Everyone loves their children but not everyone understands that the way we care for the youngest among us will have an impact on our society for years to come.
With that reality in mind, a new program run by Headway Emotional Health Services, a Twin Cities-based mental health provider for families, aims to improve the parenting skills of at-risk American Indian parents by helping them learn to give their infant-to-preschool-aged children the support they need to be prepared for success later in life.
The program, known as Family Spirit, is an evidence-based curriculum developed specifically for a Native population. Headway, which already runs other early-childhood programs, wanted to respond to a growing crisis they were seeing among American Indian families in the Twin Cities, fueled in part by high rates of opioid addiction.
Headway decided to launch Family Spirit before it was fully funded because the need felt so great. They opened the program in June 2017, thanks to a $25,000 grant from the Medica Foundation. Last month, Headway was awarded an additional $12,000 from the Sheltering Arms Foundation to support the program.
Patrick Dale, Headway CEO, explained that Family Spirit was developed as an intervention home-visit program “for mothers who are at high risk for their kids developing serious issues, either to do with abuse, neglect or developmental delays that often accompany things like unstable housing, trauma and addiction.”
Erin Hansen, Headway’s supervisor of Healthy Families and Family Spirit, explained that parents enrolled in the program are parenting under stressful circumstances. “With Native people in particular, there are so many layers of historical trauma,” she said. “Currently in Hennepin County, American Indian kids are overrepresented in the child-protection system, but they are gravely underserved in preventative programming.”
Family Spirit’s focus is prevention — beginning at the earliest stages of child development. The program sends specially trained home visitors to spend intensive one-on-one time with Native parents and their young children. At each appointment, the home visitor works with parents, using a culturally focused, strength-based curriculum that promotes healthy development and positive lifestyles. Headway’s Family Spirit infant-parent support specialist is Nicole Gurneau, a community activist with extensive experience in Minneapolis’ American Indian community.
“I was nervous that the American Indian families we wanted to serve would be skeptical about a program that comes out of a mostly white, suburban agency,” Hansen said. “But our awesome home visitor is Native herself. She’s amazing. She has personal connections in the Minneapolis Native community and she had prior work experience at the Native American Community Clinic in Minneapolis.” Gurneau, who has a bachelor’s degree in psychology, is in the process of completing a master’s degree in co-occurring substance use and mental health disorders, Hansen added: “She is the full package. She is super-personable. She knows how to reach out to families and gain their trust.”
Teaching parents to parent
Caring for young children seems like it should be instinctual, but good parenting is a skill that needs to be passed on or taught. People who are exposed to extreme poverty or trauma in their own childhoods often are more focused on survival than they are on improving their parenting skills.
There have been multiple research studies that have found that the way children are cared for in their earliest years has a big impact on their future success in school and life, Dale said.
“When parents sing, talk, or read to their young children, those children’s scores in kindergarten through high school are remarkably better than those of kids whose parents do not do those things for them when they are young. The parents we work with in this program did not necessarily have those things done for them when they were babies. And because of that they did not know that they should be doing those kinds of things for their own kids.”
In her visits, Gurneau works with parents to teach them these skills. The Family Spirit program, which was developed in the mid-1990s at Johns Hopkins University in partnership with Navajo, White Mountain Apache, and San Carlos Apache Tribes, is operated much like the post-natal home visits commonly offered by county agencies, where a public health nurse visits a new mother and her child in the first few days after leaving the hospital. The difference with Family Spirit is that the program was designed for, by and with American Indian families, focusing on issues, attitudes and needs unique to their communities. Family Spirit visits are weekly at first, and then transition to biweekly over an extended period of time.
“The ultimate goal of the program is to provide two outcomes,” Dale said. “One is that the child is prepared and ready for kindergarten, preschool or early-childhood school. We want to make sure that children are developmentally ready to participate appropriately in a formal educational setting. The second goal is to give parents skills that help them raise their kids, skills like reading to them, interacting with them, taking pictures of them, monitoring their health. It is about creating and encouraging a high level of interconnection between child and parent, which tends to not be strong in families where the mom and/or dad were raised in environments that were unstable or lacking support.”
In Minnesota, tribes operate Family Spirit programs on reservations, but Headway’s program is the first in the Twin Cities. “The program is operating nationwide in different states,” Hansen said. “We are the first nontribal entity, the first nonprofit social-service provider, to run this programming in the state.”
So far, Family Spirit has proven popular with Native families.
“We have very high engagement and retention rates with this program so far,” Hansen said. When the program was launched in June, parents quickly began to sign up: “Nicole already has 12 families that receive weekly home visits. That is a full caseload. Once these first families transition to every-other-week visits, her caseload will double in size to about 20 to 25 families.”
How Family Spirit works
At home visits, Gurneau observes not only the children and their development, but also the parents’ emotional and physical well-being.
“We do substance-use screens, depression screens, domestic violence screens,” Hansen said. “We track all those things. The Family Spirit model itself is helpful overall to support families in being healthy and to support parent-child attachment.”
Most Family Spirit participants are mothers, but fathers are also welcome to participate, Hansen said. Opioid addiction, and the chaos that often accompanies it, has put many Native mothers at risk of losing custody of their children, Hansen said. One dad is already on Gurneau’s home visit roster.
“I’ve been hearing that more dads are the primary parents now since the opioid epidemic has affected Native moms so hard,” she said.
Many of the participants have been referred to Family Spirit by Kateri Residence, a soon-to-be-shuttered Minneapolis halfway house for Native women recovering from addiction operated by St. Stephen’s Human Services.
“Some of the moms we are working with have custody of their children, some are working to gain it back,” Hansen said. “Some of the kids are transitioning out of foster care and back home with their moms. We are supporting that process to make it as smooth as possible. Family preservation is our goal. If it is possible for the family to stay together, we are there to support that.”
One way that the Family Spirit program works to keep Native families together is by helping parents understand how their own family histories impact the life choices they make and they way they raise their own children.
“In Family Spirit, the home visitor talks with parents about the things they remember about their own upbringing that they would like to retain and the things they would not like to repeat,” Dale said. “There is a strong sense of bonding between the home visitor and the parent or parents around being in this together.”
It is too early to see if Headway’s Family Spirit program has made a significant difference in the lives of the parents and children it serves, but so far families seem to be responding well to Gurneau’s interventions, Hansen said. The program’s ultimate goal is to improve parenting practices, and to explain the important long-term impacts those changes carry. For many of the Family Spirit parents, this means a significant shift in their worldview.
Dale can only hope that the parenting changes that the program encourages will stick in a community that has been historically underserved.
“You have to give a lot of credit to the parents in this program,” he said. “If you never got those kinds of things when you were a young child, it would be hard to understand why it is so important to give them to your own kids. But they’re trying, and many are succeeding. This program, thanks to Nicole’s hard work and passion, is starting to make a real difference for families in the community.”