffanyLetitia1.pdf Draw T Read aloud Ask Copilot Case Study: Tiffany and Letitia + { = that her use was not obvious to anyone and that she did it when Carmine was asleep. Tiffany talked with Letitia about generational cycles of addiction and patterns in Letitia's family. Even though Letitia was struggling with addiction, Tiffany thought that Letitia's use was a coping strategy and that new skills and working through the underlying reasons for her use would help both her and Carmine. Letitia seemed surprised that Tiffany thought her use meant that she was hurting and trying to avoid some feelings. Tiffany and Letitia explored the feelings that Letitia felt safe from when she was high. Tiffany did not reject Letitia but kept coming back and indicating that she cares about both Letitia and Carmine. Tiffany sent the message that she would not abandon Letitia as she became more vulnerable. Letitia began to trust Tiffany more and began to talk about her life-the sudden death of two boyfriends, two school friends, and several relatives, all within a year during high school. She had little support to navigate these losses and the grief she experienced. Instead, Letitia found alcohol and marijuana and used them to avoid feeling the sadness, fear, and anger she was experiencing. Before her pregnancy, Letitia had given up alcohol but was still struggling with marijuana. She was working her way through layers of defenses and was now facing the most challenging issue to overcome. Letitia recognized that she felt her brother, a year younger than her, was the prize child in the family. She remembered her brother as the one who did everything right, the one that her parents talked about as if he was most successful. Letitia described feeling alone in life and taking care of others while no one took care of her. Letitia's mother had left while she was a teenager and she wished for someone to help her navigate life's challenges. She found that her fight against addiction was actually about fear of loneliness and abandonment. Her feelings of loneliness had developed from her relationships with her parents and been confirmed by losses that she experienced. Letitia associated pain with closeness to others. Parenting Carmine and uncovering the roots of her addiction allowed Letitia to start to heal old wounds. Letitia went to live with her mother for a while, who offered her a place to live and some financial support. Conflict eventually began to occur over how to best parent. Letitia grew more confident in her ability to be a mom but also felt an impulse for her mom to take charge so she could pursue other interests like getting high. Letitia wondered if she Q Search Partly cloudy 32F PRE 0 a myhp + 6:15 AM 1/15/2024 === 3 of 4 D Case Study: Tiffany and Letitia Qnlu portal login - Search A National Louis University A Module 1: Risk and Resilience - E X Case Study X + https://d2l.nl.edu/content/enforced/193568-10859.202410/CaseStudyM01-TiffanyLetitia1.pdf Draw T Read aloud Ask Copilot { could manage alone and keep Carmine and herself safe. After much deliberation and conversations where Letitia expressed anger, she became centered and calm and dumped the marijuana in the trash. She had decided move out with Carmine. The path was not easy for Letitia. She was often present to Carmine but slipped into using again. She continued to mask her anger with using. Tiffany helped Letitia identify a help line she could call if she became overwhelmed with parenting and find ways to express her anger. Letitia held onto the hope of offering Carmine a different experience than she had lived as a child. She grieved the absence of her father in her life and of Carmine's father in hers. Tiffany and Letitia talked about how different her childhood would have been if she had someone she trusted to share her feelings with like Carmine did with her. Tiffany talked with Carmine about the fact that anger would not drive her away. After 2 years of continuing to visit Letitia, Tiffany arrived to find her angry about the death of a woman she knew who had an addiction. This woman's death had left her child alone. As Letitia was expressing her anger about this woman's choices that led to her not caring well for her child, Carmine brought Letitia her plastic box with marijuana papers and a lighter. Letitia paused suddenly and got up to put the box away. Carmine's actions affected her in a way that Tiffany's never could. The fact that Carmine could connect Tiffany's feelings of anger with the box contents forced Letitia to examine her beliefs about what Carmine was aware of. Over the course of the next few months, Letitia went back into treatment. She began to look at the strength of emotions she had been denying and ways to cope with them. Letitia was discovering she could use a safe person to help her manage emotions that felt overwhelming. She began to understand that she could control her anger instead of being controlled by it. When Carmine turned 3, the family was getting ready to transition from the home-based program. Letitia had fully embraced being Carmine's mother and her safe base. Carmine had learned to trust that her mother would be there for her. Letitia was consistently more emotionally available since she was not getting high. As Carmine moved into preschool, Letitia and Tiffany both trusted that she would be able to reference the relationship model she had with her mother that allowed her to see herself as special and competent. Carmine had a strong foundation in the skills she Partly cloudy Q Search PRE 32F = + 0 a myhp Snipping Tool Screenshot copied to clipboard and saved Select here to mark up and share the image 6:15 AM 1/15/2024 === 4 of 4 D Qnlu portal login - Search A National Louis University A Module 1: Risk and Resilience - E X Case Study X + https://d2l.nl.edu/content/enforced/193568-10859.202410/CaseStudyM01-TiffanyLetitia1.pdf Draw T Read aloud Ask Copilot Case Study: Tiffany and Letitia needed to build other relationships, communicate her needs to get help, use the help offered, and move through the emotions she would feel as she had new experiences. Letitia was building other relationships to manage her feelings about the end of her home visits with Tiffany. She had also built new relationship model that allowed Carmine to separate from her mother and become her own person. As this mother courageously opened herself face her vulnerabilities, she allowed herself to fall in love with her daughter and herself. Tiffany used reflective work and reflective supervision to understand issues that arose as she worked with this family. Others sat with her and her anxiety and guided her through her feelings the same way that Tiffany had with Letitia and Carmine. Adapted from: Ulrich, J. (2002). The healing potential and power of relationship. In D. Weatherston and Shirilla (Eds.), Case studies in infant mental health: Risk, resiliency, and relationships (pp. 27-39). Washington, DC: Zero to Three. { = Q Search a myhp Partly cloudy PRE 32F 0 + " Snipping Tool Screenshot copied to clipboard and saved Select here to mark up and share the image 6:15 AM 1/15/2024 0 a nlu portal login - Search A National Louis University A Module 1: Risk and Resilience - E X Case Study https://d2l.nl.edu/d2l/le/content/193568/Home Instructions Step 1 + & All 0 + Read the Case study with Tiffany & Letitia (PDF). This case study focuses on the healing power and potential of relationships. In this scenario, the home visitor, Tiffany, is an infant mental health therapist. Letitia, a single mother, has an important realization that feels pivotal in her relationship with her infant daughter, Carmine. Although this scenario features a mental therapist, who is playing a different role than an early childhood educator would, there are still some important takeaways from the story. Step 2 Response to this case study, including your thoughts about these questions: 1. What realization did Letitia have that felt pivotal in shifting the parent-child relationship? 2. What do you think the infant's social and emotional needs were during this time period? How did Letitia meet them? 3. What do you think Letitia's social and emotional needs were? How did they get met for her and by whom? 4. What feelings did this case bring up for you? What was it like to tolerate the risk factors presented in this case? 5. When you imagine your work with young children and parents in the future, do you have any thoughts on what your role might look like? What will be easy for you? Hard for you? 6. Are any of the diversity informed tenets (from the assigned reading handout, Diversity- Informed Tenets for Work with Infants, Children, and Families) helpful to you in considering potential responses in this case? Describe at least one in relation to the case. Q Search Partly cloudy 32F PRE a myhp + 6 6:15 AM 1/15/2024